Incorporating Chronic Disease Self Management Principles in ...

Incorporating Chronic Disease Self Management Principles in Training Packages for CHC02 Community Services and HLT07 Health

March 2007

Community and Health Industry Skills CouncilChronic Disease Self Management Scoping Report March 2007

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CONTENTS

Purpose of this scoping report...........................................................................................3

1. Background and context..............................................................................................4

2. Principles of chronic disease self management...........................................................9

3. Framework for analysis of Chronic Disease Self Management principles in Training Packages...................................................................................................................11

4. Outcomes and recommendations of CDSM analysis................................................22

5. Questions...................................................................................................................38

Appendix 1 CDSM Project Timelines …………………………………………………….40

Appendix 2 Health Training Package HLT07 qualifications and job roles...................41

Appendix 3 Community Services Training Package CHC02 qualifications and job roles..........................................................................................................48

Appendix 4 Example of CDSM Analysis………………………………………………….53

Appendix 5 Glossary and Web Links..........................................................................58

Attachment 1

Chronic Disease Self Management – Analysis of the Health Training Package

Attachment 2

Chronic Disease Self Management – Analysis of the Community Services Training Package


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Purpose of this Scoping Report

The Community Services and Health Industry Skills Council (the Skills Council) is the recognised national peak body leading the development of an integrated approach to skills development for the CS&H Industries. The Skills Council places skills recognition and development of the Community Services and Health workforce at the centre of its strategic plan for the next three years. The VET system presents opportunities for far-reaching solutions to the challenges faced by the industry. The development, maintenance and promotion of VET products, particularly Training Packages, are integral to achieving its vision of a competent workforce.

This Scoping Report is intended to provide a focus for a review of competence requirements of the Community Services and Health workforce to ensure that chronic disease self management (CDSM) principles are appropriately addressed in competency standards and qualifications within the Community Services Training Package (CHC02) and the Health Training Package (HLT07).

The Scoping Report has five main sections:1. The context and background, including the need, the definition and elements of

CDSM and the objectives of the National Chronic Disease Strategy, (2005)2;2. The principles of chronic disease self management, and a discussion about their

possible relevance to the Community Services and Health workforce;3. A Framework for the Analysis of Chronic Disease Self Management in the

Community Services Training Package (CHC02) and the Health Training Package (HLT07);

4. Findings of the Analysis of CDSM Principles. An example of the analysis is contained in Appendix 4.

5. Outcomes and recommendations of the CDSM Analysis (see attachment 1 and 2)

6. Questions

In Appendix 1 the Scoping Report provides a timeline for the project. Submissions to inform the Scoping Report are invited by 18 May 2007. Submissions may take any form or use the questions identified in Section 5. Submissions can be emailed to [email protected]. Contact Robin Flynn at the Skills Council for further information [email protected], 02 9263 3589.

1Formerly the Community Services & Health Training Australia (the national ITAB), now the Community Services & Health Industry Skills Council2 National Health Priority Action Council (NHPAC) (2006). National Chronic Disease Strategy. Australian Government Department of Health and Ageing, Canberra.


Community Services and Health Industry Skills Council Vision

Australia will have a community and health workforce with sufficient competence such that, if deployed and managed well, it will always respond

appropriately to the needs of the Australian population so that their health and well being is promoted, maintained and where necessary restored.

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mailto:[email protected]

mailto:[email protected]

1. Background and context

Chronic disease

Chronic disease accounts for over half of the global health burden, and the prevalence is rapidly rising. The Australian Institute of Health and Welfare3 reports that in 2004-05 77% of Australians had at least one long-term condition. Most common were asthma (10.0% of the total population), osteoarthritis (7.9%), depression (5.3%) and diabetes (3.5%) According to Australia’s Health 20044, chronic diseases are the primary health concerns of Australia. The prevention and management of chronic diseases is considered one of the most significant challenges facing Australia’s health and community care systems.

Features common to most chronic diseases include:

complex causality, with multiple factors leading to their onset; a long development period, some of which may have no symptoms; a prolonged course of illness, perhaps leading to other health complications; and associated functional impairment or disability.5

Chronic diseases are defined as health problems that require ongoing management over a period of years or decades and include:

diabetes; heart disease; asthma; chronic obstructive pulmonary disease (COPD); cancer; HIV/AIDS; depression; and physical disabilities.6

The Blueprint for nation-wide surveillance of chronic diseases and associated determinants (2006)7 focuses nation-wide surveillance and monitoring at a defined set of diseases, including “heart disease and stroke, Type 2 diabetes, renal disease, lung and colorectal cancers, chronic lung disease and depression.”

The Australian Institute of Health and Welfare (2006) adds oral disease to the list of chronic conditions.8

3 Australian Institute of Health and Welfare 2006. Chronic diseases and associated risk factors in Australia. Canberra:AIHW.4 Australian Institute of Health and Welfare 2004. Australia’s Health 2004. Canberra:AIHW.5 Australian Institute of Health and Welfare 2006. Chronic diseases and associated risk factors in Australia. Canberra:AIHW.6 WHO (World Health Organisation)2005. Preparing a health workforce for the 21st century: The challenges of chronic conditions. Geneva:WHO.7 National Health Priority Action Council (NHPAC) (2006). Blueprint for nation-wide surveillance of chronic diseases and associated determinants.Melbourne, Australia.8 Australian Institute of Health and Welfare 2006. Chronic diseases and associated risk factors in Australia. Canberra:AIHW.


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The National Chronic Disease Strategy (2006)9 makes specific mention of asthma; cancer; diabetes; heart, stroke and vascular disease; osteoarthritis, rheumatoid arthritis and osteoporosis.

The primary objectives of the National Chronic Disease Strategy (2006) are to:

prevent and/or delay the onset of chronic disease for individuals and population groups;

reduce the progression and complications of chronic disease; maximise the well being and quality of life of individuals living with chronic

disease and their families and carers; reduce avoidable hospital admissions and health care procedures; implement best practice in the prevention, detection and management of

chronic disease; and enhance the capacity of the health workforce to meet population demand for

chronic disease prevention and care into the future.

A continuum of chronic disease care applies to:

people without disease; to people at risk of disease; to people with chronic disease of varying levels of complexity, including people

needing palliative care.

9 National Health Priority Action Council (NHPAC) (2006). National Chronic Disease Strategy. Australian Government Department of Health and Ageing, Canberra.


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A continuum of chronic disease care seeks better outcomes to:

health promotion prevention; detection; assessment; multidisciplinary care planning and review; evidence based clinical management; self-management; care co-ordination; rehabilititation; ongoing monitoring; and end of life care.10

Chronic disease self management

Self management and collaboration between the client and all relevant service providers are essential components in both the prevention of chronic disease and the prevention of predictable complications of chronic diseases.11

Self management is the active participation by people in their own health care. Self-management incorporates health promotion and risk reduction, informed decision making, care planning, medication management, and working with health care providers to attain the best possible care and to effectively negotiate the often complex health system. All people self manage to some degree, but there are opportunities to supportpeople and their families and carers to develop skills and resources to maximise their capacity to self manage.12

10 National Health Priority Action Council (NHPAC) (2006). National Chronic Disease Strategy. Australian Government Department of Health and Ageing, Canberra.11 WHO (World Health Organisation)2005. Preparing a health workforce for the 21st century: The challenges of chronic conditions. Geneva:WHO.12 National Health Priority Action Council (NHPAC) (2006). National Chronic Disease Strategy. Australian Government Department of Health and Ageing, Canberra.


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The Chronic Disease Self Management Project has adopted the National Chronic Disease Strategy description of chronic disease, i.e. chronic diseases:

have complex and multiple causes; usually have a gradual onset, although they can have sudden onset and acute

stages; occur across the life cycle, although they become more prevalent with older

age; can compromise quality of life through physical limitations and disability; are long term and persistent, leading to a gradual deterioration of health; and while usually not immediately life threatening, they are the most common and

leading cause of premature mortality.

The Chronic Condition Self-Management Guidelines: Summary for nurses and allied health professionals13, describes chronic disease self management as the person with the chronic disease engaging in activities that:

protect and promote health; monitor and manage symptoms and signs of illness; manage the impacts of illness on functioning, emotions and interpersonal

relationships; and adhere to treatment regimes.

Self management skills that may assist people to minimise complications or delay the onset entirely include:

coping skills (i.e. managing emotions related to chronic conditions); goal setting for specific and moderately challenging behaviours; self monitoring (i.e. keeping track of behaviours); environmental modification (i.e. creating a context to maximise success); self reward (i.e. reinforcing one’s behaviour with immediate, personal and

desirable rewards); and arranging social support (i.e. gaining the support of others).14

Factors that affect a person’s ability for self management include:

motivation; knowledge of condition; knowledge of symptom management plan; co-morbidities – other conditions that may affect self management; health beliefs – religious, cultural and family beliefs; self efficacy – client’s confidence in their capacity to self manage; social context – e.g. access to services, cultural aspects of the client’s life;15

health context – knowledge and support of health professionals.

