don’t sleep on it! does your polysomnography program meet current standards? tom smalling, edd,...
TRANSCRIPT
Don’t Sleep on It! Does Your Polysomnography Program Meet
Current Standards?
Tom Smalling, EdD, RRT, RPFT, RPSGT, FAARCExecutive Director
Conflict of Interest
I have no real or perceived conflict of interest that relates to this presentation. Any use of brand names is not in any way meant to be an endorsement of a specific product, but to merely illustrate a point of emphasis.
AARC Congress 2011
ObjectivesLearning objectives for this presentation:Learning objectives for this presentation:Identify the entry pathways into the PSG
accreditation system;Describe the changes to the CoARC Standards
relevant to the PSG program option;Recognize the steps necessary to start a PSG
program option.
AARC Congress 2011
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Overview of Accredited PSG ProgramsEntry Pathways into the PSG Accreditation SystemCurrent Status of CoARC Programs
Changes to CoARC Accreditation StandardsCurricular StrategiesSample program outlinesSample instructional unitsHow do I get started? ResourcesQuestion and answers
What’s CoveredWhat’s Covered
www.coarc.com
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Pathways into the PSG Accredited System1.1. Commission on Accreditation for Respiratory Care (CoARC)Commission on Accreditation for Respiratory Care (CoARC)
Add-on component to respiratory care (base) program;
2.2. Committee on Accreditation for Education in Committee on Accreditation for Education in Electroneurodiagnostic Technology (CoA-END)*Electroneurodiagnostic Technology (CoA-END)*
Add-on component to END (base) program;
3.3. Committee on Accreditation for Polysomnographic Committee on Accreditation for Polysomnographic Technologist Education (CoA-PSG)*Technologist Education (CoA-PSG)*
Stand-alone program
* CoA-END and CoA-PSG are Committees within the Commission on Accreditation of Allied Health Education Programs (CAAHEP)
Overview of Accredited PSG ProgramsOverview of Accredited PSG Programs
www.coarc.com
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Commission on Accreditation for Respiratory Care (CoARC)Commission on Accreditation for Respiratory Care (CoARC)Must be current student or graduate of a CoARC-accredited program to
enroll;Graduates receive certificate of completion in addition to degree from RC
program;Graduates are eligible to take the Registered Polysomnographic
Technologist Exam (RPSGT) administered by the Board of Registered Polysomnographic Technologists (BRPT) without additional on-the-job training (Pathway #3). Other credentialed RTs must complete 6 months FT OJT experience to become eligible.
Graduates are eligible to take the Sleep Disorders Specialty Exam (SDS) administered by the NBRC. Other credentialed CRTs must complete 6 months FT OJT experience to become eligible. RRTs must complete FT 3 months OJT experience.
Overview of Accredited PSG ProgramsOverview of Accredited PSG Programs
www.coarc.com
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Committee on Accreditation for Education in Committee on Accreditation for Education in Electroneurodiagnostic Technology (CoA-END)Electroneurodiagnostic Technology (CoA-END)Must be current student or graduate of a CoA-END-accredited program to
enroll;Graduates of the add-on receive certificate of completion and may also
earn a degree from END program (not required);Graduates are eligible to take the Registered Polysomnographic
Technologist Exam (RPSGT) administered by the Board of Registered Polysomnographic Technologists (BRPT) without additional on-the-job training (Pathway #3).
Graduates are not eligible to take the NBRC SDS Exam.
Overview of Accredited PSG ProgramsOverview of Accredited PSG Programs
www.coarc.com
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Committee on Accreditation for Polysomnographic Committee on Accreditation for Polysomnographic Technologist Education (CoA-PSG)Technologist Education (CoA-PSG)Program enrollment is open to students in post-secondary academic
institutions and accredited sleep centers;Graduates receive a certificate of completion and may also earn a degree
from PSG program (not required);Graduates are eligible to take the Registered Polysomnographic
Technologist Exam (RPSGT) administered by the Board of Registered Polysomnographic Technologists (BRPT) without additional on-the-job training (Pathway #3).
Graduates are not eligible to take the NBRC SDS Exam.
