Unit rationale, description and aim
It is a requirement that the paramedic can link theory with practice and perform clinical duties underpinned by a theoretical understanding. To perform these skills well, the paramedic must be able to reflect critically on their practice and appraise their performance. The unit is complimented by the practical content in PARA227: Paramedic Care in Practice: Medical 2. This unit focuses on theoretical aspects of recognition, assessment and management of persons presenting with cardiac, neurological, renal, gastrointestinal and endocrine conditions in dynamic environments. Additionally, it provides opportunities for students to integrate theoretical and practical knowledge in both face to face and digital forums. Foundational concepts such as critical thinking, clinical reasoning and clinical judgement will be developed, and practice skills will be extended through scenario-based learning in the concurrent unit PARA227.
The aim of this unit is to assist students to use theory to drive their clinical practice and to understand how clinical decision making is guided by a continual process of assessment, diagnosis, planning, implementation and evaluation within a clinical decision making framework which is integral in the delivery of paramedic practice
Learning outcomes
To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.
Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.
Explore the graduate capabilities.
Outline the epidemiology, pathophysiology, implica...
Learning Outcome 01
Critique medical presentations and the associated ...
Learning Outcome 02
Apply a paramedic decision making framework underp...
Learning Outcome 03
Content
Topics will include:
- Advanced cardiology
- Neurological
- Renal
- Hepatic
- Endocrine
- Electrolyte disturbances
- Applied toxicology
For the selected aetiologies, students will develop their understanding of relevant concepts and skills relating to:
- Epidemiology;
- Biopsychosocial considerations;
- Clinical reasoning;
- Pathophysiology and presentations;
- Differential diagnosis;
- Risks and implications;
- Acuity;
- Evidence-based practice;
- Theoretical management and care concepts;
- Associated pharmacotherapy;
- Health care systems and pathways, and;
- Continuum of care and patient experiences.
Continuation of Advanced Life Support approach and cardiac arrest for associated aetiologies
Assessment strategy and rationale
A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the unit learning outcomes, attain the graduate attributes and meet professional capabilities required in paramedicine. With the ethos that assessments support and guide learning, students will see a direct relationship between each task and their development.
The group task is an effective and powerful way to learn. In addition to the creation of peer-to-peer bonds, the skills that are developed are highly relevant to the workplace: organisation, delegation, effective communication, peer-support, developing students unique voice and perspective in relation to peers, co-operation, and leadership. Situated in the digital environment, this provides contemporary skills that will be transferrable across disciplines, while still being relevant to their development in paramedicine.
The written assessment will build on students’ previous assessment by further assimilating and analysing key concepts pertinent within paramedicine. It’s context will be centred around real-world problems to a deeper understanding of the profession and practice, while developing communication and critical thinking skills. This enables students to create knowledge and solutions that will be directly relatable to paramedicine.
The exam allows students to showcase a broad understanding of the knowledge inherent in this unit and its specific application within a professional context, which will direct future practice as a paramedic. These assessments will build students knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective practitioner.
To pass the unit, students must demonstrate that they have achieved each learning outcome and obtained a total mark of 50% in the unit as the minimum standard.
Overview of assessments
Assessment Task 1: Digital Group Task Allows fo...
Assessment Task 1: Digital Group Task
Allows for cooperation and learning to be developed on a contemporary platform that will be integral to student development.
20%
Assessment Task 2: Written Assessment Provides...
Assessment Task 2: Written Assessment
Provides students with the opportunity to identify real-world problems and articulate solutions while supporting the development of academic communication and critical thinking skills.
40%
Assessment Task 3: Examination Enables students...
Assessment Task 3: Examination
Enables students to demonstrate broad understanding of the principles, management and care required for medical aetiologies within the paramedicine context.
40%
Learning and teaching strategy and rationale
This Unit provides teaching and learning strategies that engage students with materials, concepts and experiences that will support achievement of the aims and objectives of the Unit as well as relevant Graduate Attributes and professional capabilities. PARA226, coupled with PARA227 Paramedicine in Practice: Medical 2, will extend knowledge of medical conditions and their associated care within the discipline of paramedicine.
Usually situated in the second year, PARA226 continues to build students skills of becoming both an independent and social learner. Delivery methods will be multi-modal and comprised of virtual/online environments and face to face workshops.
Online learning will assist students in acquiring the fundamental theoretical concepts necessary for paramedicine. The information, delivery and exercises will be constructed in digestible portions which will allow for ease of understanding, flexibility and respect for individual learning styles. As students begin to apply the concepts in the subsequent workshops, it is expected that they will have completed the online learnings before attending the face-to-face component.
The workshops will allow students to use the fundamental concepts acquired from online learning, apply analytical thinking, and engage in discussion and group work so they can begin to solve the case-based challenges posed. These challenges are designed with a real-world focus to apply learned knowledge to relevant clinical contexts. As students progress through the cycle of theory to practice, the online learning and workshops will have a direct relationship to PARA227 practical classes and clinical placement.
It is expected that students will undertake a total 150 hours of study for this unit. The hours will comprise of the face-to-face methods, online learning and self-directed study in which students will engage with a range of online resources, readings, and prepare for and/or undertake assessments.
