HLTNE607C - Perform long term electroencephalography (EEG) monitoring Competency Mapping Template
Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners
HLTNE607C Mapping and Delivery Guide Perform long term electroencephalography (EEG) monitoring
Version 1.0 Issue Date: May 2024
Qualification
-
Unit of Competency
HLTNE607C - Perform long term electroencephalography (EEG) monitoring
Description
This unit of competency describes the skills and knowledge required to prepare a client for, and to perform long term EEG Monitoring (LTM) and to provide an interim report to assist the final LTM EEG report
Employability Skills
This unit contains Employability Skills
Learning Outcomes and Application
Work will be performed within a prescribed range of functions involving routine and non-routine methods and procedures which require the exercise of some discretion and judgementLTM EEG's usually exceed three hours recording time and are commonly conducted in hospitals and neurologists' roomsLTM EEG is usually carried out in conjunction with video and audio monitoringThe purpose of LTM is to capture sufficient reported clinical events (seizures or non-seizures) for diagnosis and/or pre-surgical investigationsAll activities are carried out in accordance with organisation policies, procedures and infection control guidelines
Duration and Setting
X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.
Prerequisites/co-requisites
Pre-requisite unitThis unit must be assessed after successful achievement of pre-requisite:HLTNE401C Perform electroencephalography (EEG)
Competency Field
Development and validation strategy and guide for assessors and learners
Student Learning Resources
Handouts Activities
Slides PPT
Assessment 1
Assessment 2
Assessment 3
Assessment 4
Elements of Competency
Performance Criteria
Element: Prepare equipment, material and environment.
Review client booking list for client details
Identify special needs of clients to capture clinical events
Select equipment, materials and location for test according to clinical events to capture previous routine EEG results and/or at the direction of neurologist/neurosurgeon
Ensure equipment and materials selected are clean and dry, in working order, and, where applicable, calibrated and sterilised
Review relevant, current literature and protocols
Arrange client bookings according to organisation procedures, clients' needs, reason for study and surgical operating
Element: Prepare client for procedure
Ensure information on access to test location and test to be attended is received by client, including hospital stay requirements where necessary
Receive and process request for LTM EEG
Correctly identify the client, reassure and inform client regarding the procedure and length of stay
Give client/carer the opportunity to ask questions and discuss areas of concern
Review client's medical history, seek clarification on specific details and take action, as required
Check client consent has been obtained
Prepare diary for recording of clinical events and give instruction on recording clinical events to client/carer
Element: Attach monitoring equipment
Utilise personal protective equipment in accordance with standard and additional precautions
Select type and number of electrodes according to client needs
Select intra-operative or depth electrodes according to client needs or surgical requirements under the guidance of the neurologist and/or neurosurgeon
Adjust camera and microphone position according to client needs, clinical event and concurrent test results where applicable
Conduct head measurement to verify sites for electrode placement according to current standards and organisation policies and procedures
Complete skin preparation according to infection control guidelines and client's needs
Attach other monitoring equipment as required
Connect correctly required leads correctly between interface/head box and machine
Connect correctly intra-operative or depth electrodes between interface/head box and machine under the guidance of the neurologist and/or neurosurgeon where applicable
Accurately label and notate intra-operative or depth electrode placement and map position on brain where applicable
Perform pre-monitoring electrode impedance and establish integrity of electrodes and application
Adjust equipment and electrodes as required
Attach devices to client safely and securely, where appropriate
Set time correlation/synchronisation between clinical and cerebral recorders
Enter client details on monitoring equipment or on long term monitoring storage devices
Perform pre monitoring on machine and biological calibration
Element: Conduct long term EEG recording
Perform additional validation techniques
Apply techniques according to client details and annotate concurrent results on record or recording diary
Validate electrode impedance throughout recording at regular intervals
Recognise artefacts, annotate on the record or in recording diary, and eliminate or reduce
Identify and action clinical events which require immediate attention
Note clinical events in recording diary
Identify and action abnormal EEG which correlates to clinical events and requires immediate attention
Use derivations and machine settings according to test requirements, concurrent results and client needs
Select activation procedures according to request form and client's concurrent results/response
Monitor client's response to activation procedure and adapt procedure accordingly
Add/attach further monitoring equipment and/or electrodes in response to concurrent findings
Annotate on recording or record diary response to activation procedure and changes throughout the procedure
Determine appropriate length of recording according to standards, medical referral, concurrent EEG results and clinical events captured
Identify and meet client needs during the LTM EEG
Identify and respond to severe reactions and complications in accordance with organisation emergency procedures
Element: Completion of procedure
Identify and capture sufficient number of clinical events, as directed by neurologist and/or neurosurgeon
Perform post monitoring of electrode impedance and verify integrity of electrode and contact
Perform post monitoring machine and biological calibration
Validate existence of the computerised file on hard drive and other long term data recording mediums if required
Remove EEG leads and electrodes from client and wash paste/gel off client where applicable.
Provide client with assistance as required, on completion of the procedure
Confirm timely follow up with referring doctor for results
Record monitoring details for retrieval and statistical purposes according to department procedures
Provide information to client and carer according to duty of care
Clean, dry and store equipment in accordance with manufacturer's guidelines and infection control guidelines
Dispose of disposable EEG electrodes and other materials in accordance with waste management procedures and infection control guidelines
Element: Generate report
Review client details and correct as required
Review clinical events diary
Identify and review EEG which correlates to clinical events
Choose additional EEG samples as required
Review and correct annotations to provide accurate and concise information
Forward technical report/results with accompanying documentation and time correlations to neurologist for review or assessment and reporting
Evidence Required
List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.
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 long term electroencephalography (EEG) monitoring
Observation of simulation and/or role play when performing long term electroencephalography (EEG) 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 long term electroencephalography (EEG) 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
Submission Requirements
List each assessment task's title, type (eg project, observation/demonstration, essay, assignment, checklist) and due date here
Assessment task 1: [title] Due date:
(add new lines for each of the assessment tasks)
Assessment Tasks
Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.
This describes the essential skills and knowledge and their level required for this unit.
Essential knowledge:
The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role
This includes knowledge of:
Anatomy and physiology relevant for EEG interpretation, including neurological disorders
Basic pharmacology related to neurological function
Complications and contraindications for clients undergoing LTM EEG procedure, in particular related to activation procedures and clinical events
Concepts of electronics and physics relevant to the performance of an LTM EEG and the EEG recording apparatus
Confidentiality requirements of client information
Data storage and recycling appropriate to LTM EEG recording apparatus and clinical events captured
Derivations, montage design and type, and machine settings, including understanding of when and how to change them
EEG rhythm disturbance and appropriate test alterations
Electrical safety requirements
Emergency procedures in the event of complications relevant in the provision of assistance in the performance of LTM EEG
Infection control policies, including standard and additional precautions, in relation to neurophysiology testing procedures
International 10/20 system as standard for electrode placement, and modified systems
Medical terminology relevant to perform an EEG
Normal EEG rhythms and abnormal EEG activity
Protocols for LTM EEG procedure
Purpose of LTM EEG eg: diagnostic, prognostic, classification of events
Routine maintenance policy and procedures for equipment
Essential skills:
It is critical that the candidate demonstrate the ability to:
Apply knowledge of boundaries of responsibilities and refer problems to supervisor, neurologist or other appropriate health professional
Communicate effectively with clients/carers in relation to the procedure and manage clients' and/or carers' anxiety level
Comply with policies and procedures including those of OHS and infection control
Ensure safety of the client during a clinical event
Identify a clinical event and its' correlation to the EEG recording
Identify steps that must be taken to ensure equipment is safe for use
Produce a diagnostic LTM EEG recording
In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role
This includes the ability to:
Attach electrodes and leads correctly
Attach intra-operative and/or depth electrode leads under the guidance of the neurologist/neurosurgeon
Correctly identify abnormal findings
Correctly operate LTM EEG and associated monitoring equipment
Correctly prepare skin
Deal with conflict
Demonstrate basic cardiopulmonary resuscitation
Demonstrate computer skills relevant to workers' role
Ensure safety for the client during a clinical event
Identify an LTM EEG recording result that is unsatisfactory for diagnostic purposes
Identify an LTM EEG recording result which may require immediate medical attention
Identify and accurately document a clinical event
Identify methods for appropriate data storage according to EEG recording apparatus and clinical events captured
Identify samples of EEG specifically required for diagnostic purposes according to clinical events and purpose of monitoring.