Overview of Accredited PSG ProgramsOverview of Accredited PSG Programs
www.coarc.com
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Current Numbers/Types of PSG Programs1.1. Commission on Accreditation for Respiratory Care (CoARC)Commission on Accreditation for Respiratory Care (CoARC)
8 Total (4 Associates; 5 Baccalaureate)
2.2. Committee on Accreditation for Education in Committee on Accreditation for Education in Electroneurodiagnostic Technology (CoA-END)*Electroneurodiagnostic Technology (CoA-END)*
13 Total (1 Diploma; 6 Certificate; 10 Associate; 1 on-line/distance)
3.3. Committee on Accreditation for Polysomnographic Committee on Accreditation for Polysomnographic Technologist Education (CoA-PSG)*Technologist Education (CoA-PSG)*
39 Total (31 Certificate; 13 Associates; 6 on-line/distance)
Overview of Accredited PSG ProgramsOverview of Accredited PSG Programs
www.coarc.com
Purpose of Standards
www.coarc.com
Outlines the minimum requirements to which an accredited respiratory care program is accountable.
Used for the development, evaluation, and self-analysis of respiratory care programs.
Provides the basis on which the CoARC confers or denies program accreditation.
Standard I – Program Administration and Sponsorship
www.coarc.com
Institutional AccreditationConsortiumSponsor ResponsibilitiesProgram LocationSubstantive Changes Affiliate Agreements
Standard II – Institutional and Personnel Resources
www.coarc.com
Institutional ResourcesPersonnel ResourcesKey Program PersonnelProgram DirectorDirector of Clinical EducationMedical DirectorInstructional FacultyAdministrative and Support Staff
CoARC Policy 6.01 E – Primary PSG Instructor
www.coarc.com
There must be a Sleep Disorders Specialist (CRT-SDS or RRT-SDS) or a Registered Polysomnographic Technologist (RPSGT), (who is preferably also a Registered Respiratory Therapist), designated as the primary instructor for that portion of the program.
While this individual may be either of the two Key Personnel noted above, (should s/he meet sleep specialist qualifications), under those circumstances the program must show that these additional responsibilities are not adversely affecting the education of those students enrolled in the base Respiratory Care program.
CoARC Policy 6.01 E – Primary PSG Instructor
www.coarc.com
In addition to the CRT-SDS, RRT-SDS, or RPSGT credential, this individual must possess at least an Associate Degree, and have at least two (2) years of clinical experience in sleep technology.
It is recommended that the individual should have at least one (1) year’s experience in an appropriate teaching position.
Standard III – Program Goals, Outcomes, and Assessment
www.coarc.com
Statement of Program GoalsAssessment of Program GoalsAssessment of Program ResourcesStudent EvaluationAssessment of Program OutcomesReporting Program OutcomesClinical Site Evaluation
Standard III – Program Goals, Outcomes, and Assessment
www.coarc.com
Standard 3.01 –Standard 3.01 –…For programs offering the polysomnography option,
the program must have the following additional goal defining minimum expectations:
“To prepare sleep disorder specialists with demonstrated competence in the cognitive
(knowledge), psychomotor (skills), and affective (behavior) learning domains of polysomnography
practice as performed by sleep disorder specialists (SDS).”
Standard III – Program Goals, Outcomes, and Assessment
www.coarc.com
Standard 3.03 - Standard 3.03 - Program goals must be compatible with nationally
accepted standards of roles and functions of registered respiratory therapists and registered sleep disorders specialists for programs offering the polysomnography option.
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1. Facilitate the entry of working therapists wishing to cross-train into this specialty.
2. Provide graduates with the opportunity to obtain specialized training and be eligible to take the national credentialing exam upon completion of the certificate.
Optional PSG Program Goals
www.coarc.com
Standard III – Program Goals, Outcomes, and Assessment
www.coarc.com
Standard 3.13 - Standard 3.13 - The program must, at a minimum, meet the assessment
thresholds established by CoARC for the following program outcomes, regardless of location and instructional methodology used: a) Graduate performance on the national credentialing examination for entry into practice; b) Programmatic retention/attrition; c) Graduate satisfaction with program; d) Employer satisfaction with program; and e) Job placement.