National Safety and Quality Health Service Standards (Second Edition)
In connection to the learning outcomes, the Australian Commission on Safety and Quality in Health Care Standards developed in this unit are:
Relating to
Clinical Governance Standard
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The governing body:
a. Provides leadership to develop a culture of safety and quality improvement, and satisfies itself that this culture exists within the organisation
b. Provides leadership to ensure partnering with patients, carers and consumers
c. Sets priorities and strategic directions for safe and high-quality clinical care, and ensures that these are communicated effectively to the workforce and the community
d. Endorses the organisation’s clinical governance framework
e. Ensures that roles and responsibilities are clearly defined for the governing body, management, clinicians and the workforce
f. Monitors the action taken as a result of analyses of clinical incidents
g. Reviews reports and monitors the organisation’s progress on safety and quality performance
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The governing body ensures that the organisation’s safety and quality priorities address the specific health needs of Aboriginal and Torres Strait Islander people
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation establishes and maintains a clinical governance framework, and uses the processes within the framework to drive improvements in safety and quality
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation implements and monitors strategies to meet the organisation’s safety and quality priorities for Aboriginal and Torres Strait Islander people
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation considers the safety and quality of health care for patients in its business decision-making
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Clinical leaders support clinicians to:
a. Understand and perform their delegated safety and quality roles and responsibilities
b. Operate within the clinical governance framework to improve the safety and quality of health care for patients
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation uses a risk management approach to:
a. Set out, review, and maintain the currency and effectiveness of, policies, procedures and protocols
b. Monitor and take action to improve adherence to policies, procedures and protocols
c. Review compliance with legislation, regulation and jurisdictional requirements
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation uses organisation-wide quality improvement systems that:
a. Identify safety and quality measures, and monitor and report performance and outcomes
b. Identify areas for improvement in safety and quality
c. Implement and monitor safety and quality improvement strategies
d. Involve consumers and the workforce in the review of safety and quality performance and systems
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation ensures that timely reports on safety and quality systems and performance are provided to:
a. The governing body
b. The workforce
c. Consumers and the local community
d. Other relevant health service organisations
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Identifies and documents organisational risks
b. Uses clinical and other data collections to support risk assessments
c. Acts to reduce risks
d. Regularly reviews and acts to improve the effectiveness of the risk management system
e. Reports on risks to the workforce and consumers
f. Plans for, and manages, internal and external emergencies and disasters
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has organisation-wide incident management and investigation systems, and:
a. Supports the workforce to recognise and report incidents
b. Supports patients, carers and families to communicate concerns or incidents
c. Involves the workforce and consumers in the review of incidents
d. Provides timely feedback on the analysis of incidents to the governing body, the workforce and consumers
e. Uses the information from the analysis of incidents to improve safety and quality
f. Incorporates risks identified in the analysis of incidents into the risk management system
g. Regularly reviews and acts to improve the effectiveness of the incident management and investigation systems
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Uses an open disclosure program that is consistent with the Australian Open Disclosure Framework
b. Monitors and acts to improve the effectiveness of open disclosure processes
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Has processes to seek regular feedback from patients, carers and families about their experiences and outcomes of care
b. Has processes to regularly seek feedback from the workforce on their understanding and use of the safety and quality systems
c. Uses this information to improve safety and quality systems
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has an organisation-wide complaints management system, and:
a. Encourages and supports patients, carers and families, and the workforce to report complaints
b. Involves the workforce and consumers in the review of complaints
c. Resolves complaints in a timely way
d. Provides timely feedback to the governing body, the workforce and consumers on the analysis of complaints and actions taken
e. Uses information from the analysis of complaints to inform improvements in safety and quality systems
f. Records the risks identified from the analysis of complaints in the risk management system
g. Regularly reviews and acts to improve the effectiveness of the complaints management system
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Identifies the diversity of the consumers using its services
b. Identifies groups of patients using its services who are at higher risk of harm
c. Incorporates information on the diversity of its consumers and higher risk groups into the planning and delivery of care
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has healthcare record systems that:
a. Make the healthcare record available to clinicians at the point of care
b. Support the workforce to maintain accurate and complete healthcare records
c. Comply with security and privacy regulations
d. Support systematic audit of clinical information
e. Integrate multiple information systems, where they are used
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation works towards implementing systems that can provide clinical information into the My Health Record system that:
a. Are designed to optimise the safety and quality of health care for patients
b. Use national patient and provider identifiers
c. Use standard national terminologies
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation providing clinical information into the My Health Record system has processes that:
a. Describe access to the system by the workforce, to comply with legislative requirements
b. Maintain the accuracy and completeness of the clinical information the organisation uploads into the system
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation provides orientation to the organisation that describes roles and responsibilities for safety and quality for:
a. Members of the governing body
b. Clinicians, and any other employed, contracted, locum, agency, student or volunteer members of the organisation
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation uses its training systems to:
a. Assess the competency and training needs of its workforce
b. Implement a mandatory training program to meet its requirements arising from these standards
c. Provide access to training to meet its safety and quality training needs
d. Monitor the workforce’s participation in training
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has strategies to improve the cultural awareness and cultural competency of the workforce to meet the needs of its Aboriginal and Torres Strait Islander patients
