Unit of competency Outline
Date retreived
22/07/2026 2:42 PM AWST
22/07/2026 2:42 PM AWST
Whilst all efforts are made to provide accurate and timely information from the relevant source/documentation, please be aware that the information supplied may not be the most current version. The accuracy of the detail has not been confirmed by the Department and therefore should not be relied upon without first confirming the contents.
Perform intra-operative neurophysiology monitoring
Perform intra-operative neurophysiology monitoring
Unit of competency
National Code
HLTNE606D
HLTNE606D
State Code
WD221
WD221
TGA Status
Deleted
Deleted
DTWD Status
Deleted
Deleted
State Implementation and Classification
Approved Date
08/08/2014
Field of Education
060301 - General Nursing
Original Release Date
08/08/2014
Nominal Hours
100
Description
DescriptorThis unit of competency describes the skills and knowledge required to prepare a client for and to perform an intraoperative neurophysiology test and to provide an interim report to assist the surgeon or neurologist
Notes
Elements and Performance Criteria
1. Prepare equipment, material and environment
- 1.1 Review client booking list is reviewed for client details
- 1.2 Identify special needs of clients
- 1.3 Select equipment, materials and location for test
- 1.4 Ensure equipment and materials selected are clean and dry, in working order, and, where applicable, calibrated
- 1.5 Clean and prepare equipment surfaces accordingly for entering the theatre environment
- 1.6 Review relevant, current literature and protocols
- 1.7 Arrange client bookings according to surgeons operative list
- 1.8 Firmly label electrodes at both ends
- 1.9 Identify in consultation with operating room staff the optimal positioning of equipment, cables and leads to achieve minimal electrical interference
2. Prepare client for pre-operative test procedure
- 2.1 Ensure information on access to test location and test to be attended is received by client
- 2.2 Receive and process request for baseline pre-operative test
- 2.3 Correctly identify client is correctly identified, reassure and inform client regarding the pre-operative test procedure and of the involvement of the neurophysiology testing during their operative procedure
- 2.4 Give client/carer the opportunity to ask questions and discuss areas of concern
- 2.5 Check client consent has been obtained
- 2.6 Review the client's medical history, seek clarification on specific details and take appropriate action, as required
3. Attach monitoring equipment
- 3.1 Utilise personal protective equipment in accordance with standard and additional precautions
- 3.2 Select type and number of electrodes according to client needs and test procedure
- 3.3 Conduct head measurement to verify sites for electrode placement according to current standards and organisation policies and procedures and confirm with neurologist requests for any additional routine electrodes
- 3.4 Apply non-routine electrodes according to neurologists advice or inserted by neurologist or surgeon
- 3.5 Complete skin preparation according to infection control guidelines and client's needs
- 3.6 Attach other monitoring equipment as required
- 3.7 Correctly connect required leads between interface/head box and machine
- 3.8 Perform pre test for electrode impedance and establish integrity of electrodes and application
- 3.9 Adjust equipment and electrodes as required
- 3.10 Enter client details on testing equipment or on paper traces, as required
- 3.11 Perform pre test on machine and biological calibration
4. Conduct intraoperative recording
- 4.1 Perform additional validation techniques
- 4.2 Apply techniques according to client details and annotate concurrent results on record
- 4.3 Validate electrode impedance throughout test as required
- 4.4 Recognise artefacts, annotate on the record, and eliminate or reduce
- 4.5 Document other variables originating or being recorded in the theatre environment on the test if appropriate
- 4.6 Document artefacts created by the theatre environment and cease recording as required
- 4.7 Identify expected waveforms related to clinical conditions and age groups
- 4.8 Identify abnormal patterns and waveforms which require immediate attention and inform neurologist and surgeon
- 4.9 Use derivations and machine settings according to test requirements, concurrent results and client needs
- 4.10 Add/attach further monitoring equipment and/or electrodes in response to concurrent findings under the guidance of the surgeon
- 4.11 Annotate on recording response to activation procedure and changes throughout the procedure
- 4.12 Determine appropriate length of recording under the guidance of the neurologist or surgeon and concurrent test results.
