This unit applies to activities associated with conducting medical grade footwear assessments for clients with footwear-related medical conditions. Foot conditions include those of medium complexity and risk. Medium complexity and risk foot conditions may include situations where:

the client is suffering foot-related pain or discomfort

ulceration is not present

there is only a single risk factor

Risk factors may include age; systemic problems such as diabetes (insulin dependent), haemophilia, peripheral vascular disease, neuropathy; ulcers; missing toes; lower limb amputations.

Work is generally conducted in a small business situation and the work role may include:

sole practitioner

member of a team of medical grade footwear specialists

member of an enterprise or regional health care team or working in association with other allied health professionals

Certain diagnostic and investigative procedures that need to be undertaken by medical professionals (such as general practitioners, specialist medical practitioners and surgeons and radiologists) and allied health professionals (such as podiatrists, physiotherapists, community health nurses) in order to provide additional information on which a full and accurate assessment can be made.

This unit is applied according to OHS and workplace practices of the enterprise, which may include:

requirements prescribed by legislation, awards, agreements and conditions of employment

standard operating procedures

work instructions

oral, written and visual communication

quality practices, including responsibility for maintenance of own work quality and contribution to quality improvement of team or section output

housekeeping

tasks related to environmental protection, waste disposal, pollution control and recycling

This unit requires the application of skills associated with communication to provide information to clients about services and products and discuss client's current conditions and assessment needs. Communication skills are also required to interpret health related information and measurements and to liaise with other professionals. Teamwork skills are required to work as part of a team of health professionals, including making and receiving referrals.

Planning and organising, problem solving and initiative and enterprise are required to undertake assessment techniques and determine treatment requirements in a manner that respects the client needs and expectations. An ability to use assessment technology is required. Self management and learning skills are also required to monitor impact of assessment activity on client comfort and to ensure currency of skill and knowledge in making assessment decisions. Learning is also applied when other health care or service providers are consulted for information, advice, and assistance with treatment.

Prerequisites

ELEMENT

PERFORMANCE CRITERIA

1 Provide potential client with information about services and products

1.1 Services and products provided are outlined and general estimates of costs of services and products are provided

1.2 Possible subsidised funding options for services and products are presented to client

1.3 Client is provided with estimate of time required to conduct assessment and the general procedures associated with the assessment

1.4 Client is advised on general and medical documentation and footwear and orthoses required for assessment

1.5 Suitable appointment time and location for assessment are negotiated and confirmed

1.6 Client's current walking condition and need for assistance in attending assessment are discussed

2 Interpret prescription or referral information

2.1 Prescriptions and referrals are reviewed to determine action to be taken

2.2 Health and medical professionals or agencies are contacted to clarify issues or to obtain further information

3 Obtain pertinent personal and medical information from client

3.1 General health status and personal information are obtained to establish client profile

3.2 Detailed information is obtained regarding client medical history and present health status and condition

3.3 Information is recorded accurately and completely to assist in determining possible plans of action

4 Observe general physical and emotional state of client and implement supportive actions

4.1 Degree of mobility and level of assistance and support required by client are noted

4.2 Client discomfort is minimised by providing walking aids or transport devices, as required

4.3 A friendly and empathic communication style is used to reassure client and reduce anxiety or stress

4.4 Other physical characteristics of client are noted that may have an affect on future plans of action

4.5 The assessment environment complies with professional and accepted community standards for client comfort and privacy

4.6 Other suitably qualified professionals are consulted with, if necessary to discuss concerns or issues arising from client's physical or emotional state

5 Identify client's needs and expectations

5.1 Client lifestyle and work needs are identified

5.2 Client personal short- and long-term goals are identified

5.3 Client expectations related to services and products to be provided are discussed and agreement reached between client and service provider

5.4 Client questions about short- and long-term improvement in condition are answered honestly and frankly

5.5 Clients' general suitability for service and products are determined and options discussed with client and medical and health professionals, as required

6 Conduct physical assessment of foot and lower limb

6.1 Physical examination of foot and lower limb is carried out and prescription and referral information compared with findings, if appropriate

6.2 Presence and extent of medical conditions of foot and lower limb are identified, including any skin conditions that may affect the provision of any medical grade footwear and orthoses

6.3 Range of motion of foot and lower limb, function of muscles and joints, status of joints, and other factors and abnormalities, which affect the functioning of the foot, are assessed against established norms

