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.


Information may include:
Client medical history
Referral letter
Correspondence
Consent forms
Current standards
Information for clients


Environment may include:
Consulting room
Acoustically treated assessment room


Equipment and instruments may include:
Audiometer (clinical, screening and diagnostic)
Headphones
Otoscope (hand held and video)
Screening tympanometer
Recorded speech sources
Sound field audiometer
Impedance audiometer
Computer


Equipment checking must include:
Acoustic calibration and integrity check of an audiometer
All parts are correctly assembled


Personal protective equipment may include:
Gloves
Masks
Eye protection


Clients may include:
Adults
Aged persons


Informed consent may include:
Written
Verbal
Implied


Confidentiality of client information may include:
Legal and ethical requirements
Secure location for written records
Telephone conversations
Offering a private location for discussions
Information disclosed to an appropriate person consistent with the responsibility of this position
Adherence to the Privacy Act


Personal hygiene/infection control procedures may include:
Washing hands
Current National Health and Medical Research Council (NHMRC) guidelines for infection control in health care settings
Standard Precautions and Additional Precautions as defined by the NHMRC
Current Australian Standards
Local Government ordinances
Other legislative requirements


Relevant policies and procedures may include:
Organisation
Industry standards (state and national)
Office of Hearing Services
Contract requirements
relevant Commonwealth and state/territory privacy legislation
Research organisations e.g. National Acoustic Laboratory (NAL)
Relevant state/territory WHS bodies
Industry professional bodies
Relevant Australian standards


Abnormalities of the ear canal may include:
Excessive cerumen
Foreign body
Discharge from the ear
Signs of inflammation/infection
Atresia
Exostosis
Collapsed ear canals
Presence of grommets
Otitis externa
Perforated tympanic membrane


Contraindications for proceeding with further tests include:
Excessive cerumen
Foreign body
Discharge from the ear
Signs of inflammation/infection
Atresia
Exostosis
Collapsed ear canals
Presence of grommets
Otitis externa
Perforated tympanic membrane


Referral agencies may include:
Audiologist
Medical practitioner
Medical facilities
Rehabilitation centres
Self help organisations


Hearing assessments must include:
Pure tone audiometry assessments ie air conduction screening and threshold assessments, threshold air and bone conduction assessments with masking as required, Stenger
Impedance audiometry assessments ie screening tympanometry and contralteral stapedius reflex recording, stapedial reflex delay
Speech audiometry assessments using at least two levels, one being at least 10dB above PB max ie phonetically balanced monosyllables, AB words, spondees


Results of hearing assessments may include:
Sensori-neural hearing loss
Conductive hearing loss
Mixed hearing loss
Identification of non-organic hearing loss


Options for client may include:
Fitting of a hearing aid or assistive listening device
Referral to a general practitioner
Referral to a local support group for training in communication strategies


Indications for medical referral include:
Visible evidence of cerumen accumulation or the presence of a foreign body which precludes assessment or taking an impression
Previously unreported apparent or confirmed perforation
Reported pain, discomfort or tenderness in the ear
Any history of active drainage from the ear during the past 3 months and/or apparent infection
A hearing loss associated with a traumatic insult to the ear
Chronic dizziness or vertigo
Reported facial numbness, weakness or asymmetrical facial movements
A hearing loss of sudden or recent onset
Unilateral hearing loss
Unilateral tinnitus
Sudden onset of tinnitus
Reported feeling of blockage or fullness in ear(s)
Rapid deterioration in audiometric thresholds


Indications for audiological referral include:
An air bone gap of 20dB or greater at 500, 1000 or 2000Hz
An asymmetrical sensory-neural loss (a difference of >20dB at 500, 1000 or 2000Hz and/or30dB at 3000, 4000 or 6000HZ)
A significant difference in speech discrimination scores between ears
Evidence of fluctuations in audiometric thresholds

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
Observation of workplace performance is essential for assessment of this unit
Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
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


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


Context of and specific resources for assessment:
Access to appropriate workplace, equipment and instruments where assessment can take place or the simulation of realistic workplace setting, including access to equipment for assessments
Relevant organisation policy, guidelines, procedures and protocols
Relevant professional bodies policies and guidelines on the conduct of screening hearing tests
Relevant legislative and regulatory documents
Relevant publications of the National Acoustic Laboratories
Access to professional library for accurate and current relevant information
Manufacturers' specifications for the use and storage of equipment


Method of assessment
Observation in the work place (if possible)
Written assignments/projects or questioning should be used to assess knowledge
Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice.
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.
Practical case presentation
Case studies and scenarios
Interviews/Questioning
Role plays


Related units:
This unit can be assessed independently, however holistic assessment practice with other audiometry units of competency is encouraged