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has valid and reliable performance review processes that:
a. Require members of the workforce to regularly take part in a review of their performance
b. Identify needs for training and development in safety and quality
c. Incorporate information on training requirements into the organisation’s training system
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has processes to:
a. Define the scope of clinical practice for clinicians, considering the clinical service capacity of the organisation and clinical services plan
b. Monitor clinicians’ practices to ensure that they are operating within their designated scope of clinical practice
c. Review the scope of clinical practice of clinicians periodically and whenever a new clinical service, procedure or technology is introduced or substantially altered
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Conducts processes to ensure that clinicians are credentialed, where relevant
b. Monitors and improves the effectiveness of the credentialing process
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has processes to:
a. Support the workforce to understand and perform their roles and responsibilities for safety and quality
b. Assign safety and quality roles and responsibilities to the workforce, including locums and agency staff
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation provides supervision for clinicians to ensure that they can safely fulfil their designated roles, including access to after-hours advice, where appropriate
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has processes that:
a. Provide clinicians with ready access to best-practice guidelines, integrated care pathways, clinical pathways and decision support tools relevant to their clinical practice
b. Support clinicians to use the best available evidence, including relevant clinical care standards developed by the Australian Commission on Safety and Quality in Health Care
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation has systems to:
a. Monitor variation in practice against expected health outcomes
b. Provide feedback to clinicians on variation in practice and health outcomes
c. Review performance against external measures
d. Support clinicians to take part in clinical review of their practice
e. Use information on unwarranted clinical variation to inform improvements in safety and quality systems
f. Record the risks identified from unwarranted clinical variation in the risk management system
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation maximises safety and quality of care:
a. Through the design of the environment
b. By maintaining buildings, plant, equipment, utilities, devices and other infrastructure that are fit for purpose
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation:
a. Identifies service areas that have a high risk of unpredictable behaviours and develops strategies to minimise the risks of harm for patients, carers, families, consumers and the workforce
b. Provides access to a calm and quiet environment when it is clinically required
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation facilitates access to services and facilities by using signage and directions that are clear and fit for purpose
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation admitting patients overnight has processes that allow flexible visiting arrangements to meet patients’ needs, when it is safe to do so
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The health service organisation demonstrates a welcoming environment that recognises the importance of the cultural beliefs and practices of Aboriginal and Torres Strait Islander people
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Partnering with Consumers Standard
Relevant Learning OutcomeLO1, LO3
Relating to
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
a. Implementing policies and procedures for partnering with consumers
b. Managing risks associated with partnering with consumers
c. Identifying training requirements for partnering with consumers
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation applies the quality improvement system from the Clinical Governance Standard when:
a. Monitoring processes for partnering with consumers
b. Implementing strategies to improve processes for partnering with consumers
c. Reporting on partnering with consumers
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation uses a charter of rights that is:
a. Consistent with the Australian Charter of Healthcare Rights
b. Easily accessible for patients, carers, families and consumers
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation ensures that its informed consent processes comply with legislation and best practice
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation has processes to identify:
a. The capacity of a patient to make decisions about their own care
b. A substitute decision-maker if a patient does not have the capacity to make decisions for themselves
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation has processes for clinicians to partner with patients and/or their substitute decision-maker to plan, communicate, set goals, and make decisions about their current and future care
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation supports the workforce to form partnerships with patients and carers so that patients can be actively involved in their own care
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation uses communication mechanisms that are tailored to the diversity of the consumers who use its services and, where relevant, the diversity of the local community
Relevant Learning OutcomeLO1, LO3
Relating to
Where information for patients, carers, families and consumers about health and health services is developed internally, the organisation involves consumers in its development and review
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation supports clinicians to communicate with patients, carers, families and consumers about health and health care so that:
a. Information is provided in a way that meets the needs of patients, carers, families and consumers
b. Information provided is easy to understand and use
c. The clinical needs of patients are addressed while they are in the health service organisation
d. Information needs for ongoing care are provided on discharge
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation:
a. Involves consumers in partnerships in the governance of, and to design, measure and evaluate, health care
b. Has processes so that the consumers involved in these partnerships reflect the diversity of consumers who use the service or, where relevant, the diversity of the local community
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation provides orientation, support and education to consumers who are partnering in the governance, design, measurement and evaluation of the organisation
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation works in partnership with Aboriginal and Torres Strait Islander communities to meet their healthcare needs
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation works in partnership with consumers to incorporate their views and experiences into training and education for the workforce
Relevant Learning OutcomeLO1, LO3
Relating to
Medication Safety Standard
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
a. Implementing policies and procedures for medication management
b. Managing risks associated with medication management
c. Identifying training requirements for medication management
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation applies the quality improvement system from the Clinical Governance Standard when:
a. Monitoring the effectiveness and performance of medication management