Manage the known common interferences in the production of a EEG recording
Measure for the placement of electrodes to achieve an EEG recording of diagnostic quality
Produce an LTM EEG recording satisfactory for diagnostic purposes
Solve problems including an ability to use available resources
continued ...
Essential skills (contd):
Take into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues
Use numeracy skills ranging from the ability to complete basic arithmetic calculations, recording stock levels, statistical information or skills related to technical equipment
Use oral communication skills required to fulfil job roles in a safe manner and as specified by the organisation, including skills in:
asking questions
providing clear information
listening to and understanding workplace instructions
clarifying workplace instructions when necessary
using effective verbal and non verbal communication skills with a range of internal and external persons
literacy in English or a community language, depending on client group and organisation requirements
Use reading and writing skills required to fulfil job roles in a safe manner and as specified by the organisation at a level of skill that involves reading and documenting clinical information and understanding complex policy and procedure manuals
Work with others and display empathy with client and relatives
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:
LTM EEG device, including cable or radio telemetry and ambulatory monitoring with or without audio and video recorders.
Time correlation between Video/audio and EEG recorder
EEG machine; digital, analogue, portable, standard
Polygraphic equipment; ECG, EMG, EOG machines, respiration, movement and tremor monitors
Electrodes eg caps, disc, mushroom, needle, intra-operative or depth electrodes
Head box
Photic stimulator and strobe light
Chair
Bed
Additional - accessories, toys, other stimuli
Gels and Electrode pastes
Tape measure
Video cassette recorder and camera
Audio recorder and microphone
Resuscitation equipment
Environment may include:
Neurophysiology department
Wards (short and long term stays)
Operating theatre
Private Neurologist's rooms
Intensive care units
Radiology department
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
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 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 time/date of last seizure
Psychiatric and behavioural disorders
Developmental disorder
Metabolic disorder
Medications
Action in response to client's medical history may include:
Omission of activation procedure/s
Additional activation procedure
Alteration of EEG procedure time
Reduction of medication only under the instruction of the Neurologist/Neurosurgeon
Personal protective equipment may include:
Gloves
Mask
Goggles
Gown
Other monitoring equipment may include:
ECG monitor
Respiration
Actogram
EMG
Oximetry
Movement sensors
Audio recorder
Integrity of electrodes must include:
Ground
Reference
Active
Devices may include:
Headbox
Microphone
Long term monitoring storage devices may include:
Cassette recorder tapes
Compact discs
Optical discs
Recording diary
Additional validation techniques must include:
Touch test (of electrodes)
Exchange electrodes
Replace electrodes
Low, and of similar value, impedances
Techniques applied must include:
Montages
Derivations
Sensitivity
Filter
Display speed
Activations
Time synchronisation between Video and EEG recorder
Accessory equipment used for activation procedures must include:
Photic stimulator and strobe light
Accessory equipment used for activation procedures may include:
Causes of changes throughout procedure must include:
Clinical events
EEG findings
Equipment
Environmental
Client's physiological and psychological state
Anaesthetic levels or sedation
Abnormal EEG patterns which require immediate medical attention must include but are not limited to:
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
Complications and severe reactions may include:
Seizure
Cardio-respiratory arrest
Information provided to client's and carer's may include:
Client event recording diary
Appropriate follow up period with referring doctor to obtain results
Risks of injury to client following procedure i.e. following sedation and/or sleep deprivation or reduced medication and prior to follow up with Neurologist i.e. driving, swimming, riding bicycles, bathing
Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.
