HLT Health Training Package

Jane Lennis 07.05.2021

"The certificate IV adequately reflects the role and scope of practice for an Aboriginal Health Worker Practitioner. The entry pathways, Certificate II, III, and option of undertaking Practice / non-practice qualification provides opportunity for Health Workers to identify whether the clinical pathway or Health Promotion / Program Delivery pathway is a better avenue based on strength-based approach. At the Certificate IV level (under AQF Framework) learners are expected to undertake specialised and skilled work - have a broad factual and technical knowledge in a specific or broad field. The skills are both routine and non-routine, predictable and unpredictable problem solving. Learners are required to demonstrate autonomy, judgement, limited responsibility in both known or changing context and within established parameters. Aboriginal Health Workers work within a multidisciplinary team that have a variety of qualifications, technical training, and on-the-job training. All have very defined scope of practice which delimitates the parameters for Aboriginal Health Practitioners (Certificate IV qualification). The removal of the Certificate IV Practice qualification and lifting this to Diploma limits the career pathways. The certificate IV should have two optional pathways. 1. Clinical practice; and 2. Health Promotion / Program Delivery. The Diploma level then should allow for 3 specific pathways. 1. Diploma Practice (Clinical); 2. Diploma Health Promotion / Program Delivery / Population Health; and 3. Practice Management / Leadership. These qualifications and pathways then are genuine reflection for the options that are available outside of the Aboriginal Health career pathways. The clinical work that is performed and completed by Aboriginal Health Workers within an AMS environment provides for the cultural safety, role-modelling, and enhanced client outcomes. The complexity of working within the AMS environment and supporting the health and wellbeing of clients requires specialised training which is acknowledged through the GP specialising pathways where overseas trained medical practitioners are required to undertake work in an AMS or rerual / regional setting – the role that the Aboriginal Health Workforce plays both in receiving clinical skills and support from senior clinicians is invaluable, however, experienced clinicians are also learning from the Aboriginal Health Workforce. The clinical skills and scope of practice is genuinely aligned to the certificate IV AQF framework – more specialised training may occur at the Diploma level however to remove the Certificate IV Practice will reduce career pathways, those that are wanting to undertake community / population health work will not commit to completing the core modules that will be retained in the remaining Certificate IV qualification. In relation to the unit packages and changes I note that a number of comments have identified that removal of units is occurring due to low enrolments or nil enrolments. However, this is not a true measure of a need for a unit to be removed. Learners undertaking any of the Aboriginal Health Worker Certificates / Diploma do not have a choice in units. Training providers outline what units will be offered and learners do not have the ability to work across training providers to receive training. Further, there is no analysis of different community needs or what units are needed in what locations. Learners are only able to complete training that is offered by the training provider. A genuine review of unit needs should be undertaken with an analysis of health trends and health measures to identify what are the current community needs for addressing, but also what are the future requirements, this review does not appear to have any evidence base behind the recommendations. Current consultations are occurring on the 10-year health workforce and alignment of this learning review should link back to the workforce needs to deliver the services and systems for the future. Based on the consultative documents there has been no evidence based on the review rather a limitation of education and development for a critical component of the Health Workforce currently addressing the gap in health and wellbeing outcomes. Until there is genuine consultation, looking at critical data and implementing genuine evidence-based recommendations, then we are in for another 30 years of worsening Aboriginal and Torres Strait Islander Health outcomes and another generation lost. "

Aboriginal and Torres Strait Islander Health Worker - Draft 2

HLT4XX21 Certificate IV in Aboriginal and Torres Strait Islander Primary Health Care_Draft 2

Simon McCormack 07.05.2021

"A couple of minor suggestions: Assessments must ensure the use of: • personal protective equipment for infection control  equipment and consumables used for ear health assessments and simple treatments to include: • otoscope (including tips) • tympanometer (including tips) • clinical waste disposal bin • ear model and resources to assist with the explanation of results  ear and hearing assessment form for documenting client histories, assessment details, findings and recommendations/referrals "

Aboriginal and Torres Strait Islander Health Worker - Draft 2

HLTAHCS014 Provide ear health care_Draft 2

Simon McCormack 07.05.2021

"Demonstrated knowledge required to complete the tasks outlined in elements and performance criteria of this unit: • organisational policies and procedures for: • maintaining ear and hearing health records • maintaining confidentiality of client information • for ear and hearing health: • legal and organisational responsibilities and the scope of practice of Aboriginal and/or Torres Strait Islander health care workers and practitioners • the roles of other members of the multidisciplinary care team including medical practitioners, audiometrists, audiologists, speech pathologists and occupational therapists • how to facilitate referrals • key information collected and recorded in medical histories specific to ear and hearing health  a good understanding of equipment used for ear examinations (otoscopy) and middle ear assessments (tympanometry), including their key features, operating procedures and basic trouble-shooting.  different types of infection control precautions to be utilised when performing different ear and hearing assessments and treatments  an excellent understanding of the anatomy and physiology of auditory system and the ability to describe this clearly to clients  common causes of hearing loss and the prevalence in Aboriginal and/or Torres Strait Islander adults and children: • congenital: • hereditary and non-hereditary genetic factors • acquired: • other ear infections (otitis externa) • middle ear infections (otitis media) - particularly in children • injury to head or ear • excessive noise • recreational exposure to loud sounds • ageing • wax or foreign bodies blocking the ear canal  signs and symptoms of otitis media and treatment options  ear wax management: • normal and abnormal presentations • when cerumenolytic softening agents can be used and when referral for ear wax removal by a medical specialist may be required  impacts of hearing loss at individual and community level: o developmental o functional (including for learning and development in children) o social and emotional o economic  first aid procedures, standard treatment protocols and referral procedures for minor ear trauma and the presence of foreign bodies in the ear canal  ear pathologies and hearing patterns requiring referral and treatment by medical or ear health specialists  self-care preventative practices for improved ear health in both children and adults: o avoidance of over-reliance on antibiotics o avoidance of smoking and smoke-filled environments o breastfeeding of infants o healthy eating o household hygiene o personal hygiene routines o regular ear health assessments  types of practical support needed by clients to access specialist services: o accommodation o interpreter services o transport o special assistance for those with hearing loss  ear health resources and support services available in the community, state or territory: o for ear health in general and for prevalent conditions in Aboriginal and/or Torres Strait Islander people, including otitis media o sound amplification services in educational settings o specialist services and government programs available to people of different genders or ages and to Aboriginal and Torres Strait Islander people o how to access information about the types of information resources and services they offer o how clients can access services and the role of health workers and practitioners in facilitating access."

Aboriginal and Torres Strait Islander Health Worker - Draft 2

HLTAHCS014 Provide ear health care_Draft 2