HLTRNL002 Provide care and support to a person undergoing renal replacement therapy

Release: 1

HLTRNL002 Provide care and support to a person undergoing renal replacement therapy

Modification History

Release	Comments
Release 1	This version was released in CHC Community Services Training Package release 3.0 and meets the requirements of the 2012 Standards for Training Packages. Merged with HLTRNL602C/HLTRNL603C/HLTRNL604C. Removed pre-requisites. Significant changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency requirements. Significant change to knowledge evidence.

Application

This unit describes the skills and knowledge required to provide care and support to a person in a health or community setting undergoing renal replacement therapy including peritoneal dialysis and haemodialysis.

This unit applies to enrolled nursing work carried out in consultation and collaboration with registered nurse, and under supervisory arrangements aligned to the Nursing and Midwifery Board of Australia regulatory authority legislative requirements; and to Aboriginal and/or Torres Strait Islander health work carried out under direct or indirect supervisory arrangements of a registered nurse or medical practitioner.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

Elements and Performance Criteria

ELEMENT	PERFORMANCE CRITERIA
Elements define the essential outcomes	Performance criteria describe the performance needed to demonstrate achievement of the element.
1. Establish therapeutic relationship with the person to support self-management of renal replacement therapy	1.1 Perform an assessment of the person to establish their cognitive ability to support self-management of renal replacement therapy 1.2 Provide the person, family or carer with the opportunity to ask questions and discuss areas of concern 1.3 Ask the person questions clearly in an appropriate manner, level and pace, and in a way that encourages the person to provide full answers 1.4 Assist and empower the person to self-manage their renal replacement therapy, and provide feedback and education as required 1.5 Recognise and respond appropriately within scope of work role to identified actual and potential problems of the person’s proposed renal replacement therapy, and report outcomes to interdisciplinary health care team 1.6 Incorporate referral to community services into advance care planning strategies in consultation and collaboration with interdisciplinary health care team
2. Assess physical health status of a person undergoing dialysis	2.1 Perform a pre-dialysis assessment of the person and report outcomes to interdisciplinary health care team in accordance with scope of work role and organisation policies and procedures 2.2 Examine the person’s vascular access for haemodialysis or catheter and exit site for peritoneal dialysis to identify actual and potential problems 2.3 Obtain specimen swab from the person’s vascular access site or catheter site if necessary, according to organisation policies and procedures, and send specimen for microbiological analysis 2.4 Identify any significant physical health issues for the person in relation to dialysis prescription and any requirement for adjustments, and report to other members of the interdisciplinary health care team 2.5 Recognise and refer actual and potential problems related to variations from the person’s normal health status to interdisciplinary health care team
3. Assist the person in self-care management of peritoneal dialysis treatment	3.1 Review the person’s understanding of the procedure in accordance with legal requirements and organisation policies and procedures 3.2 Assess the person’s self-care strategies 3.3 Appraise the person’s technique for dressing exit site and provide effective education as required 3.4 Assist the person as necessary with their peritoneal dialysis exchange technique in accordance with organisation policies and procedures and infection control guidelines 3.5 Monitor the person during treatment within scope of work role and within organisation policies and procedures 3.7 Recognise and respond appropriately to actual and potential problems of peritoneal dialysis treatment 3.8 Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis 3.9 Assess the person’s response to treatment, and document and report outcomes to interdisciplinary health care team 3.10 Assist the person to self-manage peritoneal dialysis consumables using waste minimisation and sustainable practice
4. Perform peritoneal dialysis exchange for the person unable to undertake procedure	4.1 Examine the peritoneal dialysis catheter exit site and perform exit site dressing as required 4.2 Prepare peritoneal dialysis additives for dialysis bag in line with delegation, and consider and identify causes of peritoneal fluid failure to drain 4.3 Perform peritoneal exchange according to prescribed treatment order, organisation policy and procedures 4.4 Monitor person during treatment within scope of work role and within organisation policy and procedures and refer to interdisciplinary health care team 4.5 Identify clinical features suggestive of dialysis-related peritonitis and promptly refer a person to interdisciplinary health care team 4.6 Assess the person’s response to dialysis additives and treatment as administered within scope of work role 4.7 Recognise acute and delayed adverse reactions to dialysis additives and respond within scope of work role 4.8 Obtain an effluent specimen if necessary, according to organisation policy and procedures, and send specimen for microbiological analysis 4.9 Document and report treatment outcomes to interdisciplinary health care team
5. Prepare equipment and the person for haemodialysis treatment	5.1 Explain procedure and prepare the person for treatment and make comfortable 5.2 Prepare machine according to organisation policy and procedures 5.3 Determine dialysis settings according to the person’s dialysis prescription within scope of work role and organisation policies and procedures 5.4 Prepare other interventions, including medications, under the direct supervision of, and as delegated by interdisciplinary health care team within scope of work role and organisation policies and procedures 5.5 Prepare consumables for cannulation of the person and connection to machine 5.6 Wash hands and use personal protective equipment in accordance with infection prevention and control guidelines 5.7 Prepare the person’s access for cannulation according to organisation policies and procedures 5.8 Identify appropriate site for cannulation, and check for signs suggesting fistula stenosis or infection and consult with interdisciplinary health care team. 5.9 Perform cannulation according to organisation policies and procedures
6. Perform haemodialysis	6.1 Connect the person to haemodialysis machine according to organisation policies and procedures and infection control guidelines 6.2 Monitor the person and refer variations in health status to the interdisciplinary health care team according to organisation policies and procedures 6.3 Recognise and respond appropriately to machine alarms and actual and potential problems of haemodialysis 6.4 Assess the person’s response to treatment and other interventions as administered within scope of work role and consult with interdisciplinary health care team 6.5 Recognise acute and delayed adverse reactions to other interventions and respond within scope of work role 6.7 Disconnect the person from haemodialysis machine in accordance with organisation policy and procedures 6.8 Clean and dry and store equipment in accordance with infection control and manufacturers’ instructions 6.9 Examine vascular access site to identify any actual or potential problems and refer to interdisciplinary health care team
7. Evaluate health status of the person at completion of dialysis	7.1 Complete the post-dialysis assessment of the person and document and report outcomes 7.2 Evaluate the person’s response to treatment and report to interdisciplinary health care team as required within scope of work role and organisation policy and procedures 7.3 Provide feedback to the person on physical health assessment in order to maintain optimal health status 7.4 Identify opportunities to encourage the person to voice concerns, and respond appropriately

Foundation Skills

The Foundation Skills describe those required skills (language, literacy, numeracy and employment skills) that are essential to performance.

Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.

Unit Mapping Information

No equivalent unit.

Links

Companion Volume implementation guides are found in VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=ced1390f-48d9-4ab0-bd50-b015e5485705