6.4 Information is recorded accurately and completely

7 Carry out measurements on foot, footwear and orthoses

7.1 Appropriate measurement techniques are selected based on clients presenting medical problem and OHS practices

7.2 Direct and representation measurements are taken related to shape and size of foot

7.3 Gait analysis is performed to obtain baseline data of client's walk pattern and comparison to average healthy parameters

7.4 Supplementary measurement techniques are used to confirm primary findings or to provide additional data

7.5 Trial fit is conducted using commercial or client footwear

7.6 Footwear and orthoses are examined and measurements taken, as necessary

7.7 Measurements are recorded within prescribed levels of accuracy

7.8 Data derived from measurements is analysed and results recorded in client file using established procedures

8 Work collaboratively with other health professionals

8.1 Roles and functions of other service providers are recognised, acknowledged within accepted ethical standards

8.2 Health care professionals and other service providers are consulted, as appropriate, and in accordance with relevant legislation, for information, advice, assistance or cooperation

8.3 Clients are fully advised as to indications and reasons for referral

8.4 Client consent to release relevant information to other professionals or service providers is documented

8.5 Client information is provided to other health professionals or service providers, in accordance with medico-legal requirements and ethics related to confidentiality

8.6 Outcome of referral process is communicated to initiating practitioner and service provider, verbally or in writing

9 Develop a management plan and seek approval of client and other parties to implement plan

9.1 All information provided by client, health professionals or agencies and measurements are analysed and prioritised to provide the basis for the plan of action

9.2 A plan of action is formulated and options are presented to the client, in consultation with carers, health professionals or agencies, where necessary

9.3 Client is allocated sufficient time to consult with other parties to make an informed decision about proposed plan of action

9.4 Specifications are developed that reflect the client needs, current medical condition and feasibility to produce footwear or orthoses

9.5 Agreement is reached with client, and other parties if necessary, regarding costs, timelines and payment schedules to implement plan of action

9.6 Prior to commencement of any stage of the plan of action, client is provided with a briefing to ensure complete understanding of processes, procedures and expected outcomes

This describes the essential skills and knowledge and their level, required for this unit.

Demonstrates knowledge of:

problem-solving approach to carry out assessments of clients with foot-related medical conditions based on an appropriate level of anatomy, physiology knowledge

client medical condition classification system for determining medical grade footwear and orthotic options: (common medical conditions include orthopaedic, vascular, neurological, degenerative)

principles of biomechanics and kinesiology that directly influence the design and development of medical grade footwear and orthoses

foot bones, including names, locations and functions

foot and leg muscle groups and how they work and the effect of paralysis on muscle groups

types of common skin injuries and the indications that, if present, require referral to another health professional

healthy and abnormal gait patterns, the consequences of abnormal gait, including basic knowledge of lower back problems

common surgical and physiotherapy procedures and their consequences for the provision of medical grade footwear and orthoses

measurement techniques, including direct measurements - rulers and tape measures; representation - footprints (tracing ink pressure, draw in landmarks), casts (plaster impression, foam), foot tracing (90, 60 and 45 degrees); indirect scale - footwear scales (Brannock devices)

shoe fittings (commercial and own); extra non-footwear measures - pressures (pressure footprints)

measurement techniques such as scanners, computerised and video gait pattern analysers and other new technologies

principles of medical grade footwear design and how they can be used to meet individual client requirements

general and medical grade footwear construction techniques, materials and tools and equipment used

Australian Standards or industry standards used in the construction of footwear

follow-up and ongoing review process

practitioner and client relationship and factors that can affect this relationship

services provided by medical and allied health professionals

available prefabricated footwear

safety and environmental aspects of enterprise production processes

operation of State and federal government departments (eg Department of Veterans' Affairs) and State health agencies relevant to medical grade footwear operations

health insurance funds and reimbursement or supplementary paying schemes, including Aids and Appliances Program, Department of Veterans' Affairs, workers' compensation, Brotherhood of St Laurence

health insurance and funding

industry and workplace codes of practice

multi and cross-disciplinary principles and practices

relevant codes of practice and regulations governing other practitioners, allied health professionals and service providers

roles, capabilities and limitations of appropriate medical and allied health professionals, other practitioners, community resources and services

range of services capable of being supplied by other professionals and service providers

personal, professional and medico-legal accountability

maintenance of client and colleague confidentiality

team and group leadership and group dynamics

community expectations of practitioners

documentation requirements

conflict resolution techniques

individual attributes and differences affecting the practitioner and client relationship, regulatory requirements, copyright obligations and codes of practice