b. Implementing strategies to improve medication management outcomes and associated processes
c. Reporting on outcomes for medication management
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians use organisational processes from the Partnering with Consumers Standard in medication management to:
a. Actively involve patients in their own care
b. Meet the patient’s information needs
c. Share decision-making
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to define and verify the scope of clinical practice for prescribing, dispensing and administering medicines for relevant clinicians
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians take a best possible medication history, which is documented in the healthcare record on presentation or as early as possible in the episode of care
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians review a patient’s current medication orders against their best possible medication history and the documented treatment plan, and reconcile any discrepancies on presentation and at transitions of care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes for documenting a patient’s history of medicine allergies and adverse drug reactions in the healthcare record on presentation
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes for documenting adverse drug reactions experienced by patients during an episode of care in the healthcare record and in the organisation-wide incident reporting system
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes for reporting adverse drug reactions experienced by patients to the Therapeutic Goods Administration, in accordance with its requirements
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes:
a. To perform medication reviews for patients, in line with evidence and best practice
b. To prioritise medication reviews, based on a patient’s clinical needs and minimising the risk of medication-related problems
c. That specify the requirements for documentation of medication reviews, including actions taken as a result
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to support clinicians to provide patients with information about their individual medicines needs and risks
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to:
a. Generate a current medicines list and the reasons for any changes
b. Distribute the current medicines list to receiving clinicians at transitions of care
c. Provide patients on discharge with a current medicines list and the reasons for any changes
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation ensures that information and decision support tools for medicines are available to clinicians
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation complies with manufacturers’ directions, legislation, and jurisdictional requirements for the:
a. Safe and secure storage and distribution of medicines
b. Storage of temperature-sensitive medicines and cold chain management
c. Disposal of unused, unwanted or expired medicines
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation:
a. Identifies high-risk medicines used within the organisation
b. Has a system to store, prescribe, dispense and administer high-risk medicines safely
Relevant Learning OutcomeLO2, LO3
Relating to
Comprehensive Care Standard
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
a. Implementing policies and procedures for comprehensive care
b. Managing risks associated with comprehensive care
c. Identifying training requirements to deliver comprehensive care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation applies the quality improvement system from the Clinical Governance Standard when:
a. Monitoring the delivery of comprehensive care
b. Implementing strategies to improve the outcomes from comprehensive care and associated processes
c. Reporting on delivery of comprehensive care
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians use organisational processes from the Partnering with Consumers Standard when providing comprehensive care to:
a. Actively involve patients in their own care
b. Meet the patient’s information needs
c. Share decision-making
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has systems for comprehensive care that:
a. Support clinicians to develop, document and communicate comprehensive plans for patients’ care and treatment
b. Provide care to patients in the setting that best meets their clinical needs
c. Ensure timely referral of patients with specialist healthcare needs to relevant services
d. Identify, at all times, the clinician with overall accountability for a patient’s care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to:
a. Support multidisciplinary collaboration and teamwork
b. Define the roles and responsibilities of each clinician working in a team
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians work collaboratively to plan and deliver comprehensive care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes relevant to the patients using the service and the services provided:
a. For integrated and timely screening and assessment
b. That identify the risks of harm in the ‘Minimising patient harm’ criterion
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to routinely ask patients if they identify as being of Aboriginal and/or Torres Strait Islander origin, and to record this information in administrative and clinical information systems
Relevant Learning OutcomeLO2, LO3
Relating to
Patients are supported to document clear advance care plans
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians use relevant screening processes:
a. On presentation, during clinical examination and history taking, and when required during care
b. To identify cognitive, behavioural, mental and physical conditions, issues, and risks of harm
c. To identify social and other circumstances that may compound these risks
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians comprehensively assess the conditions and risks identified through the screening process
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians document the findings of the screening and clinical assessment processes, including any relevant alerts, in the healthcare record
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians use processes for shared decision making to develop and document a comprehensive and individualised plan that:
a. Addresses the significance and complexity of the patient’s health issues and risks of harm
b. Identifies agreed goals and actions for the patient’s treatment and care
c. Identifies the support people a patient wants involved in communications and decision-making about their care
d. Commences discharge planning at the beginning of the episode of care
e. Includes a plan for referral to follow-up services, if appropriate and available
f. Is consistent with best practice and evidence
Relevant Learning OutcomeLO2, LO3
Relating to
The workforce, patients, carers and families work in partnership to:
a. Use the comprehensive care plan to deliver care
b. Monitor the effectiveness of the comprehensive care plan in meeting the goals of care
c. Review and update the comprehensive care plan if it is not effective
d. Reassess the patient’s needs if changes in diagnosis, behaviour, cognition, or mental or physical condition occur
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to identify patients who are at the end of life that are consistent with the National Consensus Statement: Essential elements for safe and high-quality end-of-life care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation providing end-of-life care has processes to provide clinicians with access to specialist palliative care advice
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to ensure that current advance care plans:
a. Can be received from patients
b. Are documented in the patient’s healthcare record
