Course Title: Contribute to client assessment and developing nursing care plans

Part B: Course Detail

Teaching Period: Term2 2015

Course Code: NURS5272C

Course Title: Contribute to client assessment and developing nursing care plans

School: 155T Vocational Health and Sciences

Campus: City Campus

Program: C5313 - Diploma of Nursing (Enrolled-Division 2 Nursing)

Course Contact: Leeanne Mond

Course Contact Phone: +61 3 9925 4837

Course Contact Email:

Name and Contact Details of All Other Relevant Staff

Program Coordinator: Pamela Maher


Phone: +61 3 9925 4299

Nominal Hours: 50

Regardless of the mode of delivery, represent a guide to the relative teaching time and student effort required to successfully achieve a particular competency/module. This may include not only scheduled classes or workplace visits but also the amount of effort required to undertake, evaluate and complete all assessment requirements, including any non-classroom activities.

Pre-requisites and Co-requisites


This unit of competency is co delivered with HLTAP501C Analyse Health Information. This co delivered unit has the prerequisite attached HLTAP401B Confirmed Physical Health Status which must be successfully completed prior to the commencement of this unit.

Course Description

This unit of competency describes the skills and knowledge required of an Enrolled/Division 2 Nurse in contributing to the development of individualised health care plans by collection of data captured during a client’s preliminary and ongoing health assessments. Assessment is based on a lifespan approach

The knowledge and skills described in thiscompetency unit are to be applied withinjurisdictional nursing and midwifery regulatory authority legislative requirements. Enrolled/Division 2 nursing work is to be carried out in consultation/collaboration with registered nurse and under direct or indirect supervisory arrangements in line with jurisdictional regulatory requirements

National Codes, Titles, Elements and Performance Criteria

National Element Code & Title:

HLTEN503B Contribute to client assessment and developing nursing care plans


1. Collect data that contributes to client health care plan


2. Undertake client assessment for admission and discharge


3. Analyse client health assessment data and observations


4. Contribute to the development of individual care plans for clients


5. Prepare for client discharge


1. Collect data that contributes to client health care plan
2. Undertake client assessment for admission and discharge
3. Analyse client health assessment data and observations
4. Contribute to the development of individual care plans for clients
5. Prepare for client discharge

Performance Criteria:

1.1 Ensure appropriate introductions and explanations precede all nursing assessment and interventions

1.2 Measure vital signs of the client using appropriate biomedical equipment according to the acuity of care and physical characteristics of the client

1.3 Perform other clinical measurements/assessments such as activities of daily living

1.4 Record lifestyle patterns and coping mechanisms in documentation

1.5 Document current client health practices, issues and needs

1.6 Document gender, age, cultural, religious and/or spiritual data in preliminary health assessment

1.7 Identify the likely impact of specific health care on the client’s health

1.8 Involve client in the process of data collection wherever possible

1.9 Access client information from appropriate family member or carer (if client is unable)

1.10 Identify the emotional and physical needs of family and significant others in supporting the client

1.11 Document and report variations from normal on a regular basis

1.12 Validate extraordinary findings immediately, document and report abnormalities to the registered nurse

1.13 Undertake ongoing client assessment

2.1 Collect client-based data for admission and/or discharge planning

2.2 Communicate effectively with clients, family and health team members within jurisdictional scope of practice

2.3 Contribute to nursing assessment documentation relating to physical, psychosocial and contextual client factor

2.4 Follow organisational policies and procedures relating to client participation

2.5 Undertake client admission with understanding of processes involved and key issues to be addressed

2.6 Take into account individual’s values and attitudes regarding health care and any issues the client may be experiencing and report to the registered nurse, as appropriate

2.7 Document client information, such a community resources, to assist in planning for discharge

2.8 Accurately record and report admission and discharge information

3.1 Accurately interpret information gained from health assessments and observations as being within normal range and/or refer to appropriate health care colleague for interpretation

3.2 Report change in client health status in a timely manner to the appropriate health care colleague

3.3 Identify the likely cause of any significant variation(s) from normal in relation to providing care

3.4 Reflect consideration for age and developmental state of client in performance of clinical nursing assessment

3.5 Analyse physiological aspects of human growth and its impact on client health

3.6 Reflect the client’s interests, physical, emotional and psychosocial needs in documentation

3.7 Respect cultural, spiritual and religious wishes during nursing assessment

3.8 Use client health history as part of planning care in line with health organisation requirements

Learning Outcomes

At the end of this unit students should be able to:

• Collect data that contributes to client health care plan
• Undertake client assessment for admission and discharge
• Analyse client health assessment data and observations
• Contribute to the development of individual care plans for clients
• Prepare for client discharge

Details of Learning Activities

  • Lecture
  • Student Discussion and Group Work

Teaching Schedule

As per Student Timetable Matrix located on blackboard

L1    Growth & Development

L2    Documentation

L3    Developing care Plans

L4    Assessment Skills

L5    Vital Signs

L6     Pain, Neurological & neurovascular obs 

L7     Diagnostic testing

L8     Emergency Conditions

L9     Implementing Services

Labs x 3


Taught in conjunction with HLTEN504C

Learning Resources

Prescribed Texts

Kozier and Erbs ‘ Fundamentals of Nursing’. (2010). 1st edition. Pearson: Australia


Crisp, J Taylor, C 2009 Potter and Perry’s fundamentals of nursing 3e, Chatswood

Flinders University, Come into my World

Funnell, R Koutoukidis, G and Lawrence, K 2009 Tabbner’s nursing care 5e, Chatswood

Other Resources

All classroom powerpoints posted on student Blackboard



Power Points



Overview of Assessment

Underpinning knowledge for this unit of comtency will be assessed via the following methods:

  • Written Examination / Written Assessment
  • Practical Assessment
  • Clinical Placement

Assessment Tasks


Online Quizzes

Poster Presentation

Case Study

Clinical Placement


Assessed in conjunction with HLTEN504C. All assessments must achieve a Satisfactory to gain an overall Competent for the unit

Student must pass Clinical Placement in order to pass overall subject.

Assessment Matrix

See assessment matrix on Blackboard

Other Information

Assessment Information

Please refer to RMIT assessment policy for, Special Consideration, extensions of time, equitable assessment arrangements and future assessment adjustments.

Additional Information

Re-submission of written work, or other assessments, (once only, Excluding exams) can be granted on recommendation from the teacher and approval coordinator


Plagiarism is a form of cheating in assessment and may occur in oral, written or visual presentations. It is the presentation of the work, idea or creation of another person, without appropriate referencing, as though it is your own:http://rmit.edy\


Is an online service, in to which teachers and students submit student assignments into a large database, via Blackboard, refer Turnitin website

Course Overview: Access Course Overview