OHS practices, including hazard identification and control measures

quality practices

workplace practices

recording and reporting practices

Demonstrates skills to:

adhere to prescribed professional reporting processes

establish and maintaining effective working relationships with associates and other professionals

work as a member of a multi- or cross-disciplinary team

acknowledge limits of knowledge and skill and referring clients to other professionals when necessary

document information for referral to, or review by, industry associates and other professionals

objectively evaluate services and products of industry associates and other professionals

use appropriate communication skills to collect information from clients and provide advice and information that are commensurate with the client's language and cognitive abilities

use consultative skills for eliciting information from medical and allied health professionals

examine foot and lower limb and taking measurements using appropriate techniques

record and document all consultative, client and measurement data

use problem-solving and decision making skills to formulate plans of action and provide options for a variety of footwear problems

read, interpret and follow information on work specifications, standard operating procedures and work instructions and other reference material

maintain accurate records

communicate within the workplace

sequence operations

meet specifications

clarify and check task-related information

carry out work according to OHS practices

The Evidence Guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for the Training Package.

Critical aspects for assessment and evidence required to demonstrate competency in this unit

Demonstrates skills and knowledge to:

communicate with clients and carers in a manner consistent with the client level of understanding of processes and procedures

liaise and consult with medical and allied health professionals

conduct physical examinations of the foot and lower limbs and obtain measurements

perform gait analysis, including:

comparison to average healthy parameters

identification of common problems and consequences

influence of medical grade footwear on gait

basic knowledge of relationship of gait to lower back anatomy

other health professional is identified

record and document measurements and other test results

use problem-solving approach to make decisions related to medical grade footwear or orthoses options

develop a plan of action and management plan

comply with the principles and standards of 'duty of care'

observe ethical standards of client confidentiality

follow up and review client's progress

perform administrative tasks associated with maintaining client records, financial record keeping and filing and storing client's foot tracings, impressions or casts

establish and maintain effective working relationships with clients and colleagues

identify limitation of own knowledge and skills and make referral to more appropriate service providers as required

clear, accurate and relevant communication, written and verbal, which meets professional and ethical standards

achieve multi-disciplinary collaboration and input when necessary

recognise primary accountability and responsibility for client

apply OHS policies in work operations

maintain accurate records

Consistently applies skills and knowledge when:

organising work

completing tasks

identifying improvements

using workplace practices

using OHS practices

recording and reporting accidents and incidents

assessing operational readiness of equipment used and work processes

recognising and adapting to cultural differences in the workplace, including modes of behaviour and interactions

completing work systematically with attention to detail without damage to goods and equipment

Context and specific resources for assessment

Assessment may occur on the job or in an appropriately simulated environment and requires access to work areas, materials and equipment and to information on workplace practices and OHS practices.

Guidance information for assessment

This unit may be assessed independently or in combination with other relevant units.

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the Performance Criteria, is detailed below. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs if the candidate, accessibility of the item, and local industry and regional contexts.

Legislative/regulatory requirements

All work must comply with relevant Federal and State or Territory legislative or regulatory requirements.

Client may include

referred for assessment by medical or health care professionals

making direct contact

Assessment may include:

initial meeting of client and practitioner, ongoing during development of medical grade footwear and orthoses, and as part of follow-up or regular client review

Need for assistance in attending assessment may include:

language interpreters or other facilitators experienced in sign language or the use of communication devices used by physically or intellectually impaired people

walking aids or transport devices such as walking sticks, frames or wheelchairs

Assessment environment may include:

on-site at workplace

in a hospital or community health care centre

at a residential aged care or disability facility

at client or carer home

Qualified professionals are consulted with:

to verified and confirm the level and status of foot-related medical condition to be treated

OHS practices

OHS practices must include hazard identification and control, risk assessment and implementation of risk reduction measures specific to the tasks described by this unit, and may include:

manual handling techniques

standard operating procedures

personal protective equipment

safe materials handling

taking of rest breaks

ergonomic arrangement of workplaces

following marked walkways

safe storage of equipment

housekeeping

reporting accidents and incidents

other OHS practices relevant to the job and enterprise

Sector

Medical Grade Footwear

This unit contains employability skills.