13 The Royal College of General Practioners(2006). Chronic condition self management guidelines: Summary for nurses

and allied health professionals. Australia. 14 WHO (World Health Organisation)2005. Preparing a health workforce for the 21st century: The challenges of chronic conditions. Geneva:WHO.15 The Royal College of General Practioners(2006). Chronic condition self management guidelines: Summary for nurses and allied health professionals. Australia.


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The Chronic Disease Self Management Project will adopt the National Chronic Disease Strategy definition of self management.

Self management is the active participation by people in their own health care. Self-management incorporates health promotion and risk reduction, informed decision making, care planning, medication management, and working with health care providers to attain the best possible care and to effectively negotiate the often complex health system.

The Chronic Disease Self Management Project will consider all aspects of the continuum of chronic disease care:

health promotion; prevention; detection; assessment; multidisciplinary care planning and review; evidence based clinical management; self-management; care co-ordination; rehabilititation; ongoing monitoring; and end of life care.

The Chronic Disease Self Management Project will accept that chronic disease self management involves the person with chronic disease engaging in activities that:

Protect and promote health; Monitor and manage symptoms and signs of illness; Manage the impacts of illness on functioning, emotions and interpersonal

relationships; and Adhere to treatment regimes.

2. Principles of chronic disease self management

Six key principles of chronic disease self management underpin good practice for health and community service workers trained through the Vocational Education Training (VET) system. These key principles have been generated from concepts and practices discussed in current documents (see References).

The principles are expressed by outlining the key principles and including some examples of practices that support the principles that are relevant to the Community Services and Health workforce.

Principle 1: Client-centred practice The concept of client-centred practice is now well established in the delivery of health and community services and there is an increasing recognition of the need to work in collaboration with clients and their families. Client-centred practice requires working with clients with respect, to build on their strengths and build resilience and behaviours that support the self management of chronic disease. In order to achieve successful chronic disease self management, support and care must be centred on the unique needs, characteristics and circumstances of the client. Practices that support client-centred practice include (but not limited to) the need to:

1. Work within the client’s context (including, motivation, beliefs and values, language);

2. Work within the client’s access constraints (including financial, travel, cultural);

3. Work according to informed client choices and preferences;4. Work according to client’s pace and timing requirements; and5. Work with regard for the client’s pain, suffering and impact of condition on life

circumstances.

Principle 2: Holistic practiceChronic disease self management requires support and care across a range of issues other than clinical treatment. The application of this principle requires information and support across all aspects of the client’s life that could have an impact on the management of a chronic disease, including (but not limited to) the need to:

1. Provide direct support for positive lifestyle (including information, kits, education and support services)

2. Provide indirect support for positive lifestyle (including, preparation of food, policy, staff development);

3. Support appropriate client coping skills and behaviour; and4. Support family and other networks capacity to support client.

Principle 3: Accurate, comprehensible, timely and appropriate information Successful self management of chronic disease is reliant on the client being an active partner in the management of chronic disease. Accurate, comprehensive, timely and appropriate information is essential for active participation. Some applications of this principle include the client (but not limited to) the need to:

1. Support client understanding of the nature of the condition; and2. Support client understanding of treatment, care and behavioural responses to

the condition.


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Principle 4: Partnership and participationClient partnership and participation underpins the self management of chronic disease. This occurs through care planning and monitoring, decision making and problem solving. The application of the partnership and participation principle requires collaboration with the client as an equal (at the very minimum) partner with health and community workers in the management of chronic disease. Practices that support partnership and participation include (but not limited to) the need to:

1. Support client to actively participate in planning and monitoring;2. Support client decision making and problem solving; and3. Support client self management practices and priorities.

Principle 5: Strengths-basedTraditional health and community service provision has focused on “doing for” rather than “doing with”. Many health and community services are designed around addressing the gaps between a person’s current health status or life functioning, and what is required for either wellness or life function. Working within a strengths based perspective requires the identification and building on coping skills, competencies and positive aspects of the client in order to facilitate the knowledge and skills required to self manage chronic disease. Practices that support this principle include (but not limited to) the need to:

1. Support client to identify and mobilise strengths;2. Support client in solution focused self management strategies;3. Provide feedback to client to validate decisions and actions; and4. Provide information and support to clients to access and use compensatory

equipment, aides and procedures.

Principle 6: Coordination of supportPeople with chronic diseases may be required to negotiate a complex service system, and wherever possible and within the client’s context, assistance and support with coordination or integration of services on a local level, and in a culturally sensitive manner is a priority to the facilitation of the capacity to self manage chronic disease. Supporting practices include (but not limited to) the need to:

1. Support contact and use of appropriate service and resources;;2. Provide information to appropriate personnel about variations to client well

being; and3. Utilise information technology to effectively communicate with client and other

services as appropriate.


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3. Framework for analysis of CDSM principles in Training Packages

The Framework used for identifying chronic disease self management principles in Training Packages consists of two stages:

1. Prioritising qualifications and work roles to determine the level of impact these have in a chronic disease self management context;

2. Identifying which chronic disease self management principles are included in qualifications and units of competency and recommending amendments where gaps exist.

The results of the analysis are then collated in companion documents for both the Health Training Package and Community Services Training Package which show how the principles of chronic disease self management are included in individual units of competency and qualifications.

Stage One

The CDSM Project is initially required to determine and/or verify which health and community service workers trained through the Vocational Education Training (VET) system have a significant level of contact with people with a chronic disease as part of their work, their role in relation to chronic disease self management (CDSM) and relevant VET qualifications.16 Listings of qualifications covered in the Community Services Training Package (CHC02) and the Health Training Package (HLT07) and relevant job roles appear in Appendix 2 and Appendix 3.

Stage One includes three steps to:

1. Determine the nature of client contact;2. Identify possible job functions across the continuum of chronic disease care; and 3. Identify possible impact of job functions on client CDSM activity

Step 1 – Determine the nature of client contact

Key to this action is an analysis and definition of the concept of significant level of contact, in the context of worker roles in relation to CDSM. At its most basic application significant level of contact could be defined by:

Whether the contact is one-off or on-going e.g. an ambulance paramedic would most likely have one-off client contact whilst an Aged Care worker will have an on-going client contact;

The context of the job function e.g. an enrolled nurse in an acute setting may have contact over a defined and specific hospital stay, whilst an enrolled nurse in an Aged Care setting will have on-going contact; and/or

The amount of contact in a continuum of care context e.g. from diagnosis to end of life care.

16 Department of Health and Ageing (2006), Chronic Disease Self Management Project Brief. Canberra, Australia.


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Factors that influence the significance of client contact can be illustrated as follows:

In addition, a worker may have minimal or no contact with a client but may have the potential to have significant impact on a client’s CDSM activities.

For example, a Practice Manager might have no direct client contact but has many job functions that have the potential to have a significant impact on a client’s CDSM activities. These include appointment scheduling and management, information management and staff management.

Similarly, a telephone counsellor might provide a one-off, minimal contact service, but the provision of appropriate referral – in a manner that is likely to be taken up by the client – has the potential to have a significant impact on client CDSM activities.

As job roles with minimal or no direct contact still have the potential to have significant impact on CDSM, the analysis considers the impact on CDSM, of which client contact is a component.

For the purpose of the analysis, the nature of client contact is described:

As direct, minimal, indirect or no direct contact As one-off, short term/intermittent or on-going; Within possible different occupational contexts.


One-off versus on-going contact

Context of job function

Contribution to continuum of

care

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Clientcontact

Example

HLT43407 Certificate IV in Nursing (Enrolled/Division 2 Nursing)This qualification covers the application of nursing skills and knowledge required to be eligible for enrolment* with some State/Territory nursing and midwifery regulatory authorities (*or registration as a Division 2 Nurse in Victoria).

This worker has direct client contact that can be short term/intermittent or on-going depending on the occupational context. Different occupational contexts include working in acute care, working in Aged Care, working in a large general practice or working in community care.

Step 2 - Identify possible job functions across the continuum of chronic disease care

In order to identify the contribution of client contact to the continuum of chronic disease care, job functions relevant to chronic disease self management will be identified against the continuum of chronic disease care.

The continuum of chronic disease care has been taken from the National Chronic Disease Strategy.17 The table below provides a working definition of each stage in the continuum of chronic disease care.

Continuum of chronic disease care Working definitionHealth promotion Any job function that promotes good health

and well being. This could be at an individual level, group level or community level. For example, a Practice Manager could organise group sessions on healthy diet. A Community Development Worker might conduct surveys of community health concerns as a basis for educational programs.

Prevention Any job that prevents chronic disease. For example, a youth worker might provide services in a smoke free zone, an Allied Health Assistant might provide information on healthy diet.

Assessment Any job function that contributes to the assessment of a chronic disease. For example, a Community Care Worker might identify indicators of a chronic disease and refer the information to their supervisor.

Multidisciplinary care planning and review Any job function that contributes to care planning and review for people with a chronic disease. For example, a Disability Support Officer might ensure that all information pertinent to possible self management of a client’s diabetes is available at planning meetings. An advocate might attend a planning meeting with a client.

Evidence based clinical management Any job function that constitutes direct clinical management of a chronic disease (based on clinical evidence and good practice). For example, an Enrolled nurse.might assist a person adhere to a medication regime.

17 National Health Priority Action Council (NHPAC) (2006). National Chronic Disease Strategy. Australian Government Department of Health and Ageing, Canberra.


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Continuum of chronic disease care Working definitionCare co-ordination Any job function that supports the co-

ordination of all services (formal and informal) the client requires. For example, a HACC Co-ordinator might ensure that transport is available for a community-based older person with a heart problem to get to the full range of services and activities that support management of the disease and a positive lifestyle.

Rehabilitation Any job function that supports rehabilitation following treatment for a chronic disease. For example, a Practice Manager might set up a local support group for people dealing with the impact of chemotherapy.

On-going monitoring Any job function that involves monitoring the status/progress of a client. For example, an Aboriginal Health Worker might monitor a client’s health status, and also lifestyle requirements to manage a chronic disease.

End of life Any job function that supports clients at the final stages of a chronic disease. For example, an Aboriginal Health Worker could support family by providing information and support. An Aged Care Worker could support an older person in a residential setting.

The table below outlines possible job functions against the chronic disease care continuum for a Certificate IV Allied Health Assistant.

Continuum of chronic disease care Possible job functionsHealth promotion Provision of information to individuals and

groups.Prevention Provision of information to individuals and

groups.Assessment Provision of information about concerns

about a client to supervising professional.Multidisciplinary care planning and review Participate, where appropriate, in

planning.Support client to identify strengths.Support client to be solution focused.Provide feedback to client.

Evidence-based clinical management Conduct programs as directed.Care co-ordination Recognise and pass on information about

variation in client wellbeing.


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Continuum of chronic disease care Possible job functionsRehabilitation Implement program, as directed.

Recognise and pass on information about variation in client wellbeing.Support client to identify strengths.Support client to be solution focused.Provide feedback to client.

On-going monitoring Support client to self monitor.End of life care Implement program, as directed.

Recognise and pass on information about variation in client wellbeing.

At this stage of the analysis the:

nature of client contact has been determined; and job functions that could occur across the chronic care disease continuum have

been identified.

Step 3 - Identify possible impact of job functions on client CDSM activity

Stage One

In order to determine if these possible job functions have an impact on CDSM, the job functions are considered against the self management activities of people with chronic disease. The Chronic Condition Self-Management Guidelines: Summary for nurses and allied health professionals18 describes four client chronic disease self management activities. These four major areas of activity describe the client behaviour that supports chronic disease self management across a range of settings and contexts, and provide an indicator of the potential impact of job functions on chronic disease self management. The four client activities are:

A. protecting and promoting health;B. monitoring and managing symptoms and signs of illness;C. managing the impacts of illness on functioning, emotions and interpersonal

relationships; andD. adhering to treatment regimes.

For purposes of the analysis these activities have been referred to as A, B, C and D.

CDSM client activity ReferenceProtecting and promoting health AMonitoring and managing symptoms and signs of illness BManaging the impacts of illness on functioning, emotions and interpersonal relationships

C

Adhering to treatment regimes D

18 The Royal College of General Practioners(2006). Chronic condition self management guidelines: Summary for nurses

and allied health professionals. Australia.


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The table below contains an example of the impact job function for Certificate IV in Allied Health Assistance might have on client chronic disease self management activities.

Continuum of chronic disease care

Possible job function Client activity

Health promotion Provision of information to individuals and groups.

A

Prevention Provision of information to individuals and groups.

A

Assessment Provision of information about concerns about a client to supervising professional.

B

Multidisciplinary care planning and review

Participate where appropriate in planning.Support client to identify strengths.Support client to be solution focused.Provide feedback to client.

A, B, C, D

Evidence based clinical management

Conduct programs as directed. A, B, C, D

Care co-ordination Recognise and pass on information about variation in client wellbeing.

A, B, C, D

Rehabilitation Implement program, as directed.Recognise and pass on information about variation in client wellbeing.Support client to identify strengths.Support client to be solution focused.Provide feedback to client.

A, B, C, D

On-going monitoring Support client to self monitor. A, B, C, DEnd of life care Implement program, as directed.

Recognise and pass on information about variation in client wellbeing.

B, C, D

This step in the analysis of CDSM is considered an essential identification of the link between a job function and its likely impact on client CDSM behaviour.

The Allied Health Assistant example highlights how some job functions can have impact on one type of client activity, whilst other job functions have a potential impact across all four client CDSM activities.


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CDSM Impact Statement The following diagram illustrates the first three steps of CDSM analysis. These three steps inform the CDSM Impact Statement.

The CDSM Impact Statement contains the findings from these three steps of the analysis. In summary:

A qualification is considered to have a significant impact on CDSM where possible worker functions are: identified across five or more stages of the continuum of chronic disease care; and have potential influence on three or more client CDSM activities

A qualification is considered to have a no significant impact on CDSM where possible worker functions are: identified across four or less stages of the continuum of chronic disease care; and have potential influence on two or less client CDSM activities

A qualification is considered to have a narrow impact on CDSM where possible worker functions are: identified across four or less stages of the continuum of chronic disease care; and have potential influence on three or more client CDSM activities


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Determine the nature of client contact

Identify possible job functions across the continuum of

chronic disease care

Identify possible impact of job functions on client CDSM

activity

Clearly, the Allied Health Assistant has the potential to have a significant impact on CDSM. Other workers might have an impact but in a narrow range across the continuum of chronic disease care, e.g. a Rehabilitation Technician has no client contact, and has possible job functions at only one point of the continuum of chronic disease care (Rehabilitation) that influences one aspect of client CDSM activity (Managing the impacts of illness on functioning, emotions and interpersonal relationships).


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Example:

HLT 42507 Certificate IV in Allied Health AssistanceThis qualification covers workers who provide therapeutic and program related support to allied health professionals. The worker is required to conduct therapeutic and program related activities under the guidance of an allied health professional. Supervision may be direct, indirect or remote and must occur within organisation requirements. The worker is required to identify client circumstances that need additional input from the allied health professional. Occupational titles for these workers may include:

Therapy assistant Podiatry assistant

Physiotherapy assistant Speech pathology assistant

Occupational therapy assistant Allied health assistant

Nutrition assistant Dietetic assistant CDSM IMPACT STATEMENTThis worker has direct client contact that can be short term /intermittent or on-going depending on the occupational context. Different occupational contexts include working in a hospital setting, working in aged care or working in community care. This worker has possible job functions across all stages in the continuum of chronic disease care. These job functions affect all aspects of client CDSM activities. This qualification has a significant impact on CDSM.

Example:

HLT43607 Certificate IV in Rehabilitation and Assistive TechnologyThis qualification covers the skills and knowledge required by workers who undertake the design, construction and modification of specialized seating and associated equipment for people with disabilities based on multi-disciplinary assessment. Occupational titles for these workers include:

Rehabilitation technician Rehabilitation engineering technician

Assistive technology technicians Seating technician

CDSM IMPACT STATEMENTThis worker has no direct client contact. This worker has job functions at one stage of the continuum of chronic disease care and impact on one aspect of client CDSM activity. This qualification has a narrow impact on CDSM.

Stage Two

The CDSM Project is also required to determine where the self management principles exist in the current units of competency and qualifications of the Community Services and Health Training Packages (CHC02 and HTP07); and determine opportunities where the self management principles could be enhanced and/or incorporated into existing elements, units, qualifications or teaching resources of the Training Packages.19

Stage Two of the analysis addresses these requirements.

In the case where the CDSM Impact Statement reveals that the qualification has a narrow impact on CDSM there is no further analysis. In cases where the CDSM Impact Statement reveals that the qualification has no significant impact on CDSM there is no further analysis.

Four steps are then applied once the analysis has determined that a qualification has a significant impact on CDSM.