Observation Checklist
Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice
Yes
No
Comments/feedback
Review client booking list for client details
Identify special needs of clients to capture clinical events
Select equipment, materials and location for test according to clinical events to capture previous routine EEG results and/or at the direction of neurologist/neurosurgeon
Ensure equipment and materials selected are clean and dry, in working order, and, where applicable, calibrated and sterilised
Review relevant, current literature and protocols
Arrange client bookings according to organisation procedures, clients' needs, reason for study and surgical operating
Ensure information on access to test location and test to be attended is received by client, including hospital stay requirements where necessary
Receive and process request for LTM EEG
Correctly identify the client, reassure and inform client regarding the procedure and length of stay
Give client/carer the opportunity to ask questions and discuss areas of concern
Review client's medical history, seek clarification on specific details and take action, as required
Check client consent has been obtained
Prepare diary for recording of clinical events and give instruction on recording clinical events to client/carer
Utilise personal protective equipment in accordance with standard and additional precautions
Select type and number of electrodes according to client needs
Select intra-operative or depth electrodes according to client needs or surgical requirements under the guidance of the neurologist and/or neurosurgeon
Adjust camera and microphone position according to client needs, clinical event and concurrent test results where applicable
Conduct head measurement to verify sites for electrode placement according to current standards and organisation policies and procedures
Complete skin preparation according to infection control guidelines and client's needs
Attach other monitoring equipment as required
Connect correctly required leads correctly between interface/head box and machine
Connect correctly intra-operative or depth electrodes between interface/head box and machine under the guidance of the neurologist and/or neurosurgeon where applicable
Accurately label and notate intra-operative or depth electrode placement and map position on brain where applicable
Perform pre-monitoring electrode impedance and establish integrity of electrodes and application
Adjust equipment and electrodes as required
Attach devices to client safely and securely, where appropriate
Set time correlation/synchronisation between clinical and cerebral recorders
Enter client details on monitoring equipment or on long term monitoring storage devices
Perform pre monitoring on machine and biological calibration
Perform additional validation techniques
Apply techniques according to client details and annotate concurrent results on record or recording diary
Validate electrode impedance throughout recording at regular intervals
Recognise artefacts, annotate on the record or in recording diary, and eliminate or reduce
Identify and action clinical events which require immediate attention
Note clinical events in recording diary
Identify and action abnormal EEG which correlates to clinical events and requires immediate attention
Use derivations and machine settings according to test requirements, concurrent results and client needs
Select activation procedures according to request form and client's concurrent results/response
Monitor client's response to activation procedure and adapt procedure accordingly
Add/attach further monitoring equipment and/or electrodes in response to concurrent findings
Annotate on recording or record diary response to activation procedure and changes throughout the procedure
Determine appropriate length of recording according to standards, medical referral, concurrent EEG results and clinical events captured
Identify and meet client needs during the LTM EEG
Identify and respond to severe reactions and complications in accordance with organisation emergency procedures
Identify and capture sufficient number of clinical events, as directed by neurologist and/or neurosurgeon
Perform post monitoring of electrode impedance and verify integrity of electrode and contact
Perform post monitoring machine and biological calibration
Validate existence of the computerised file on hard drive and other long term data recording mediums if required
Remove EEG leads and electrodes from client and wash paste/gel off client where applicable.
Provide client with assistance as required, on completion of the procedure
Confirm timely follow up with referring doctor for results
Record monitoring details for retrieval and statistical purposes according to department procedures
Provide information to client and carer according to duty of care
Clean, dry and store equipment in accordance with manufacturer's guidelines and infection control guidelines
Dispose of disposable EEG electrodes and other materials in accordance with waste management procedures and infection control guidelines
Review client details and correct as required
Review clinical events diary
Identify and review EEG which correlates to clinical events
Choose additional EEG samples as required
Review and correct annotations to provide accurate and concise information
Forward technical report/results with accompanying documentation and time correlations to neurologist for review or assessment and reporting
Forms
Assessment Cover Sheet
HLTNE607C - Perform long term electroencephalography (EEG) monitoring
Assessment task 1: [title]
Student name:
Student ID:
I declare that the assessment tasks submitted for this unit are my own work.
Student signature:
Result: Competent Not yet competent
Feedback to student
Assessor name:
Signature:
Date:
Assessment Record Sheet
HLTNE607C - Perform long term electroencephalography (EEG) monitoring
Student name:
Student ID:
Assessment task 1: [title] Result: Competent Not yet competent
(add lines for each task)
Feedback to student:
Overall assessment result: Competent Not yet competent