Course Title: Implement and evaluate a plan of nursing care

National Element Code & Title:

HLTEN504A Implement and evaluate a plan of nursing care

Performance Criteria:

1.1 Identify actual and potential nursing care needs in
consultation/collaboration with the client
1.2 Identify client needs for health education and
implement education within scope of nursing
practice and in consultation/collaboration with
registered nurse
1.3 Introduce and explain all nursing interventions,
using appropriate language and interpersonal skills
to address the diverse needs of clients and health
care settings
1.4 Establish and maintain a safe environment through
effective communication with clients, family and
carers



2.1 Explain to client the importance of hygiene and
grooming to achieving health outcomes
2.2 Assist clients to address hygiene, dressing and
grooming needs
2.3 Describe conditions which affect the oral cavity
and demonstrate effective oral hygiene to client
2.4 Identify client nutritional needs in consultation/
collaboration with client and their significant
others




3.1 Apply the principles and techniques of safe
manual handling and principles of ‘no-lift’ policy
when assisting clients with movement
3.2 Identify situations of risk or potential risk and
implement risk prevention/minimisation strategies
and refer to registered nurse as appropriate
3.3 Actively encourage clients to contribute to their
own mobility
3.4 Assist clients to safely transfer using appropriate
mobility procedures with reference to safety of
self, client and others involved



4.1 Provide each client with a full explanation
regarding preparation for specific procedures
4.2 Maintain privacy and dignity of client throughout
4.3 Complete documentation as per organisation
policy and procedures
4.4 Observe validity of consent and report any
concerns to the registered nurse, as appropriate


5.1 Participate in the implementation of a plan of
nursing care in line with duty of care and OH&S
policies and procedures
5.2 Monitor the application of safe workplace
procedures as per OH&S policies and organisation
policies and procedures
5.3 Monitor the application of infection control
principles in all work activities
5.4 Prioritise work activities to meet acuity of client
needs and maintain a balanced approach to own
workload

6.1 Maintain ongoing observation and assessment
during nursing care
6.2 Monitor the use of diagnostic tools and document
results
6.3 Monitor and evaluate client progress and changes
implemented within the nursing role
6.4 Assess and document changes in client
independence or pain tolerance within scope of
Enrolled Nurse practice




7.1 Clarify client needs for community support
services on discharge and identify appropriate
community support services to the client
7.2 Promote client awareness and understanding
through health education within the enrolled nurse
scope of practice
7.3 Ensure client has all requirements for discharge:
next GP’s appointment: medications; and any
referrals



8.1 Evaluate own contribution to nursing care in
consultation/collaboration with the client and
registered nurse
8.2 Evaluate implementation of plan of nursing care in
consultation/collaboration with the
multidisciplinary team and/or registered nurse
8.3 Evaluate nursing care in light of potential and
actual client outcomes
8.4 Evaluate risk prevention and management
strategies applied in delivery of nursing care

Funnell, R. Koutoukidis, G. Lawrence, K. 2009, Tabner’s Nursing Care: Theory and Practice, 5th Ed., Australia : Churchill Livingstone: Elsevier.
Crisp, J. & Taylor, C. 2008, 3nd ed., Potter & Perry’s Fundamentals of Nursing, Australia: Chatswood, N.S.W. : Elsevier Australia
Brown, D., Edwards, H. (eds) 2008, 2nd ed., Lewis’s medical surgical nursing; assessment and management of clinical problems, Marrickville, N.S.W. : Elsevier Australia, 2008 
Perry, A. & Potter, P.A. 2010, Clinical Nursing Skills & Techniques, 7th Ed., Mosby