1. Compulsory and mandatory units of competency that address the job functions are identified;

2. These units of competency are analysed to identify how well they address the CDSM principles, as outlined in the table below;

3. Gaps in how the units address the CDSM principles are identified; and4. Strategies are identified to address the gaps/or improve coverage of CDSM

principles.

CDSM Principles and Practices

CDSM Principle Practices that support CDSM principlesClient-centred practice, including:

1. Work within the clients context (including, motivation, beliefs and values, language)2. Work within the client’s access constraints (including, financial, travel, cultural)3. Work according to informed client choices and preferences4. Work according to client’s pace and timing requirements5. Work with regard for client’s pain, suffering and impact of chronic disease on life circumstances

19 Department of Health and Ageing (2006), Chronic Disease Self Management Project Brief. Canberra, Australia


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In cases where the CDSM Impact Statement reveals a significant impact on CDSM there is further analysis. Significant impact on CDSM occurs when job functions appear over a range of stages in the continuum of chronic disease care, and have an impact on more than one client CDSM activity.

Holistic practice, including:

1. Provide direct support for positive lifestyle (including, information, kits, education and support services)2. Provide indirect support for positive lifestyle (including, preparation of food, policy, staff development)3. Support appropriate client coping skills and behaviour4. Support family other networks capacity to support client

Provision of information, including

1. Support client understanding of the nature of the condition2. Support client understanding of treatment, care and behavioural responses to the condition

Partnership and participation, including

1. Support client to actively participate in the planning and monitoring 2. Support client decision making and problem solving skills3. Support client self management practices and priorities

Strength based practice, including:

1. Support client to identify and mobilise strengths2. Support client in solution focused self management strategies 3. Provide feedback to clients to validate decisions and actions4. Provide information and support to clients to access and use compensatory equipment, aides and procedures

Coordinated support, including:

1. Supporting contact and use of appropriate services and resources to support the client2. Providing information to appropriate personnel about variations to client well being3. Utilising information technology to effectively communicate with client and appropriate other services

An example of this analysis is contained in Appendix 4.


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Summary of the framework for CDSM analysis


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2. Identify possible job functions across the

continuum of chronic disease

care

3. Identify possible impact of job

functions on client CDSM activity

1. Determine the nature of client

contact

CDSM IMPACT STATEMENT

1. Determine the competency units that address job

functions

2. Identify competency unit address of the CDSM

principles

3. Identify gaps in competency unit address of

CDSM principles

4. Identify strategies to address identified gaps/or

improve coverage of CDSM

STAGE 1

STAGE 2

4 Outcomes and recommendations of CDSM analysis

In the Health Training Package fourteen (14) qualifications were identified as having a significant impact on chronic disease self management.

Direct Client Care Work

Aboriginal and/or Torres Strait Islander Health WorkCode TitleHLT21306 Certificate II in Aboriginal and/or Torres Strait Islander Primary

Health CareHLT33206 Certificate III in Aboriginal and/or Torres Strait Islander Primary

Health CareHLT43906 Certificate IV in Aboriginal and/or Torres Strait Islander Primary

Health Care (Practice)HLT44006 Certificate IV in Aboriginal and/or Torres Strait Islander Primary

Health Care (Community Care)HLT52106 Diploma of Aboriginal and/or Torres Strait Islander Primary Health

Care (Practice)

Allied Health AssistingCode TitleHLT32407 Certificate III in Allied Health AssistanceHLT42506 Certificate IV in Allied Health Assistance

Complementary and Alternative HealthCode TitleHLT42706 Certificate IV in AromatherapyHLT51406 Diploma of AromatherapyHLT60906 Advance Diploma of Aromatic Medicine

Enrolled nursingCode TitleHLT43406 Certificate IV in Nursing (Enrolled/Division 2 nursing)HLT51606 Diploma of Nursing (Enrolled/Division 2 nursing)HLT61106 Advanced Diploma of Nursing (Enrolled/Division 2 nursing)

General business operationsCode TitleHLT52007 Diploma of Practice Management


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In the Community Services Training Package twenty nine qualifications were identified as having a significant impact on chronic disease self management.

Community Services Work – GeneralCode TitleCHC30802 Certificate III in Community Services WorkCHC40902 Certificate IV in Community Services WorkCHC50702 Diploma of Community Welfare WorkCHC60302 Advanced Diploma of Community Services Work

ManagementCode TitleCHC42002 Certificate IV in Community Services (Service Coordination)CHC51602 Diploma of Community Services ManagementCHC60402 Advanced Diploma of Community Services Management

Community Services Work – Specialist

Aged Care and Disability WorkCode TitleCHC30102 Certificate III in Aged Care WorkCHC30202 Certificate III in Home and Community CareCHC30302 Certificate III in Disability WorkCHC40202 Certificate IV in Service Co-ordination (Ageing and Disability)CHC40102 Certificate IV in Aged Care WorkCHC40302 Certificate IV in Disability WorkCHC50102 Diploma of Disability WorkCHC60102 Advanced Diploma of Disability Work

Child ProtectionCode TitleCHC41802 Certificate IV in Community Services (Protective Services)CHC51202 Diploma of Community Services (Protective Intervention)CHC51302 Diploma of Statutory Child Protections

Youth Work and Juvenile JusticeCode TitleCHC30602 Certificate III in Youth WorkCHC40602 Certificate IV in Youth WorkCHC40702 Certificate IV in Youth Work (Juvenile Justice)CHC50502 Diploma of Youth Work


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Community Services Work – Other Specialist QualificationsCode TitleCHC41702 Certificate IV in Alcohol and Other Drugs WorkCHC51102 Diploma of Alcohol and Other Drugs WorkCHC41102 Certificate IV in Mental Health Work (Non-clinical)CHC41202 Certificate IV in Community Services AdvocacyCHC41602 Certificate IV in Community Services (Lifestyle and Leisure)CHC50802 Diploma of Community Services (Lifestyle and Leisure)CHC50902 Diploma of Community Services (Case Management)


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Health Training Package Recommendations

Aboriginal and/or Torres Strait Islander Health WorkCode Title RecommendationsHLT21306 Certificate II in Aboriginal

and/or Torres Strait Islander Primary Health Care

Include Providing information to appropriate personnel about variations to client well being in HLTHIR301A Communicate and work effectively in health.

HLT33206 Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care

Develop a competency unit on Supporting clients to make decisions and use problem solving. This competency unit to include solution focus.

Develop a competency unit on Supporting client to function from a personal strength base.

HLT43906 Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)

Develop a competency unit on supporting clients to make decisions and use problem solving. This competency unit to include solution focus.

Develop a competency unit on supporting client to function from a personal strength base.

HLT44006 Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Community Care)



HLT52106 Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)



Develop a competency unit to Support groups/communities to identify and build on strengths in a community development context


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Allied Health AssistingCode Title RecommendationsHLT32407 Certificate III in Allied Health

AssistanceAdd a performance criteria to Element 1 of HLTAH301 Assist with an allied health program about providing information to support a positive lifestyle

Develop a competency unit on Supporting client to function from a personal strength base in an allied health treatment context.

HLT42506 Certificate IV in Allied Health Assistance

Include Support of chronic disease self management in appropriate range statements of competency units

Include the provision of information about supporting positive lifestyle in appropriate range statements of competency units.

Include a statement about including family and other networks (where appropriate), in client range statements of appropriate competency units.

Develop a competency unit on Supporting clients to make decisions and use problem solving

Develop a competency unit on Supporting client to function from a personal strength base


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Complementary and Alternative HealthCode Title RecommendationsHLT42706 Certificate IV in

AromatherapyInclude support of chronic disease self management in appropriate range statements of HLTARO403A Provide aromatherapy treatment.

Supporting client understanding of the nature of the condition, Supporting client understanding of treatment, care and behavioural responses to the condition are outside the scope of these workers and need not be addressed.


Develop a competency unit on Supporting clients to make decisions and use problem solving.



27

Code Title RecommendationsHLT51406 Diploma of Aromatherapy Include support of chronic disease self management in appropriate range

statements of HLTARO403A Provide aromatherapy treatment

Supporting client understanding of the nature of the condition, Supporting client understanding of treatment, care and behavioural responses to the condition to be addressed in performance criteria and range statements in HLTARO509A Plan a specialised aromatherapy treatment and HLTARO511A Provide specific aromatherapy assessment and care


Develop a competency unit on Supporting clients to make decisions and use problem solving



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Code Title RecommendationsHLT60906 Advance Diploma of

Aromatic MedicineInclude support of chronic disease self management in appropriate range statements of HLTARO403A Provide aromatherapy treatment.

