Elements and Performance Criteria

RANGE STATEMENT

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.


Equipment and material may include:
EEG machine; digital, analogue, portable, standard, video and audio
Polygraphic equipment; ECG, EMG, EOG machines, respiration, movement and tremor monitors
Electrodes eg caps, disc, mushroom
Head box
Chair
Bed
Additional - accessories, toys, other stimuli
Gels and Electrode pastes
Tape measure
Video cassette recorder and camera with audio
Resuscitation equipment
CPAP machine
Monitoring equipment including monitors for TCO2, SaO2, sound, body position


Environment may include:
Neurophysiology department
Wards
Sleep Laboratories
Private Neurologist's rooms
Intensive care units


Client details may include:
Referral letter/request
Reason for study/referral
Medical history
Address and telephone number
Date of birth and age
Medications
Client's presenting condition
Sleep patterns
Date of test
Date of previous test
In care client/out of care client
Clients' expectations
Test requested
Referring doctor address and telephone number


Clients may include:
Adults
Children
Neonates
Adolescents
Elderly


Client medical history may include:
Event/s leading to referral
Sleep disorder
Current sleep patterns
Cardiac disorder
Respiratory disorder
Vascular disorder
Neurological disorder
Infectious diseases
Epilepsy type and frequency, and date of last seizure
Psychiatric and behavioural disorders
Developmental disorder
Metabolic disorder
Medications


Action in response to client's medical history may include:
Use of various additional recording devices including: CPAP machine, TCO2 monitors, etc.
Varied activation procedure or disturbances
Alteration of Test procedure time
Waking the client


Personal protective equipment may include:
Gloves
Mask
Goggles
Gown


Positioning of monitoring equipment for other physiological measurement may include:
Respiratory i.e. diaphragm, nasal, oral
EMG


Other monitoring equipment may include:
ECG monitor
Respiration
Actogram
EMG
Oximetry
Movement sensors
CPAP machine
TCO2 monitor


Integrity of electrodes must include:
Ground
Reference
Active
Respiration thermistors or equivalent
Respiration straps
Oximetry
Movement Sensors
CPAP machine
TCO2 monitor


Additional validation techniques must include:
Touch test (of electrodes)
Exchange electrodes
Replace electrodes
Low, and of similar value, impedances
Amplifier calibration for DC and AC
Continuous monitoring of CPAP
Continuous viewing of the sleep study in progress


Techniques applied must include:
Montages
Derivations
Sensitivity
Filter
Display speed
Activations


Sleep states and staging must include:
Wake
REM and REM onset
Non-REM, including stages I, II, III, IV
Sleep onset


Physiological parameters may include:
Respiration
ECG
Oxygen saturation
Actogram
EMG


Causes of changes throughout procedure must include:
EEG findings
ECG findings
Respiration findings
SaO2 findings
TCO2 findings
EMG findings
Clinical events
Equipment
Environmental
Client's physiological and psychological state


Abnormal patterns which require immediate medical attention must include:
Continuous spiking or spike and wave
Hypsarrhythmic EEG
Frequent sub clinical seizure pattern
Status epilepticus
EEG finding consistent with infectious or reportable diseases/conditions eg Herpes Encephalitis, Creutzfeldt Jakob Disease (CJD) or CJD variant
Burst suppression and /or isoelectric EEG
Unilateral abnormality
Any other conditions which may endanger the health and well being of the client, particularly if not expected prior to recording or indicated on the referral letter
Other abnormalities that may be identified on the ECG, respiration or SaO2 channels or other recording devices


Complications and severe reactions may include:
Seizure
Cardio-respiratory arrest


Information provided to client's and carer's may include:
Appropriate follow up period with referring doctor to obtain results
Risks of injury to client following procedure ie. if overtired, or if have ceased medication for test etc.
How to clean the hair etc. appropriately to remove all glues/pastes.

EVIDENCE GUIDE

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:
The individual being assessed must provide evidence of specified essential knowledge as well as skills
Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
Consistency of performance should be demonstrated over the required range of situations relevant to the workplace


Context of and specific resources for assessment:
Relevant organisation policy, guidelines, procedures and protocols


Method of assessment:
Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision.
Observation of work activities when performing polysomnographic recordings
Observation of simulation and/or role play when performing polysomnographic recordings
Discussion of physical and/or behavioural contingency scenarios involving duty of care
Authenticated transcripts of relevant education/training courses
Recognition of relevant life/work experience
Questioning, written assessments/projects, e-learning can be used to assess knowledge
Authenticated reports of experience in performing polysomnographic recordings (Documentation associated with performance reviews, supervisor/co-ordinator evaluations of work performance)
Training records associated with First Aid, OH Safety training, Orientation/Induction Training, Safe Manual Handing, Universal infection control procedures
Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice


Access and equity considerations:
All workers in the health industry should be aware of access and equity issues in relation to their own area of work
All workers should develop their ability to work in a culturally diverse environment
In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities