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The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts. |
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Cultural respect | This competency standard supports the recognition, protection and continued advancement of the inherent rights, cultures and traditions of Aboriginal and Torres Strait Islander peoplesIt recognises that the improvement of the health status of Aboriginal and Torres Strait Islander people must include attention to physical, spiritual, cultural, emotional and social well being, community capacity and governanceIts application must be culturally sensitive and supportive of traditional healing and health, knowledge and practices |
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Community control | Community participation and control in decision-making is essential to all aspects of health work, and the role of the health worker is to support the community in this process |
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Supervision | Supervision must be conducted in accordance with prevailing state/territory and organisation legislative and regulatory requirementsReferences to supervision may include either direct or indirect supervision of work by more experienced workers, supervisors, managers or other health professionalsA person at this level should only be required to make decisions about clients within the organisation's standard treatment protocols and associated guidelines |
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Legislative requirements | Federal, state or territory legislation may impact on workers' practices and responsibilities. Implementation of the competency standards should reflect the legislative framework in which a health worker operates. It is recognised that this may sometimes reduce the application of the Range of Variables in practice. However, assessment in the workplace or through simulation should address all essential skills and knowledge across the Range of VariablesAboriginal and/or Torres Strait Islander Health Workers may be required to operate in situations that do not constitute "usual practice" due to lack of resources, remote locations and community needs. As a result, they may need to possess more competencies than described by "usual practice circumstances"Under all circumstances, the employer must enable the worker to function within the prevailing legislative framework |
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An accurate history includes: | History of the presenting problem (character, severity and duration of symptoms)Client concerns and beliefs regarding their problemsPast medical history, including use of alcohol, tobacco and other substancesMedicines being takenAllergiesFamily and community circumstances, including identifying environmental health factors that may contribute to client's health problemsBasic dietary information, including diet history to determine food and drink intake |
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Related health care providers may include: | Personnel internal to the service providerExternal health care providersOther service providers |
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Client information may include: | Significant ongoing health problemsCurrent medicationsClinical progress notes relevant to the presenting problemRecord of allergiesFamily historyMedical and surgical history, including but not limited to:painrespiratory symptomsurinary symptoms or abdominal symptomsdiseases such as diabetes, rheumatic fever or valvular heart diseaseimmunisation statussurgical historyuse of alcohol and other drugsoral health care historyDocuments such as: client file/notesreports/results from referral, allied professionals and specialists (including x-ray, pathology tests) |
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Standing orders/written care protocols include: | Written guidelines or orders that support the clinical assessment and management of presenting health problems (eg. CARPA) |
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Medical equipment includes, but is not limited to: | SteriliserAuroscopeHaemoglobinometerEye chartsTape measureSphygmomanometerStethoscopeOphthalmoscopeGlucometerScalesThermometers (relevant types)Urinalysis stripsPeak expiratory flow rate metersBlood glucose testing unitsSurgical instrumentsCentrifugePlaster cutterNebulisersResuscitation equipment (including oxygen equipment) |
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Vital signs include: | TemperaturePulseBlood pressureRespiratory rate |
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Non-clinical factors responsible for abnormal readings may include: | Failure to properly shake down a mercury thermometerEffect of ingestion of hot or cold beverage on oral temperature measurementDifferences in temperature measurements taken at sites (ie. oral, axillary, ear)Effect of exertion and anxiety on pulse rate and blood pressureImpact of cuff size on the accurate measurement of blood pressureFaulty equipmentFailure to correctly calibrate equipmentImpact of environmental factors on equipment |
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Health assessments may include: | Routine health assessments for clients with chronic diseaseWell-person's health checkAssessment of client with presenting physical problems |