- 4.13 Identify and meet surgeon's needs during the test procedure relevant to obtaining maximal accuracy
- 4.14 Identify and respond to severe reactions and complications in accordance with organisation emergency procedures
5. Completion of procedure
- 5.1 Perform post test electrode impedance and verify integrity of electrode and contact
- 5.2 Perform post test machine and biological calibration performed
- 5.3 Validate existence of the computerised file validated on hard drive, if required
- 5.4 Remove electrodes from client and wash paste/gel/glue off client at completion of procedure
- 5.5 Record test details for retrieval and statistical purposes according to department procedures
- 5.6 Provide information to client and carer according to duty of care
- 5.7 Clean, dry and store equipment in accordance with manufacturer's guidelines and infection control guidelines
- 5.8 Dispose of disposable electrodes and other materials in accordance with waste management procedures and infection control guidelines
6. Generate report
- 6.1 Review and correct client details as required
- 6.2 Review and correct annotations to provide accurate and concise information
- 6.3 Forward technical report/results with accompanying documentation to neurologist for review or assessment and reporting
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/EP/MEP machine; digital, analogue, portable, standard, ambulatory, video and audio
Polygraphic equipment; ECG, EMG, EOG machines, respiration, movement and tremor monitors
Electrodes eg , disc, disc, screw, depth, grid or strip
Head box
Electrical Stimulator
Motor Evoked Stimulator
Photic stimulator
Operating Theatre Bed
Additional spare equipment, as required
Gels
Electrode pastes
Tape measure
Video cassette recorder and camera
Resuscitation equipment
Environment for pre-operative baseline may include:
Neurophysiology department
Wards
Private Neurologist's rooms
Intensive care units
Environment for operative test procedure may include:
Operating rooms
Radiology department
Clients must include:
Neonates
Infants
Children
Adolescents
Adults
Elderly
Client medical history may include:
Event/s leading to referral
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
Orthopaedic disorder
Action in response to client's medical history may include:
Omission of activation procedure/s
Additional activation procedure
Alteration to routine Neurophysiology test procedure
Personal protective equipment may include:
Gloves
Mask
Goggles
Gown
Other monitoring equipment may include:
Actogram
EMG
Movement sensors
Integrity of electrodes must include:
Ground
Reference
Active
Additional validation techniques must include:
Touch test (of electrodes)
Exchange electrodes
Replace electrodes
Low, and of similar value, impedances
Adequate twitch for EP stimulation
Techniques applied must include:
Montages
Derivations
Sensitivity
Filter
Display speed
Activations
Other variables may include:
Anaesthetic levels
Client blood pressure changes
Artefacts created by the theatre environment may include:
Use of electrical equipment eg diathermy, monitors
Client originated
Staff originated
Causes of changes throughout procedure must include:
Test findings
Clinical events
Variation in level of anaesthetic drug administered
Blood pressure alterations
Respiration changes
Position of machinery
Equipment
Environmental
Client's physiological and psychological state
Abnormal test patterns which require immediate medical attention must include:
Unilateral changes
Burst suppression and/or isoelectric
Frequent sub clinical seizure pattern
Status epilepticus
Reduction in waveforms from baseline traces not associated with anaesthetic changes
Delays in waveforms from baseline traces not associated with anaesthetic changes
Other conditions or variations to waveforms which may endanger the health and well being of the client
Complications and severe reactions may include:
Seizure
Cardio-respiratory arrest
Information provided to client/carer may include:
Appropriate follow up period with referring doctor to obtain results
How to remove residual glues, pastes from recording sites if client
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/EP/MEP machine; digital, analogue, portable, standard, ambulatory, video and audio
Polygraphic equipment; ECG, EMG, EOG machines, respiration, movement and tremor monitors
Electrodes eg , disc, disc, screw, depth, grid or strip
Head box
Electrical Stimulator
Motor Evoked Stimulator
Photic stimulator
Operating Theatre Bed
Additional spare equipment, as required
Gels
Electrode pastes
Tape measure
Video cassette recorder and camera
Resuscitation equipment
Environment for pre-operative baseline may include:
Neurophysiology department
Wards
Private Neurologist's rooms
Intensive care units
Environment for operative test procedure may include:
Operating rooms
Radiology department
Clients must include:
Neonates
Infants
Children
Adolescents
Adults
Elderly
Client medical history may include:
Event/s leading to referral
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
Orthopaedic disorder
Action in response to client's medical history may include:
Omission of activation procedure/s
Additional activation procedure
Alteration to routine Neurophysiology test procedure
Personal protective equipment may include:
Gloves
Mask
Goggles
Gown
Other monitoring equipment may include:
Actogram
EMG
Movement sensors
Integrity of electrodes must include:
Ground
Reference
Active
Additional validation techniques must include:
Touch test (of electrodes)
Exchange electrodes
Replace electrodes
Low, and of similar value, impedances
Adequate twitch for EP stimulation
Techniques applied must include:
Montages
Derivations
Sensitivity
Filter
Display speed
Activations
Other variables may include:
Anaesthetic levels
Client blood pressure changes
Artefacts created by the theatre environment may include:
Use of electrical equipment eg diathermy, monitors
Client originated
Staff originated
Causes of changes throughout procedure must include:
Test findings
Clinical events
Variation in level of anaesthetic drug administered
Blood pressure alterations
Respiration changes
Position of machinery
Equipment
Environmental
Client's physiological and psychological state
Abnormal test patterns which require immediate medical attention must include:
Unilateral changes
Burst suppression and/or isoelectric
Frequent sub clinical seizure pattern
Status epilepticus
Reduction in waveforms from baseline traces not associated with anaesthetic changes
Delays in waveforms from baseline traces not associated with anaesthetic changes
Other conditions or variations to waveforms which may endanger the health and well being of the client
Complications and severe reactions may include:
Seizure
Cardio-respiratory arrest
Information provided to client/carer may include:
Appropriate follow up period with referring doctor to obtain results
How to remove residual glues, pastes from recording sites if client
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 intra-operative neurophysiology monitoring
Observation of simulation and/or role play when performing intra-operative neurophysiology monitoring
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 intra-operative neurophysiology monitoring (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
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 intra-operative neurophysiology monitoring
Observation of simulation and/or role play when performing intra-operative neurophysiology monitoring
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 intra-operative neurophysiology monitoring (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
Replaces
| State Code | National Code | Title | Type |
|---|---|---|---|
| D8366 | HLTNE606C | Perform intra-operative neurophysiology monitoring | Unit of competency |
| State Code | National Code | Title | Type |
|---|---|---|---|
| J117 | HLT60812 | Advanced Diploma of Neurophysiology Technology | Qualification |