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation provides access to supervision and support for the workforce providing end-of-life care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes for routinely reviewing the safety and quality of end-of-life care that is provided against the planned goals of care
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians support patients, carers and families to make shared decisions about end-of-life care in accordance with the National Consensus Statement: Essential elements for safe and high-quality end-of-life care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation providing services to patients at risk of pressure injuries has systems for pressure injury prevention and wound management that are consistent with best-practice guidelines
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians providing care to patients at risk of developing, or with, a pressure injury conduct comprehensive skin inspections in accordance with best-practice time frames and frequency
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation providing services to patients at risk of pressure injuries ensures that:
a. Patients, carers and families are provided with information about preventing pressure injuries
b. Equipment, devices and products are used in line with best-practice guidelines to prevent and effectively manage pressure injuries
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation providing services to patients at risk of falls has systems that are consistent with best-practice guidelines for:
a. Falls prevention
b. Minimising harm from falls
c. Post-fall management
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation providing services to patients at risk of falls ensures that equipment, devices and tools are available to promote safe mobility and manage the risks of falls
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians providing care to patients at risk of falls provide patients, carers and families with information about reducing falls risks and falls prevention strategies
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation that admits patients overnight has systems for the preparation and distribution of food and fluids that include nutrition care plans based on current evidence and best practice
Relevant Learning OutcomeLO2, LO3
Relating to
The workforce uses the systems for preparation and distribution of food and fluids to:
a. Meet patients’ nutritional needs and requirements
b. Monitor the nutritional care of patients at risk
c. Identify, and provide access to, nutritional support for patients who cannot meet their nutritional requirements with food alone
d. Support patients who require assistance with eating and drinking
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation providing services to patients who have cognitive impairment or are at risk of developing delirium has a system for caring for patients with cognitive impairment to:
a. Incorporate best-practice strategies for early recognition, prevention, treatment and management of cognitive impairment in the care plan, including the Delirium Clinical Care Standard, where relevant
b. Manage the use of antipsychotics and other psychoactive medicines, in accordance with best practice and legislation
Relevant Learning OutcomeLO2, LO3
Relating to
Clinicians providing care to patients who have cognitive impairment or are at risk of developing delirium use the system for caring for patients with cognitive impairment to:
a. Recognise, prevent, treat and manage cognitive impairment
b. Collaborate with patients, carers and families to understand the patient and implement individualised strategies that minimise any anxiety or distress while they are receiving care
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has systems to support collaboration with patients, carers and families to:
a. Identify when a patient is at risk of self-harm
b. Identify when a patient is at risk of suicide
c. Safely and effectively respond to patients who are distressed, have thoughts of self-harm or suicide, or have self-harmed
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation ensures that follow-up arrangements are developed, communicated and implemented for people who have harmed themselves or reported suicidal thoughts
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to identify and mitigate situations that may precipitate aggression
Relevant Learning OutcomeLO2, LO3
Relating to
The health service organisation has processes to support collaboration with patients, carers and families to:
a. Identify patients at risk of becoming aggressive or violent
b. Implement de-escalation strategies
c. Safely manage aggression, and minimise harm to patients, carers, families and the workforce
Relevant Learning OutcomeLO2, LO3
Relating to
Where restraint is clinically necessary to prevent harm, the health service organisation has systems that:
a. Minimise and, where possible, eliminate the use of restraint
b. Govern the use of restraint in accordance with legislation
c. Report use of restraint to the governing body
Relevant Learning OutcomeLO2, LO3
Relating to
Where seclusion is clinically necessary to prevent harm and is permitted under legislation, the health service organisation has systems that:
a. Minimise and, where possible, eliminate the use of seclusion
b. Govern the use of seclusion in accordance with legislation
c. Report use of seclusion to the governing body
Relevant Learning OutcomeLO2, LO3
Relating to
Communicating for Safety Standard
Relevant Learning OutcomeLO1, LO3
Relating to
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
a. Implementing policies and procedures to support effective clinical communication
b. Managing risks associated with clinical communication
c. Identifying training requirements for effective and coordinated clinical communication
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation applies the quality improvement system from the Clinical Governance Standard when:
a. Monitoring the effectiveness of clinical communication and associated processes
b. Implementing strategies to improve clinical communication and associated processes
c. Reporting on the effectiveness and outcomes of clinical communication processes
Relevant Learning OutcomeLO1, LO3
Relating to
Clinicians use organisational processes from the Partnering with Consumers Standard to effectively communicate with patients, carers and families during high-risk situations to:
a. Actively involve patients in their own care
b. Meet the patient’s information needs
c. Share decision-making
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation has clinical communications processes to support effective communication when:
a. Identification and procedure matching should occur
b. All or part of a patient’s care is transferred within the organisation, between multidisciplinary teams, between clinicians or between organisations; and on discharge
c. Critical information about a patient’s care, including information on risks, emerges or changes
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation:
a. Defines approved identifiers for patients according to best-practice guidelines
b. Requires at least three approved identifiers on registration and admission; when care, medication, therapy and other services are provided; and when clinical handover, transfer or discharge documentation is generated
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation specifies the:
a. Processes to correctly match patients to their care
b. Information that should be documented about the process of correctly matching patients to their intended care
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation, in collaboration with clinicians, defines the:
a. Minimum information content to be communicated at clinical handover, based on best-practice guidelines
b. Risks relevant to the service context and the particular needs of patients, carers and families
c. Clinicians who are involved in the clinical handover