Standard IV– Curriculum
www.coarc.com
Minimum Course ContentMinimum CompetenciesLength of StudyEquivalencyClinical Practice
Standard IV– Curriculum
www.coarc.com
Standard 4.07 - Standard 4.07 - …For the polysomnography option, curricular content must
be periodically reviewed and revised to ensure its consistency with the competencies and duties performed by sleep disorder specialists in the workforce, as established by the national credentialing agency through its periodic job analysis and outlined in its credentialing examination specifications. These nationally accepted standards provide the basis for formulating the objectives and competencies of the program’s curriculum…
NBRC SDSDetailed ContentOutline
Comparisonwith
Curriculum
www.coarc.com
Page 1 of 1
NBRC Sleep Disorders Specialist (SDS) Examination Detailed Content Outline Comparison
with Curriculum (Program # )
List Course Number(s)
I. PRE-TESTING A. Identification and Care of At-Risk Individuals
1. Recognize signs and symptoms associated with sleep disorders as revealed by history, interview, or clinical assessment
2. Identify special factors and co-morbid conditions affecting individuals with potential sleep disorders
3. Interact with members of the health care team
a. communicate findings b. recommend diagnostic studies
c. recommend therapeutic intervention
B. Study Preparations 1. Review
a. a patient’s history, current medications, questionnaire, and notes
b. the physician’s order for a sleep study
2. Set up
a. equipment to achieve the desired data collection
b. special equipment as indicated
3. Select the appropriate study procedure and corresponding montage e.g. • Polysomnography with or without PAP titration • Maintenance of Wakefulness Test • Multiple Sleep Latency Test
4. Set high and low filters, and sensitivity settings 5. Evaluate equipment calibrations to ensure accuracy and linearity of amplified signals e.g. pneumotach, EMG, EEG
6. Confirm adequate audiovisual signals 7. Recommend modifications to the physician’s order when necessary 8. Assess the patient’s current clinical condition 9. Explain testing procedures and potential interventions to the patient
10. Determine the patient’s expectations about the study 11. Recognize special needs associated with a patient’s
a. age
b. psychological status
c. physical status
d. culture
e. language
f. cognitive status
12. Identify patient medications that may affect test results
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Curriculum content and length, and documentation of student progress must be designed to enable achievement of program goals and objectives.
Curricular content must be designed to supplement as well as take advantage of the comprehensive didactic, laboratory, and clinical instruction already established in a respiratory care curriculum.
For instance, while respiratory care program curricula provide significant instruction on positive airway pressure (PAP) therapy, respiratory therapy students enrolled in an optional polysomnography program would learn about the distinct application of PAP devices within the context of the sleep laboratory.
Curricular Strategies
www.coarc.com
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Learning and clinical resources must be appropriate to the program’s goals and should be available to students outside of regular classroom hours.
Physician input, preferably those who are Board-certified in sleep medicine, should also be adequate.
Program competencies should provide the basis for deriving the objectives and activities constituting the program's curriculum.
The competencies stated and the curriculum objectives derived should be consistent with the level of practitioner preparation delineated in the program's goals, and should encompass the knowledge, technical expertise and behavior expected of graduates.
Curricular Strategies
www.coarc.com
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The curriculum must include an appropriate sequence of learning experiences consisting of classroom and laboratory presentations, discussions, demonstrations, and supervised laboratory and clinical practice that progresses in sequence from entry-level cognitive, psychomotor, and affective components of instruction to more advanced levels.
Clearly written course syllabi which describe learning objectives and competencies must be developed for each of the didactic, laboratory, and clinical components.
Clinical affiliates should conform to professional standards, such as those established by the AASM, JCAHO, and by other health care accrediting entities where appropriate.
Curricular Strategies
www.coarc.com
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The above strategies are not meant to be all-inclusive, but are attentive and consistent with current accreditation standards and practices.
The polysomnography curriculum should be designed in such a way as to addresses the unique characteristics and constraints of each respiratory therapy program.
What works well for a university-based, baccalaureate respiratory therapy program with 10-week modular curricula, for example, will not necessarily work for a semester-based, associate degree community college program.