Supporting client understanding of the nature of the condition, Supporting client understanding of treatment, care and behavioural responses to the condition to be addressed in performance criteria and range statements in HLTARO509A Plan a specialised aromatherapy treatment and HLTARO511A Provide specific aromatherapy assessment and care.





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Enrolled nursingCode Title RecommendationsHLT43406 Certificate IV in Nursing

(Enrolled/Division 2 nursing)Include support of Identify and support client’s appropriate coping skills, Support family and others to support the client as performance criteria in relevant units of competency. Include a statement about including family and other networks (where appropriate), in client range statements of appropriate competency units.

Develop a competency unit on Supporting client strengths in nursing care.


HLT51606 Diploma of Nursing (Enrolled/Division 2 nursing)

Include Supporting client self management practices and priorities as an element in HLTEN513A Contribute to nursing care for clients with chronic health problems.

Develop a competency unit on Supporting client strengths in nursing care.HLT61106 Advanced Diploma of

Nursing (Enrolled/Division 2 nursing)

Include Supporting clients to identify and mobilize strengths and Supporting solution focused self management as elements in CHCCM3B Develop, facilitate and monitor all aspects of case management

General business operationsHLT52007 Diploma of Practice

ManagementDevelop a competency unit on Manage a practice to facilitate client self management.


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Community Services Training Package Recommendations

Community Services Work – GeneralCode Title RecommendationsCHC30802 Certificate III in Community

Services WorkInclude statements in the range statement of CHCCS9A Provide support services to clients to include working with clients with chronic disease and working with regard for the client’s pain.

Include identifying and supporting appropriate client coping skills and behaviours in an element of CHCCS9A Provide support services to clients.




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Code Title RecommendationsCHC40902 Certificate IV in Community

Services WorkDevelop an element for CHCCS2C Deliver and develop client services that highlights involvement of client in decision making and planning.

Develop an element for CHCCS402A Respond holistically to client issues that highlights supporting client solution finding and planning.

Review CHCCS402A Respond holistically to client issues to include provision of information, discussion of options and consequences of action and involving family in action plan.

In CHCCS2C Deliver and develop client services add a range statement of possible service and include a range of positive lifestyle service options.

Develop a competency unit on Supporting people with chronic disease in the community.

Develop a competency unit on Supporting clients to make decisions and use problem solvingDevelop a competency unit on Supporting client to function from a personal strength base.

CHC50702 Diploma of Community Welfare Work

Develop a element of developing and supporting self management in CHCCM3B Develop, facilitate and monitor all aspects of case management.

Develop a competency unit on Supporting people with chronic disease in the community.




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Code Title RecommendationsCHC60302 Advanced Diploma of

Community Services WorkDevelop a set of competency units that focus on working with clients with complex (and maybe urgent) needs on decision making, problem solving, self management and working with strengths

ManagementCode Title RecommendationsCHC42002 Certificate IV in Community

Services (Service Coordination)

Develop a competency unit that has a focus on considering the needs of clients with chronic diseases in service co-ordination.

CHC51602 Diploma of Community Services Management

Develop additional elements for CHCORG23B Co-ordinate work to include managing/coordinating service practices that promote positive lifestyle, client-centred, holistic and strength based practices

CHC60402 Advanced Diploma of Community Services Management

Develop additional elements for CHCCS4C Manage the delivery of quality client services to include managing/coordinating service practices that promote positive lifestyle, client-centred, holistic and strength based practices


Aged Care and Disability WorkCode Title RecommendationsCHC30102 Certificate III in Aged Care

WorkInclude Supporting the client to self manage health conditions as an element in CHCAC1C Provide support to an older person.

Include Identifying and supporting client coping skills and behaviours as an element in CHCAC1C Provide support to an older person.

CHC30202 Certificate III in Home and Community Care

Develop a competency unit on Supporting the client to self manage life and health conditions in a home setting (within this job scope).

CHC30302 Certificate III in Disability Work

Develop a competency unit on Providing support to optimise self management of life and health conditions in a home setting (within this job scope)

Develop a competency unit on Providing support to optimise self management of life and health conditions in a recreation setting (within this job scope)


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Code Title RecommendationsCHC40202 Certificate IV in Service Co-

ordination (Ageing and Disability)

Develop a competency unit that has a focus on Considering the needs of clients with chronic diseases in service co-ordination.

CHC40102 Certificate IV in Aged Care Work

Develop a competency unit on Supporting older people with chronic health conditions(within this job scope)

CHC40302 Certificate IV in Disability Work

Develop a competency unit on Providing support to optimise self management of life and health conditions in a home setting (within this job scope).

Develop a competency unit on Facilitating environments that foster a positive lifestyle.



CHC50102 Diploma of Disability Work Develop a competency unit on Providing support to optimise self management of life and health conditions in a home setting (within this job scope).


Include supporting family and other networks as an element in CHCCM3B Develop, facilitate and monitor all aspects of case management.




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Code Title RecommendationsCHC60102 Advanced Diploma of

Disability WorkDevelop a competency unit on Providing support to optimise self management of life and health conditions in a home setting (within this job scope).


Develop a set of competency units that focus on working with clients with complex (and maybe urgent) needs on decision making, problem solving, self management and working with strengths

Child ProtectionCode Title RecommendationsCHC41802 Certificate IV in Community

Services (Protective Services)

Include an element about Address health and health related requirements of child/young person in CHCPROT9C Provide primary/residential care

CHC51202 Diploma of Community Services (Protective Intervention)

Develop a unit of competency that addresses Supporting children/young people to make informed choices from a personal strength base

CHC51302 Diploma of Statutory Child Protections

Develop a unit of competency that addresses Supporting children/young people to make informed choices from a personal strength base

Youth Work and Juvenile JusticeCode Title RecommendationsCHC30602 Certificate III in Youth Work Develop a competency unit on Supporting youth with chronic health conditions.

Develop a competency unit on Supporting youth lifestyle to prevent chronic disease.

Include CHCYTH5C Support youth programs as a compulsory unit.


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Code Title RecommendationsCHC40602 Certificate IV in Youth Work Develop a competency unit on Supporting youth with chronic health conditions.


Include CHCYTH5C Support youth programs as a compulsory unit.CHC40702 Certificate IV in Youth Work

(Juvenile Justice)Develop a competency unit on Supporting youth with chronic health conditions.


CHC50502 Diploma of Youth Work Develop a competency unit on Supporting youth with chronic health conditions

Develop a competency unit on Supporting youth lifestyle to prevent chronic disease

Community Services Work – Other Specialist QualificationsCode Title RecommendationsCHC41702 Certificate IV in Alcohol and

Other Drugs WorkInclude an element on Identifying the links between AOD use and chronic disease in CHCAOD2C Orientation to alcohol and other drugs work.

Develop a competency unit on Supporting the alcohol and other drug user to manage chronic disease.

CHC51102 Diploma of Alcohol and Other Drugs Work

Include an element on Identifying the links between AOD use and chronic disease in CHCAOD2C Orientation to alcohol and other drugs work.

Develop a competency unit on Supporting the alcohol and other drug user to manage chronic disease.

CHC41102 Certificate IV in Mental Health Work (Non-clinical)

Develop a competency unit on Supporting a person with mental health issues to manage chronic disease



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Code Title RecommendationsCHC41202 Certificate IV in Community

Services AdvocacyDevelop a competency unit on Supporting client to function from a personal strength base


CHC41602 Certificate IV in Community Services (Lifestyle and Leisure)

Reconfigure the competency units to reflect: client participation in decision making and planning; building on identified client strengths; and contributing to a care plan i.e. linking activities to the overall care plan.

CHC50802 Diploma of Community Services (Lifestyle and Leisure)

Reconfigure the competency units to reflect: client participation in decision making and planning; building on identified client strengths; and contributing to a care plan i.e. linking activities to the overall care plan.

CHC50902 Diploma of Community Services (Case Management)


Develop a competency unit on Supporting clients to make decisions and use problem solving. This competency unit to include solution focus


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5 Questions

Questions have been formulated to guide feedback. The two questions seek feedback on the accuracy and thoroughness of the analysis of the CDSM principles.

Question 1 – Health and community services workers with contact with people with chronic disease.

Current literature clearly identifies and provides guidance for the roles of professional (degree qualified) workers who have contact with people with chronic diseases. The purpose of this question is to.

identify the health and community service workers trained through the Vocational Education Training (VET) system who have a level of contact with people with chronic disease as part of their job role; and

explore their role in relation to chronic disease self management.

Question 1A: Who are the health and community service workers trained through the Vocational Education Training (VET) system that have a significant impact on with people with chronic disease?

Question 1B: What level of client contact do these workers have in relation to supporting self management of chronic disease? Has the analysis correctly defined the nature of client contact?