Relevant Learning OutcomeLO1, LO3
Relating to
Clinicians use structured clinical handover processes that include:
a. Preparing and scheduling clinical handover
b. Having the relevant information at clinical handover
c. Organising relevant clinicians and others to participate in clinical handover
d. Being aware of the patient’s goals and preferences
e. Supporting patients, carers and families to be involved in clinical handover, in accordance with the wishes of the patient
f. Ensuring that clinical handover results in the transfer of responsibility and accountability for care
Relevant Learning OutcomeLO1, LO3
Relating to
Clinicians and multidisciplinary teams use clinical communication processes to effectively communicate critical information, alerts and risks, in a timely way, when they emerge or change to:
a. Clinicians who can make decisions about care
b. Patients, carers and families, in accordance with the wishes of the patient
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation ensures that there are communication processes for patients, carers and families to directly communicate critical information and risks about care to clinicians
Relevant Learning OutcomeLO1, LO3
Relating to
The health service organisation has processes to contemporaneously document information in the healthcare record, including:
a. Critical information, alerts and risks
b. Reassessment processes and outcomes
c. Changes to the care plan
Relevant Learning OutcomeLO1, LO3
Relating to
Recognising and Responding to Acute Deterioration Standard
Relevant Learning OutcomeLO3
Relating to
Clinicians use the safety and quality systems from the Clinical Governance Standard when:
a. Implementing policies and procedures for recognising and responding to acute deterioration
b. Managing risks associated with recognising and responding to acute deterioration
c. Identifying training requirements for recognising and responding to acute deterioration
Relevant Learning OutcomeLO3
Relating to
The health service organisation applies the quality improvement system from the Clinical Governance Standard when:
a. Monitoring recognition and response systems
b. Implementing strategies to improve recognition and response systems
c. Reporting on effectiveness and outcomes of recognition and response systems
Relevant Learning OutcomeLO3
Relating to
Clinicians use organisational processes from the Partnering with Consumers Standard when recognising and responding to acute deterioration to:
a. Actively involve patients in their own care
b. Meet the patient’s information needs
c. Share decision-making
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes for clinicians to detect acute physiological deterioration that require clinicians to:
a. Document individualised vital sign monitoring plans
b. Monitor patients as required by their individualised monitoring plan
c. Graphically document and track changes in agreed observations to detect acute deterioration over time, as appropriate for the patient
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes for clinicians to recognise acute deterioration in mental state that require clinicians to:
a. Monitor patients at risk of acute deterioration in mental state, including patients at risk of developing delirium
b. Include the person’s known early warning signs of deterioration in mental state in their individualised monitoring plan
c. Assess possible causes of acute deterioration in mental state, including delirium, when changes in behaviour, cognitive function, perception, physical function or emotional state are observed or reported
d. Determine the required level of observation
e. Document and communicate observed or reported changes in mental state
Relevant Learning OutcomeLO3
Relating to
The health service organisation has protocols that specify criteria for escalating care, including:
a. Agreed vital sign parameters and other indicators of physiological deterioration
b. Agreed indicators of deterioration in mental state
c. Agreed parameters and other indicators for calling emergency assistance
d. Patient pain or distress that is not able to be managed using available treatment
e. Worry or concern in members of the workforce, patients, carers and families about acute deterioration
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes for patients, carers or families to directly escalate care
Relevant Learning OutcomeLO3
Relating to
The health service organisation provides the workforce with mechanisms to escalate care and call for emergency assistance
Relevant Learning OutcomeLO3
Relating to
The workforce uses the recognition and response systems to escalate care
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes that support timely response by clinicians with the skills required to manage episodes of acute deterioration
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes to ensure rapid access at all times to at least one clinician, either on site or in close proximity, who can deliver advanced life support
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes to ensure rapid referral to mental health services to meet the needs of patients whose mental state has acutely deteriorated
Relevant Learning OutcomeLO3
Relating to
The health service organisation has processes for rapid referral to services that can provide definitive management of acute physical deterioration
Relevant Learning OutcomeLO3
Paramedicine Board of Australia Professional Capabilities for Registered Paramedics
The Paramedicine Board of Australia is responsible for assessing, consulting on and setting the standards for paramedics practicing in Australia. These standards and relevant domains are articulated in the Professional Capabilities for a Registered Paramedic document. The learning outcomes of this unit are matched to the relevant capabilities, in order to align your development with the requirements of a paramedic.
Relating to
The professional and ethical practitioner
This domain covers paramedics’ responsibility to be professional and ethical, and to practise with professional autonomy and accountability within the current medico-legal framework. It also addresses their responsibility for ensuring that patient confidentiality and privacy is always maintained, while recognising the potential role as a patient advocate.
Relevant Learning OutcomeLO1, LO3
Relating to
Practise ethically and professionally, consistent with relevant legislation and regulatory requirements
- Demonstrate understanding of: reporting obligations, legal responsibilities, legal requirements, ethical and professional responsibilities, and the legal and ethical boundaries of paramedicine practice.
- Manage personal, mental and physical health to ensure fitness to practice.
- Follow mandatory and voluntary reporting obligations. • Apply the Paramedicine Board of Australia’s Code of conduct to their practice.
- Provide relevant information to a patient and demonstrate appropriate methods to obtain informed consent.
- Demonstrate knowledge of Australia’s healthcare systems, their standards and requirements.
- Demonstrate understanding of the basic principles underpinning bio- ethics in paramedicine practice.
- Demonstrate culturally safe practice when providing healthcare services for Aboriginal and Torres Strait Islander Peoples.
- Exercise appropriate levels of autonomy and professional judgement in a variety of practice settings.
- Operate within the current legislation applicable to paramedicine practice.
- Practise in accordance with the applicable legislation governing the safe use of scheduled medicines by paramedics in the jurisdiction of practice.
Legal responsibilities may include an understanding of responsibilities contained in relevant Commonwealth, state and territory legislation and regulations, specific responsibilities to maintain confidentiality, confirm informed consent and exercising duty of care.