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Routine health assessments may be initiated for: | Clients with identified chronic disease, such as:diabeteschronic renal impairmentheart diseasejoint diseasehypertensionasthmaWell-person's health check, appropriate to: agesexethnicityregional disease prevalence |
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Observation of client includes: | Physical appearanceBody language and speechGeneral appearance (the 'unwell child') |
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Clinical tests may be initiated in response to: | Standard protocols for routine health checksResults of other tests and/or observationsRequest from client, another practitioner or specialist |
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Examination/testing of client includes:
| Assessment for signs and symptoms of serious underlying causes of fever, including:general appearance (the 'unwell child')history of pain, respiratory symptoms, urinary symptoms or abdominal symptomshistory of diabetes, rheumatic fever or valvular heart diseaserespiratory rate and pulse rateurinalysisexamination of skin for infectionexamination of ears and throatUrine specimen collection using multi-reagent sticks and including:mid-stream urine collectionfirst pass urine collectionpaediatric bag collectionUse of capillary and venous blood glucose levels (BGL) [also referred to as blood sugar levels (BSL)] in diagnosis and monitoring control of clients with diabetesExamination of extremities, including:feet of people with diabetes are examined for protective sensation, ulcers, calluses, infections, nail condition and peripheral circulationextremities of clients with Hansen's disease are examined for ulceration and infectionPeripheral circulation problemsAssessment of infant and child growth, including:measure, document and plot weight and heightcompare growth with major developmental milestones and identify potential delayed growthidentify possible causes of delayed growthIdentify symptoms of pregnancy and calculate expected date of delivery.Identify:abnormal post-natal conditionscommon or serious neonatal conditionscontinued ... |
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Examination/testing of client includes: (continued) | Test:blood pressureblood glucose levelhaemoglobin levelurinalysisMeasure (monitor):height, weight and head circumference using correct equipmentExamine/assess:external eye and eyelidearskin (for infection and other significant variations) peak flow rateSimple abdominal examination: locate tendernesssimple tests for peritoneal inflammationpresence of abdominal massesSimple peripheral nerve examinations, including: testing extremities (hands, feet) for light touch and sharp sensationvisible wasting of hand musclesgrip strength and finger abductionBasic oral health assessment, including: visual inspection of oral cavity, teeth and gums palpation of gums and jaw-line for tendernessidentification of common dental variations from normalClinical assessment of eye problems, including: lid eversionidentification of the signs and symptoms of trachoma (in children and adults), using the WHO simplified trachoma grading systemretinal photographyuse of fluorescein stainingVisual acuity testing, including: Snellen or Bailey-Lovie chartE-chartcounting fingerslight perceptioncontinued ... |
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Examination/testing of client includes: (continued) | Respiratory assessments, including: measurement of adult, child and infant respiratory rateschest auscultation, measurement of peak expiratory flow rate (adult, child)recognition of signs of respiratory distress; spirometry; oximetryEar examinations, including: use of otoscope to identify abnormal appearance of tympanic membrane and/or ear canalaudiometrytympanometryExamination of extremities for: protective sensationulcerscallusesinfectionsnail conditionperipheral circulationEspecially hands and feet of people with chronic conditions (eg. diabetes or Hansens' disease)Screen for: diabetesproteinuriaurinary tract infectionhypertension |
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Specimen collection includes: | Urine (mid-stream, first pass urine and paediatric bag collection)BloodSputumFaecesSwabs for culture and sensitivity and for pcr testing from wounds, skin and bodily orifices where appropriate (e.g. throat, ear and nasal swabs) Tissue samples (for example skin scrapings for fungal infections) |
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Correct procedures for collection and handling of human pathology samples include: | Correct use of both sealed vacuum system and needle and syringeObservance of universal precautions in collection and handling of specimens for pathology testingUse of appropriate sample/specimen containersAccurate labelling in line with organisation policies and proceduresCorrect packaging, storage and transportation, in accordance with legislative and regulatory requirements for specific samples/specimensCorrect disposal of waste (including sharps) |
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Presence of health signs and symptoms to be identified and described include: | Common respiratory problems, including:nasal discharge sore throat coughbreathlessness haemoptysis (blood in sputum) Genitourinary conditions, including:dysuria (urinary tract infection [UTI], sexually transmitted infection [STI])urinary frequency (UTI, prostatism, diabetes)haematuria (UTI, kidney trauma, urinary stones, tumour)symptoms of sexual assaultGastro-intestinal and abdominal conditions, including:indigestion and heartburn diarrhoea and/or vomiting constipationacute abdominal pain Signs of trauma, such as burns, assaultCommon ear health conditions, including:ear ache discharging ear deafness foreign bodies or impacted wax in the ear canalvertigobleeding from the ear continued ... |