Question 1C What level of impact do these workers have in relation to supporting self management of chronic disease? Has the analysis correctly defined the CDSM impact?

Question 2 – Addressing Chronic Disease Self Management in qualifications and competencies

The purpose of this question is to explore how well the current competency units and qualifications of the Community Services and Health Training Packages (CHC02 and HLT07) incorporate chronic disease self management. See Appendix 5 for an example of this process.

The ISC seeks input from employers, unions, peak industry bodies, professional bodies and regulatory bodies to identify strengths and weaknesses of the capacity of current qualifications to meet the competencies required to support chronic disease self management. As job roles are constantly being redefined in the workplace, respondents may wish to consider new or emerging roles or skill sets that are not currently covered by the CHC02 or HLT07 Training Packages.


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Question 2A: Which Community Services and Health Training Packages (CHC02 and HLT07) qualifications should address chronic disease self management (CDSM)? Has the analysis correctly identified these qualifications?

Question 2B: How well do the required competency units address CDSM in these qualifications? Has the analysis correctly identified the address of CDSM?

Question 2C: Where the required competencies do not adequately address CDSM what possible action would provide the best result for industry (e.g. additional units of competency, additional element)?


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Appendix 1 Project timelines

Key stages of stakeholder participation

The key stages of the CDSM project are presented in the diagram below.

Industry stakeholders are invited to comment on the draft Scoping Report

Date Key Stages Stakeholder activities

December 06 Project Start up IRG establishment Develop draft Discussion Paper IRG meeting Thurs 14 December 2006 IRG advice regarding Discussion Paper and

development of Scoping Report

January 07 Draft Scoping Report development

ISC staff and consultant develop draft Scoping Report

Updated on project the ISC newsletter promoting upcoming release of the Scoping Report and validation sessions.

February/March 07

Draft Scoping Report distributed to IRG

IRG meeting to consider draft Scoping Report IRG meeting to revise Scoping Report

April 07 Scoping Report distributed to industry for validation

Scoping report distributed to industry Validation session promoted for late April

(including at least 1 month lead time) Documents hosted on ISC webpage

http://www.cshisc.com.au/load_page.asp?ID=221 April/May 07 National Validation

sessions National validation sessions Invitations/EOI issued early April and registration

collated via webpageMay 07 Final Report Data collated and presented in a final report

IRG convened to provide feedback/sign off for final report


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http://www.cshisc.com.au/load_page.asp?ID=221

Appendix 2 Health Training Package HLT07 qualifications

The Health Training Package HLT07 was endorsed in February 2007. The qualifications in Health Training Package HLT07 are grouped under the major sub-headings “Direct Client Care Work”, “Technical Support Work”, “Ancillary and Business Services Work’ and “Public Health Work”.

DIRECT CLIENT CARE WORK

Aboriginal and/or Torres Strait Islander Health WorkQualification Title Job roles Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care

Aboriginal Health Worker, Torres Strait Islander Health Worker

Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care


Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)


Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Community Care)


Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)


Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Community Care)


Advanced Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)


Advanced Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Community Care)


Allied Health AssistingQualification Title Job rolesCertificate III in Allied Health Assistance Therapy Assistant, Physiotherapy

Assistant, Occupational Therapy Assistant, Podiatry Assistant, Speech Pathology Assistant, Allied Health Assistant

Certificate IV in Allied Health Assistance Therapy Assistant, Physiotherapy Assistant, Occupational Therapy Assistant, Podiatry Assistant, Speech Pathology Assistant, Allied Health Assistant, Dietitian Assistant


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AmbulanceQualification Title Job rolesCertificate II in Emergency Medical Service First ResponseCertificate III in Basic Health CareCertificate III in Non-Emergency Client Transport

Ambulance transport officer, Patient transport officer, Patient transport attendant

Certificate III in Ambulance Communications (Call-taking)Certificate IV in Ambulance CommunicationCertificate IV in Health Care (Ambulance) Volunteer ambulance officer, Community

ambulance officer, Ambulance attendant, Honorary ambulance officer, Casual ambulance officer, Emergency patient transport officer

Diploma of Paramedical Science (Ambulance)

Ambulance officer, Ambulance paramedic, Ambulance transport attendant

Advance Diploma of Paramedical Science (Ambulance)

Intensive care paramedic, Mobile intensive care ambulance paramedic

Anaesthetic technologyQualification Title Job rolesCertificate IV in Anaesthetic technology Anaesthetic or anaesthesia technician,

Anaesthetic assistant, Anaesthetic paramedical officer

Diploma of Paramedical Science (Anaesthetic)

Anaesthetic or anaesthesia technician, Anaesthetic paramedical officer

AudiometryQualification title Job rolesCertificate IV in Audiometric Assessment Audiometrist, Hearing aid audiometristDiploma of Hearing Aid Dispensing Audiometrist, Hearing aid audiometrist

Complementary and Alternative HealthQualification title Job rolesCertificate IV in Aromatherapy AromatherapistDiploma of Aromatherapy Aromatherapist, Clinical aromatherapistAdvance Diploma of Aromatic Medicine Arometic medicine practitionerCertificate IV in Ayurvedic Lifestyle Consultation

Ayurvedic lifestyle consultant, Ayurvedic assistant

Advance Diploma of Ayurveda Ayurvedic practitioner, Ayurvedic therapist

Advance Diploma of Homeopathy Homeopath, Homeopathic practitionerCertificate IV in Kinesiology Kinesiology practitioner, Natural therapistDiploma of Kinesiology Kinesiologist, Specialist kinesiology

practitionerCertificate IV in Massage Therapy Practice Massage therapist, Massage therapy


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practitioner, Assistant massage therapistDiploma of Remedial Massage Remedial massage practitioner,

Remedial massage therapist, Remedial therapists

Advance Diploma of Naturopathy Naturopath, Naturopathic practitioner, Natural medicine practitioner

Advance Diploma of Nutritional Medicine Natural medicine practitioner, Natural therapist

Diploma of Reflexology ReflexologistDiploma of Shiatsu and Oriental Therapies Shiatsu therapist, Shiatsu practitionerDiploma of Traditional Chinese Medicine Remedial Massage (An Mo Tui Na)

TCM remedial massage practitioner, TCM remedial massage therapist, Chinese remedial massage practitioner, Tui Na practitioner

Advance Diploma of Western Herbal Medicine

Botanical medical practitioner, Phytotherapist, Herbalist, Western herbal medical practitioner

Dental workQualification Title Job rolesCertificate III in Dental Assisting Dental assistantCertificate IV in Dental Assisting Dental assistantAdvanced Diploma of Dental Prosthetics Dental prosthetist

Enrolled nursingQualification Title Job rolesCertificate IV in Nursing (Enrolled/Division 2 nursing)

Enrolled Nurse, Division Two Registered Nurse

Diploma of Nursing (Enrolled/Division 2 nursing)


Advanced Diploma of Nursing (Enrolled/Division 2 nursing)


Health service assistanceQualification Title Job rolesCertificate III in Health Service Assistance Ward assistant, Theatre assistant,

Orderly, Wardsperson, Patient support assistant, Personal care assistant

Certificate IV in Operating Theatre Technical Support

Senior theatre technician, Senior theatre wardsperson

Medical assistingQualification Title Job rolesCertificate IV in Defence Health Care Medical assistant, Health care providerCertificate IV in Medical Practice Assisting Medical assistant


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Neurophysiology technologyQualification Titles Job rolesCertificate IV in Neurophysiology Technology

Neurophysiology technician, Neurophysiology technologist

Advanced Diploma of Neurophysiology Technology

Neurophysiology technician, Neurophysiology technologist

Nutrition/dietetic assistanceQualification Title Job rolesCertificate III in Nutrition and Dietetic Support

Diet aide, Nutrition assistant, Meal coordinator

Optical dispensingQualification Title Job rolesCertificate IV in Optical Dispensing Optical dispenser, Optical technician

(NZ)

PathologyQualification Title Job rolesCertificate III in Pathology Specimen collection officer, Pathology

assistant, Laboratory aide, Pathology collector

Certificate IV in Pathology Experienced specimen collector, Specialist specimen collector, Advanced testing and collection officer

TECHNICAL SUPPORT WORK

Cardiac technologyQualification Title Job rolesCertificate IV in Cardiac Technology Cardiac technician, Cardiac technologist

Cast technologyQualification title Job rolesCertificate IV in Cast technology Cast technician, Plaster orderly

Dental technologyQualification Titles Job rolesCertificate III in Dental Laboratory Technology