Informed consent is a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved.
Principles underpinning bio-ethics must include: respect the rights of the individual, respect the autonomy of the individual, cause no harm, and advance the common good.
Relevant aspects of the Australian health care systems may include knowledge of service provision arrangements, the structure of the health system, points of access and the range of roles that paramedics may play within that structure.
Key elements of fitness to practise must include competence, professionalism, including a sense of responsibility and accountability, self-awareness and professional values, sound mental health and the capacity to maintain health and wellbeing for practice.
Reporting obligations must include making a notification about the health (impairment), conduct or performance of a registered health practitioner that may be placing the public at risk; as well as of their own impairments to practice.
Relevant Learning OutcomeLO1, LO3
Relating to
Provide each patient with an appropriate level of dignity and care
- Demonstrate understanding of the influence of socio-cultural factors on patient attitudes and behaviour.
- Display appropriate professional behaviour in patient interactions.
- Provide culturally safe care for all patients.
- Identify and respect appropriate boundaries between patients and health professionals.
- Assess each situation, determine the nature and severity of the problem and apply the required knowledge and experience to provide a response that is in the best interest of the patient/s.
- Facilitating advance care planning where appropriate.
Socio-cultural factors may include those related to cultural and linguistic diversity, age, gender, disability, socio-economic, geographic locations; and identifying as Aboriginal and Torres Strait Islander Peoples.
Appropriate professional behaviour must include behaviour that:
- is culturally safe for Aboriginal and Torres Strait Islander patients to access safe and responsive healthcare, free of racism
- respects socio-cultural difference, is empathetic and non-discriminatory, regardless of individuals’ or groups’ race, culture, religion, age, gender identity, sexuality, physical or mental state, and
- respects, and so far as possible, upholds the rights, dignity, values and autonomy of every patient. This includes their role in the diagnostic and therapeutic process and in maintaining health and well being.
Cultural Safety is determined by Aboriginal and Torres Strait Islander individuals, families and communities. Culturally safe practise is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practicing behaviours and power differentials in delivering safe, accessible and responsive healthcare free from racism.
- To ensure culturally safe and respectful practice, health practitioners must:
- acknowledge colonisation and systemic racism, social, cultural, behavioural and economic factors which affect individual and community health
- acknowledge and address individual racism, their own biases, assumptions, stereotypes and prejudices and provide care that is holistic, free of bias and racism
- recognise the importance of self-determined decision- making, partnership and collaboration in healthcare which is driven by the individual, family and community, and
- foster a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander People and colleagues.
Relevant Learning OutcomeLO1, LO3
Relating to
Assume responsibility, and accept accountability, for professional decisions
- Recognise and respond appropriately to unsafe or unprofessional practice.
- Integrate organisational directives, policies, procedures and guidelines with Professional standards.
- Apply relevant quality frameworks and processes to practice.
Quality frameworks may include workplace specific frameworks, relevant jurisdictional publications and the Australian Safety and Quality Framework for Health Care published by the Australian Commission on Safety and Quality in Health Care.
Relevant Learning OutcomeLO1, LO3
Relating to
Advocate on behalf of the patient, when appropriate in the context of the practitioner’s practice as a paramedic
- Demonstrate understanding of the principles of patient advocacy and their application to paramedicine practice.
- Recognise when it may be appropriate to intervene on the patient’s behalf.
Principles of advocacy may include supporting and promoting the rights and interests of individuals, helping individuals to achieve or maintain their rights and representing their needs.
Relevant Learning OutcomeLO1, LO3
Relating to
The communicator and the collaborator
This domain covers paramedics’ responsibility to use appropriate, clear and effective communication. It also addresses their responsibility to ensure that they always function effectively with other healthcare team members.
Relevant Learning OutcomeLO3
Relating to
Collaborate with other health practitioners
- Establish and maintain effective and respectful collaborative working relationships as a member of a healthcare team.
- Demonstrate an understanding of professional roles and responsibilities of healthcare team members and other service providers and how they interact with the role of a paramedic.
- Follow appropriate protocols, procedures and guidelines to give and receive relevant and timely verbal and written communication.
- Effectively supervise tasks delegated to other healthcare team members.
- Consult effectively with healthcare team members and other relevant people to facilitate continuity of care.
- Make appropriate referrals, delegations and handovers to other healthcare team members and other service providers.
Healthcare team members may include registered health practitioners, accredited health professionals, volunteers, licensed and unlicensed healthcare workers, police, fire and other emergency service personnel.
Relevant Learning OutcomeLO3
Relating to
The evidence-based practitioner
This domain covers paramedics’ responsibility to engage in evidence-based practice and to critically monitor their actions through a range of reflective processes. It also addresses their responsibility for identifying, planning and implementing their ongoing professional learning and development needs.
Relevant Learning OutcomeLO2, LO3
Relating to
Make informed and reasonable decisions
- Operate within a framework of making informed, evidence-based, reasonable and professional judgements about their practice, with acting in the best interests of their patients as their primary concern.
- Make sensible, practical, and culturally safe decisions about their practice, taking account of all relevant information and the best interests of the people who use, or are affected by, the service being provided.
Relevant Learning OutcomeLO2, LO3
Relating to
Use clinical reasoning and problem-solving skills to determine clinical judgements and appropriate actions
- Apply evidence-based practice principles along with critical and reflective thinking to resolve clinical challenges.