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Presence of health signs and symptoms to be identified and described include: (continued) | Common types of skin conditions, including:impetigocellulitisboilsscabiesfungal infectionsCommon dental problems, including:tooth decay or abscess bleeding gums poor dental hygiene (dental plaque, halitosis, gum recession)inability to chew food (toothache, malocclusion, tooth loss)jaw problemCommon eye problems, including:red eyes (conjunctivitis, injury)discharging eyes (conjunctivitis)itchy eyes (allergic conjunctivitis)squint, cross eye, misalignmentpain on blinking rapid visual deterioration gradual visual deterioration Peripheral circulation problems |
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Clinical features suggesting potentially serious health problems include: | The 'unwell child'Features suggesting dehydrationChest pain, productive cough, haemoptysis, breathlessness or fast breathingPelvic pain, pain passing urine or blood in the urineAbdominal tenderness or unexplained abdominal painFever among high risk persons (infants, elderly and clients with chronic disease, valvular heart disease or past rheumatic fever)Fever with features that might indicate serious infection (eg. abdominal pain, urinary symptoms, headache, productive cough, skin infection)Wounds or sores that are deep, extensive, on the face or on the extremities of clients with diabetes Unexplained weight lossHeavy vaginal bleedingBleeding or pain in pregnancyRash with fever as sign of meningitis or measles.Joint pain (possibly moving from limb to limb) and/or swollen face and/or heart murmur and fever (or recent history of fever) as a sign of rheumatic heart feverHeadache, pain, fever, photophobia and/or neck stiffness as sign of meningitis or encephalitisRash, high pitched cry, fever, skin discolouration as signs of meningococcal disease |
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Potentially serious or complicated health conditions include | Serious infections (pneumonia, blood poisoning, meningitis, endocarditis, kidney infection)Cancers (lung, bowel, throat, breast, leukaemia)Heart disease (heart attack, angina and heart failure) Asthma and chronic obstructive lung diseaseSexually transmitted infections (gonorrhoea, chlamydia, syphilis, HIV/AIDS, warts, genital herpes, pubic lice)Pregnancy complications (miscarriage, ectopic pregnancy, placental abruption)Surgical causes of abdominal pain (appendicitis, pancreatitis, biliary colic, renal stones)Stroke, spinal cord injury, intra-cerebral bleeding |
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Information to promote and maintain good health may include: | Summary of test results and readingsInformation on links between heart disease and smoking, diet and physical activityInformation on management of uncomplicated gastrointestinal conditions, such as:constipation (ie. eat more fibre, drink more water, appropriate use of laxatives)gastroenteritis (ie. maintain fluid intake, eat according to appetite, continue breast-feeding, handwashing and infection control)indigestion and heartburn (eg. trial of antacids, avoid late meals, identify other aggravating factors - alcohol, aspirin, anti-inflammatory medicines, smoking)food handling and storageInformation on causes of health problems, such as:ear problems (ie. infection and relationship to poverty and crowding; traumatic and noise-induced deafness)skin infections (ie. crowding; poor access to water; high levels of scabies infestation)Information on strategies to manage health problems, such as diabetes, including:physical activity, healthy diet (low fat, low sugar, high fibre carbohydrates, high vegetables and fruits), weight loss and foot care (eg. appropriate footwear, regular foot self-care, ongoing review)use of medicinesimportance of regular health checksInformation on dental health, including:link between dental health and diet (ie. consumption of simple sugars and developing dental caries; specific risks such as lolly-pops and baby bottle with sweet drinks or cow's milk; suckling on breast all night)chart showing oral assessment findings and teeth developmentgood dental hygiene practices (regular brushing and use of dental floss)importance of regular dental checks, especially for clients with rheumatic heart disease |
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Signs of respiratory distress include: | Raised respiratory rateRaised pulse rateIncreased respiratory effort (use of accessory muscles, inspiratory in-drawing of soft tissues)Inability to speak through breathlessnessAnxiety |
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Presentations of common sexually transmitted infections include: | Male urethral discharge and/or dysuriaVaginal dischargeFemale pelvic painUlcerative genital diseaseGenital lumps |
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Reasons for testing urine include: | Screening for urine infectionScreening for kidney diseaseAssessment of possible renal traumaAnte-natal care |
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