Dental laboratory assistant

Diploma of Dental Technology Dental technician


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Hyperbaric technologyQualification Titles Job rolesCertificate IV in Hyperbaric Technology Hyperbaric technician, Hyperbaric

technical officerDiploma in Hyperbaric Technology Technical facilities manager, Senior

hyperbaric technical officer, Hyperbaric technical officer grade two

Mortuary assisting/technologyQualification Titles Job rolesCertificate III in Mortuary Theatre Practice Mortuary technician, Mortuary assistant,

Post mortem assistant, mortuary attendant

Certificate IV in Mortuary Theatre Practice Mortuary technician, Mortuary assistant, Post mortem assistant, mortuary attendant

Diploma of Mortuary Theatre Practice Senior mortuary assistant, senior mortuary assistant

Optical technologyQualification Title Job rolesCertificate IV in Optical Technology Optical mechanic, Optical technician

Pharmacy supportQualification Titles Job rolesCertificate III in Hospital/Health Services Pharmacy Support

Pharmacy technician, Pharmacy assistant, Dispensing technician, Distribution technician

Certificate IV in Hospital/Health Services Pharmacy Support

Pharmacy technician, Senior pharmacy technician

Prosthetic/orthotic technologyQualification Titles Job rolesCertificate III in Prosthetic/Orthotic Technology

Rehabilitation and Assistive TechnologyQualification Titles Job rolesCertificate IV in Rehabilitation and Assistive Technology

Rehabilitation technician, Assistive technology technician, Seating technician

Sleep technologyQualification Titles Job rolesCertificate IV in Sleep technology Sleep technicianDiploma of Sleep Technology Sleep technician


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Sterilisation servicesQualification Titles Job rolesCertificate III in Sterilisation Services Sterilising assistant, Sterilising aideCertificate IV in Sterilisation Services Sterilisation supervisor, CSSD supervisor

ANCILLARY AND BUSINESS SERVICES WORK

Ancillary servicesQualification Titles Job rolesCertificate II in Health Support Services Administration support, Assistant cook,

Cleaner, Clerk, Food services assistant,Domestic assistant, Handyperson, Grounds maintenance worker, Kitchen hand, Laundry worker, Stores assistant, Ward assistant

Certificate III in Health Support Services Cook, Laundry leading hand, Maintenance supervisor, Senior kitchen hand, Senior cleaner

General business operationsQualification Titles Job rolesCertificate III in Health Administration Administration clerk, Clinical coding

clerk, Ward clerk, Administrative workerCertificate IV in Health Administration Administration supervisor, Practice

manager, Medical records section leader, Senior clinical coder

Certificate IV in Health Supervision Supervisor, Assistant managerDiploma of Practice Management Practice manager, Business manager,

Service manager

Public Health WorkQualification Titles Job rolesCertificate II in Population HealthCertificate II in Indigenous Environmental Health

Indigenous Environmental Health Worker

Certificate III in Population Health Disease Control Officer, Assistant Project OfficerTeam Support Worker, Outreach worker, Needle & Syringe Exchange Program

Certificate III in Indigenous Environmental Health

Indigenous Environmental Health Worker

Certificate IV in Population Health Data Entry Supervisor, Registry Officer, Cancer Surveillance, Health Sponsorship Coordinator, Team Support Worker, Outreach Worker, Health Liaison Worker, Assistant Community Health Worker

Certificate IV in Indigenous Environmental Indigenous Environmental Health Worker


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HealthDiploma of Population Health Cancer Notifications Coordinator,

Immunisation Officer, Immunisation and TB Coordinator, Gay Men’s Education Support Officer, Peer Education Officer, Health Sponsorship Coordinator

Diploma of Indigenous Environmental Health Indigenous Environmental Health Worker


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Appendix 3 Community Services Training Package CHC02 qualifications

The qualifications in Community Services Training Package CHC02 are grouped under the major sub-headings “Community Services Work - General”, “Management”, “Community Services Work –Specialist” and “Community Services Work – Other Specialist Qualifications”.

Community Services Work – General

Qualification Titles Job rolesCertificate I in Work PreparationCertificate II in Community Services WorkCertificate II in Community Services (First Point of Contact)

Contact officer, Assistant community workers, Customer service staff, Administration/reception staff

Certificate III in Community Services Work Support worker, Case Worker, Assistant community worker, Youth housing support worker, Neighbourhood centre worker, Intake and referral worker (Aboriginal), Youth case worker, Indigenous youth worker, Youth worker, Juvenile justice worker, Community care worker, AOD worker

Certificate IV in Community Services Work Community Support worker, Detoxification worker, Case worker, Support worker, Welfare support worker, Family support worker, Mental health worker, Domestic violence worker, Outreach officer, Drug and alcohol worker

Diploma of Community Welfare Work Assessor, Case manager, Case coordinator, Family services coordinator, Welfare worker, Social welfare worker, Program manager, Local area coordinator

Advanced Diploma of Community Services Work

Management

Qualification Titles Job rolesCertificate IV in Community Services (Service Co-ordination)

Assistant manager, Community care worker, Residential respite officer, Program coordinator, Volunteer coordinator, Respite care coordinator, Local area coordinator (supervisor), House coordinator, Case coordinator, Unit coordinator, Unit manager


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Qualification Titles Job rolesDiploma of Community Services Management

Business manager, Employment services manager, Program manager, Service manager, Executive officer, Manager, General manager

Advanced Diploma of Community Services Management

Executive officer, Executive director, Manager (large organisation), Community service manager, Community education manager, Community development manger


Aged Care and Disability WorkQualification Titles Job rolesCertificate II in Community Services Support Work

Cleaner, Housekeeper, maintenance officer, Launderer, Home helper, Gardner, Care service employee, Handyperson

Certificate III in Aged Care Work Support worker, Carer, Personal care assistant, Home care assistant, Field officer, Personal care worker, Community care worker, Disability service officer

Certificate III in Home and Community Care

Care assistant, Carer, Driver, Food service assistant, Home maintenance officer, Personal care give, Home care worker, Disability support worker, Community care worker

Certificate III in Disability Work Support worker, Carer, Personal care assistant, Home care assistant, Personal care giver, Disability Service officer, Disability Support officer

Certificate IV in Aged Care Work Day activity worker, Support worker, Carer, Field officer, Community house worker, Community support worker, In-home respite carer, Accommodation support officer

Certificate IV in Service Co-ordination (Ageing and Disability)

(Assistant) Activities program coordinator,Assistant care coordinator, Assistant house coordinator, Assistant options coordinator, Assistant respite coordinator, Shift coordinator

Certificate IV in Disability Work Social educator, Lifestyle support officer, Employment coordinator, Disability support officer, Job coordinator, Residential care officer, Behaviour support officer

Diploma of Disability Work Assessor, Case coordinator, Case manager, Coordinator, Local area coordinator, Manager, Service/Program manager


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Qualification Titles Job rolesAdvanced Diploma of Disability Work Case manager, House supervisor, Psycho-

Social trainer, Service Coordinator, team leader, Supervisor, Unit manager

Children’s ServicesQualification Titles Job rolesCertificate III in Children’s Services Child care assistant, Family day carer,

Nanny, Out of school hours care assistantCertificate IV in Out of School Hours Care Recreation assistant, out of school hours

care supervisor, group leader, Youth worker, Play leader, Senior play leader

Diploma of Out of School Hours Care Out of school hours care coordinator, team leader, Group leader, Program leader

Diploma of Children’s Services Child care worker –qualified, Group leader, Team leader, Program leader, Service manager, Service director

Advanced Diploma of Children’s Services Service director

Child ProtectionQualification Titles Job rolesCertificate IV in Community Services (Protective Care)

Cottage parent, Residential care worker, Foster parent, Case support worker, Family support worker, Children’s support worker, Direct care worker

Diploma of Community Services (Protective Intervention)

Youth support worker, Foster care worker, Protective case worker, Senior protective case worker

Diploma of Statutory Child Protection Child protection investigation officer, Case manager, Child protection caseworker

Community DevelopmentQualification Titles Job rolesCertificate IV in Community Development Community development worker,

Community worker, Project worker, Neighbourhood centre worker

Diploma of Community Development Community development officer, Project officer, Economic development manager, Community builder, Migrant resource worker

Diploma of Community Education Family worker, Women’s support worker, Community education and health promotions officer, Gay men’s educators,Aboriginal HIV/STD education/promotions officer


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Employment ServicesQualification Titles Job rolesCertificate III in Employment Services Client services officer, Disability

employment support officer, Trainee employment consultant

Certificate IV in Employment Services Business development consultant, Disability employment support officer, Job development officer, Job matching consultant, Employment consultant

Diploma of Employment Services Program manager, Unit manager, Senior employment consultant, Intensive assistance consultant, Marketing consultant

