Cirrhosis Competencies

Section 2: Nursing Assessment Competencies

2.1 Describe the importance of income and social status in cirrhosis prevention, care and treatment

• The role of income security (e.g., employed, social assistance, retired)
• Types of income assistance available
• The impact of barriers such as unsafe housing, lack of food security and lack of affordable transportation on client health
• Strategies clients can use to access services such as alcohol treatment programs, travel support, and nutritional supplementation
• Access to medication coverage (e.g., private, provincial, NIHB)

2.2 Describe the importance and impact of the client’s social network

• Living with uncertainty
• Quality of life
• Dysfunctional lassitude
• Palliation

2.3 Explain how the client’s level of literacy can impact health

• Assess the client’s understanding of information (e.g., reading, writing, expression and comprehension)
• Use of principles of adult learning (e.g., language that is appropriate to the client’s education, literacy level and ethno-cultural context
• Facilitate client access to evidence-based information (e.g., peer support groups, internet)

2.4 Explain the impact of employment/working conditions

• Individual’s rights to confidentiality and privacy
• Decrease exposure to hepatotoxins
• Need to plan for changes in Activities of Daily Living (ADL) and employment

2.5 Understand the influence of social environments

• Importance and impact of social network e.g., community groups
• Access to community resources
• Impact of stigma on health behavior and human rights

2.6 Understand the importance of physical environments

• Housing instability, need for supportive housing
• Importance of a safe home environment (e.g. falls prevention)
• Contribution of the physical environment (e.g., air/ground/water quality and chemical/biological exposure)

2.7 Understand the importance of personal health practices and coping skills

• Promote optimal liver function (e.g., addressing alcohol intake, balanced nutrition, physical activity and smoking cessation)
• Choices can be affected by socio-economic environments (e.g., self-care, advocacy and coping mechanisms)
• Self-esteem, self-worth and resilience can affect health practices
• Impact of historic trauma
  

2.8 Explain the importance of healthy child development

• Experiences in early life that can affect lifestyle choices and behaviours in adulthood (e.g., childhood obesity, trauma and family history of substance use)

2.9 Describe the role of biology and genetics

• Role of genetic disorders causing cirrhosis
• Importance of family history
• Identification of at-risk individuals or groups e.g., family screening

2.10 Describe the impact of health services on cirrhosis

• Importance of client self-advocacy
• Role of significant others in client advocacy
• Nurse’s role in client advocacy
• Nurses’ role in advocating for health system change (e.g., improved access for care and medications, participation in advocacy organizations)
• Effect of stigma and discrimination on service access and utilization

2.11 Understand the role of gender

• Recognize gender differences in likelihood of diagnosis, disease progression, and cancer risk

2.12 Understand the impact of culture and ethnicity

• Cultural implications related to cirrhosis
• Culturally sensitive awareness (e.g., avoid actions that diminish, demean or disempower the cultural identity and well-being of an individual)
• Spiritual and religious beliefs impact decisions (e.g., natural healing beliefs)
• Recognize the impact of provider’s values on relationships and client decision making