- Demonstrate a logical and systematic approach to problem-solving and situation analysis.
- Analyse and critically evaluate the information collected to make clinical judgments.
- Recognise that clinical judgements involve consideration of conflicting information and evidence.
- Formulate a diagnosis informed by the patient assessment and analysis of context and situation.
- Identify the time criticality of treatment, referral, handover and where appropriate, transport.
Critical thinking may include skills in questioning, analysing, synthesising, interpreting, and cognitive reasoning, and the critical appraisal of literature and evidence.
Reflective practice may include critical self-reflection during and after a clinical challenge or experience. It may involve structured and informal reflection to review and integrate knowledge including culturally safe practise and findings into practice.
Relevant Learning OutcomeLO2, LO3
Relating to
Draw on appropriate knowledge, resources and skills in order to make professional judgements
- Select or modify approaches to meet the needs of patients, their relatives and carers, reflecting culturally safe practice when practicing.
- Practise situational awareness to changes in risks or hazards and change their practice as needed to take account of new developments.
- Using appropriate resources to support professional decision-making.
- Demonstrate a level of skill in the use of information technology appropriate to their practice.
Relevant Learning OutcomeLO2, LO3
Relating to
The safety and risk management practitioner
This domain covers paramedics’ responsibility to protect patients and others from harm by managing and responding to the risks inherent in paramedicine practice. It also addresses their responsibility to ensure high-quality professional services are provided for the benefit of patients and others.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
Protect and enhance patient safety
- Follow patient identification procedures to confirm the correct match of a patient with the intended procedure, care and/or treatment.
- Obtain valid informed consent when possible.
- Identify and manage risks associated with patient transfers.
- Ensure when patients are required to be moved it is in a considered and safe manner.
- Identify and manage the risk of infection, including during aseptic procedures.
Patient identification procedures for interfacility transfer and handover of a patient consistent with best practice approaches published by bodies such as the Australian Commission on Safety and Quality in HealthCare.
Infection prevention and control risk management: Registered paramedics must demonstrate an understanding of transmission modes of healthcare associated and community-acquired infections (host, agent and environment); established practices for preventing the transmission including effective hand hygiene; and ability to implement NHMRC infection prevention and control guidelines.
Relevant Learning OutcomeLO1, LO2, LO3
Relating to
The paramedicine practitioner
This domain covers profession-specific knowledge, skills and capabilities required for practice as a registered paramedic
Relevant Learning OutcomeLO3
Relating to
Assess and monitor the patient capacity to receive care
- Identify factors or conditions that may affect the patient behaviour and/or capacity to undergo the procedure.
- Identify patients who are vulnerable or otherwise most at risk including those with mental health issues particularly Aboriginal and Torres Strait Islander Peoples.
- Identify contraindications and limitations arising from the patient capacity to consent or refuse to receive care; determine appropriate adjustments to procedures; and, where appropriate, communicate these to the patient.
- Perform patient assessment and interventions in accordance with legislation, registration standards, codes and guidelines, including gaining informed consent.
- Identify and respond to a patient deteriorating condition, or inability to undergo a procedure or treatment, consistent with duty of care and statutory requirements.
Patient capacity or behaviour may include pre-existing medical and/or physical and physiological conditions and other factors that may affect their capacity to receive care which includes culturally safe care.
Relevant Learning OutcomeLO3
Relating to
Understand the key concepts of the bodies of knowledge which are specifically relevant to paramedicine practice
- Understand the structure, function and pathophysiology of the human body, relevant to their practice, together with knowledge of health, human growth and development, disease, disorder and dysfunction.
- Understand the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process.
- Understand the theoretical basis of and the variety of approaches to assessment and intervention.
- Demonstrate an applied knowledge of human anatomy and physiology sufficient to understand the nature and effects of injury or illness and to conduct assessment and observation in order to establish patient management strategies.
- Understand psychological and social factors, including intergenerational trauma that impact and influence an individual in health and illness.
- Understand the clinical sciences underpinning paramedic practice, including physiological, pharmacological, behavioural and functional.
Relevant Learning OutcomeLO3
Relating to
Conduct appropriate diagnostic or monitoring procedures, treatment, therapy or other actions safely
- Maintain the safety of self, patients and those involved in their care.
- Practice safely and effectively across the full range of patient presentations and circumstances.
- Arrive at a reasonable working diagnosis.
- Position for safe and effective interventions.
- Demonstrate an applied knowledge of the indications and contra-indications of using specific paramedic interventions including their modifications.
- Modify and adapt practice appropriate and inclusive of a culturally safe practice environment.
Relevant Learning OutcomeLO3
Relating to
Formulate specific and appropriate patient care and treatment actions
- Adapt practice to meet the needs of different groups distinguished by, for example, physical, psychological, environmental, cultural or socio-economic factors within their authorised scope of practice.
- Demonstrate sensitivity to the factors which shape lifestyle that may impact on the individual’s health and affect the interaction between the patient and registered paramedic.
- Utilise knowledge, reasoning and problem-solving skills to determine appropriate judgements and actions.
- Prioritise the care provided to optimise safety and health outcomes for the patient and demonstrate a logical and systematic approach to problem-solving in a culturally safe framework.
Relevant Learning OutcomeLO3