Social HousingQualification Titles Job rolesCertificate III in Social Housing Housing assistant, Tenant administration

assistant, Administration assistant, clerical worker

Certificate IV in Social Housing Aboriginal housing worker, Community housing worker, Housing manger, Tenancy worker, Supported housing worker

Diploma of Social Housing Property housing manager (specialist), Tenancy advice manager, Senior housing manager, Team leader, Policy worker

Youth Work and Juvenile JusticeQualification Titles Job rolesCertificate III in Youth Work Youth support worker (community based),

Case worker (community based), Indigenous youth worker, Youth worker, Youth officer

Certificate IV in Youth Work Community development worker (youth), Coordinator – youth services, Coordinator – youth and family services

Certificate IV in Youth Work (Juvenile Justice)

Youth worker (juvenile justice), Senior youth officer, Juvenile justice officer

Diploma of Youth Work Senior juvenile justice officer, Senior youth worker, Senior case worker


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Community Services Work – Other Specialist Qualifications

Qualification Titles Job rolesCertificate III in Telephone Counselling Telephone counselor, Youth help line

counsellor, Alcohol and other drugs telephone counsellor, Men’s help line telephone counsellor

Certificate IV in Telephone Counselling Telephone counselor, Youth help line counsellor, Alcohol and other drugs telephone counsellor, Men’s help line telephone counsellor

Certificate IV in Mental Health Work (Non-clinical)

Case worker, Coordinator, Family support worker, Mental health worker, Indigenous mental health worker, Health education worker, Domestic violence worker

Certificate IV in Community Services Advocacy

Tenant advice and advocacy worker, Community legal officers, Information worker, Community education worker

Certificate IV in Community Mediation Family mediator, Indigenous connection worker, Mediation worker, Mediation caseworker, Counsellor

Certificate IV in Community Services (Information, Advice and Referral)

Personal advisor, Information worker

Certificate IV in Marriage Celebrancy Marriage celebrantCertificate IV in Community Services (Lifestyle and Leisure)

Leisure officer, Recreational activities officer, Diversional therapy assistant, Disability officer – day support

Certificate IV in Alcohol and Other Drugs Work

Case worker, Detoxification worker, Drug and alcohol worker, Outreach worker, Drug and alcohol counsellor

Diploma of Community Services (Case Management)

Case manager, Options coordinator

Diploma of Community Services (Financial Counselling)

Financial counsellor, Senior financial counsellor, Rural financial counsellor

Diploma of Alcohol and Other Drugs Work Alcohol and drugs worker, Alcohol and drugs counsellor


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Appendix 4 Example analysis of CDSM

HLT51607 Diploma of Nursing (Enrolled/Division 2 nursing)

This qualification covers the application of nursing skills and knowledge required to be eligible for enrolment** with state/territory nursing and midwifery regulatory authorities (**or registration as a Division 2 Nurse in Victoria).

CDSM IMPACT STATEMENTThis worker has direct client contact that can be short term /intermittent or on-going depending on the occupational context. Different occupational contexts include working in acute care, working in aged care, working in a large general practice or working in community care. This worker has possible job functions across all but three stages in the continuum of chronic disease care. These job functions affect most aspects of client CDSM activities. This qualification has a significant impact on CDSM. KEY ASPECTS of CDSM activity for these workers are:Continuum of chronic disease care

Possible job function Client activity

Units of competency

Health promotion n/a n/a n/aPrevention n/a n/a n/aAssessment Conducts basic health assessment

Collects and analyses client informationAssess wound impact on client and familyIdentifies impact of chronic health problem on client and family

B,C HLTAP401A Confirm physical health statusHLTEN503A Contribute to client assessment and developing nursing care plansHLTEN506A Apply principles of wound management in the clinical environmentHLTEN513A Contribute to nursing care for clients with chronic health problems

Multidisciplinary care planning and review

Contributes to care plans, including wound care, mental health conditions, chronic health problems, older clients

B,C HLTEN503A Contribute to client assessment and developing nursing care plansHLTEN506A Apply principles of wound management in the clinical environmentHLTEN510A Implement and monitor


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nursing care for clients with mental health conditionsHLTEN513A Contribute to nursing care for clients with chronic health problemsHLTEN515A Implement and monitor nursing care for older clients

Evidence based clinical management

Assists client with daily living skillsProvides information to clientsAssists with a range of client requirements and proceduresAssists with client movementPrepares clients for procedurePerforms nursing interventions to support clients with complex needsProvide nursing care for specific disorders/conditionsImplements wound care strategiesAdminister medicationContributes to nursing clients with mental health conditionsPerforms nursing intervention for clients with chronic health problemsProvide nursing support to older clients

B,C,D HLTEN504A Implement and evaluate a plan of nursing careHLTEN505A Contribute to the complex nursing care of clientsHLTEN506A Apply principles of wound management in the clinical environmentHLTEN507A Administer and monitor medications in the work environmentHLTEN510A Implement and monitor nursing care for clients with mental health conditionsHLTEN513A Contribute to nursing care for clients with chronic health problemsHLTEN515A Implement and monitor nursing care for older clients

Care co-ordination n/a n/a n/aRehabilitation Supports clients recovering from an acute

chronic disease experienceB,C,D HLTEN507A Administer and monitor

medications in the work environmentHLTEN513A Contribute to nursing care for clients with chronic health problemsHLTEN510A Implement and monitor nursing care for clients with mental health conditionsHLTEN515A Implement and monitor nursing care for older clients


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On-going monitoring Monitors wound managementMonitor medication impact

B,C,D HLTEN506A Apply principles of wound management in the clinical environmentHLTEN507A Administer and monitor medications in the work environment

End of life care Provide care of deceased person B,C,D HLTEN515A Implement and monitor nursing care for older clients


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Coverage of CDSM Principles in the competency units

The table shows the coverage of aspects of CDSM in the relevant competency units for the qualification, which are listed in the left hand column.

CDSM practices highlighted in blue indicate that they are addressed by the particular competency unit. CDSM practices with no highlight are not addressed by the compulsory competency unit – and therefore must be addressed

somewhere else. The Qualification Summary outlines any gaps found in coverage of CDSM by this qualification and how these gaps will be

addressed.

Compulsory Competency Units

Client-centred Holistic practice

Information Partnership &Participation

Strength-based

Support Coordination

HLTAP401A Confirm physical health status

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN501A Analayse health information

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN503A Contribute to client assessment and developing nursing care plans

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN504A Implement and evaluate basic nursing care

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN505A Contribute to the complex nursing care of clients

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN506A Apply principles of wound management in the clinical environment

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN507A Administer and monitor medications

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3


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in the work environmentHLTEN510A Implement and monitor nursing care to consumers with mental health issues

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN513A Contribute to nursing care for clients with chronic health problems

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN515A Implement and monitor nursing care to older clients

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN512A Contribute to nursing care for clients with acute health problems

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

HLTEN413A Promotes positive health outcomes

1,2,3,4,5 1,2,3,4 1,2 1,2,3 1,2,3,4 1,2,3

Qualification summary Client-centred Holistic practice

Information Partnership &Participation

Strength-based

Support Coordination

Gaps identified in competency units

nil nil nil 3 1,2,3,4 nil

Summary of CDSM principles coverage in this qualification

The matrix suggests that the Client-centred, Holistic Practice Information and Coordinated Support CDSM principles are addressed in this qualification.

The matrix suggests a number of gaps. Strategy to address identified gaps/or improve coverage of CDSM principles

Include Supporting client self management practices and priorities as an element in HLTEN513A Contribute to nursing care for clients with chronic health problems

Develop a competency unit on supporting client strengths in nursing care


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Appendix 5 Glossary and Web Links

Glossary

AIHW Australian Institute of Health and Welfare

AQF Australian Qualifications Framework

AQTF Australian Qualifications Training Framework

CDSM Chronic Disease Self Management

CHC02 Community Services Training Package – revised in 2002

CS&H ISC Community Services and Health Industry Skills Council Ltd

DEST Australian Government Department of Education, Science and Training

DoHA Australian Government Department of Health and Ageing

HLT07 Health Training Package – revised in 2007

ISC Industry Skills Council

NTIS National Training Information Service

RPL Recognition of prior learning

RTO Registered Training Organisation

VET Vocational education and training

Web Links

Community Services and Health Industry Skills Council

www.cshisc.com.au

Community Services and Health Industry Skills Council – CDSM project page


Community Services and Health Industry Skills Council – HLT07 and CHC02 pages


Australian Qualifications Framework www.aqf.edu.au

National Training Information Service

www.ntis.gov.au


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http://www.ntis.gov.au/

http://www.aqf.edu.au/



http://www.cshisc.com.au/

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