Curricular Strategies
www.coarc.com
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LAST SEMESTER (YEAR 1) OBSERVATIONAL CLINICAL IN A SLEEP LABORATORY
FIRST SEMESTER (YEAR 2) PSG LECTURE I -------------------------- 20 contact hours
PSG LAB I ----------------------------------- 30 contact hours PSG CLINICAL I --------------------------- 80 contact hours
SECOND SEMESTER (YEAR 2) PSG LECTURE II -------------------------- 20 contact hours PSG LAB II ----------------------------------- 30 contact hours PSG CLINICAL II --------------------------- 80 contact hours
TOTAL CONTACT HOURS: 260
Sample Program Curriculum
www.coarc.com
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Sample Program Curriculum
www.coarc.com
Professional-Technical
RESP 250 Beginning Polysomnography 2
RESP 251 Intermediate Polysomnography 3
RESP 252 Polygrphy Directed Practice I 3
RESP 253 Neurophysiology of Sleep 2
RESP 254 Intermediate Polysomnography II 3
RESP 255 Intermediate Polysomnography II 3
Professional-Technical: 16
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Sample Program Curriculum
www.coarc.com
First Term Course Title CreditsPSG 1000 Polysomnographic Technology I 3PSG 1000L Polysomnographic Technology Laboratory I 1PSG 1800L Polysomnographic Technology Clinical Practicum I 1 Total Credits 5Second TermCourse Title CreditsPSG 1001 Polysomnographic Technology II 3PSG 1001L Polysomnographic Technology Laboratory II 1PSG 1801L Polysomnographic Technology Clinical Practicum II 1 Total Credits 5 Total Certificate Credits 10
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Medical Terminology related to SleepPatient and Laboratory Safety IssuesProcedures/Documentation for Initiating Sleep StudiesElectrode Theory/InstrumentationPatient Preparation Procedures/International 10-20 SystemNeuroanatomy and Physiology Intro to sleep architecture/sleep stagesAncillary equipment applicationSignal processingMontage selection/Equipment calibrationPhysiologic Calibrations/Lights Out ProceduresSleep disorders pathophysiology
Typical Sequence of Instructional Units
www.coarc.com
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Monitoring proceduresSleep microanatomy and architectureSleep pathophysiologyPSG record staging (R&K/AASM)Event recognition (Limb movement; Respiratory; Cardiac; Neuro) Sleep PharmacologySleep CalculationsPediatric PSGMSLT/MWTData archiving/Report generationTherapeutic Interventions (PAP, surgical, non-surgical)Sleep lab/center managementTreatment plans (development/implementation/evaluation)
Typical Sequence of Instructional Units
www.coarc.com
Standard V– Fair Practices and Recordkeeping
www.coarc.com
DisclosureNon-discriminatory PracticeSafeguardsAcademic GuidanceStudent IdentificationStudent RecordsProgram Records
How do I get started?CoARC Policy 2.01All sponsors must have an accredited base program. A base program holding continuing accreditation with no pending progress reports may expand its offerings by adding a Polysomnography Specialty, or Satellite (U.S. or International).
www.coarc.com
Accreditation Policy ChangeCoARC Policy Change to go into effect as of March 2012:Polysomnography Program Option referred to as Sleep Specialist Program Option (SSPO);
More accurate/appropriate description of the respiratory therapist’s role in the sleep field;
Alignment with description used by NBRC.
www.coarc.com
How do I get started?Initiation of Accreditation (CoARC Policy 2.03)Initiation of Accreditation (CoARC Policy 2.03)
Letter of Intent Application- SSPO Advisory Committee support; Letters of support from affiliates; Establishes maximum enrollment. $250 application fee
Action by CoARC Board (Approval/Denial of Intent)Enrollment of students for the first class must occur within
six (6) months of the date of the Approval of Intent.
www.coarc.com
How do I get started?Initiation of Accreditation (CoARC Policy 2.03)Initiation of Accreditation (CoARC Policy 2.03)
Submit a CoARC Accreditation Services Application;Sleep Specialist Initial Accreditation Self Study Report (ISSR-
Sleep) – submitted within 3 months after enrollment of first class;
$500 self-study fee;On-Site Review – conducted within 3-5 months after ISSR;Action by CoARC (Initial Accreditation or Withhold of Initial
Accreditation); Initial Accreditation for 5 years
$500 annual fee.
www.coarc.com
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Perform a needs assessment; Interest from the community; Assess your resources;Find a qualified primary PSG instructor/facility;
Obtain support/feedback from administration, advisory committee, and medical director; co-medical director?
Go to www.coarc.com, download and review the Letter of intent application and self study;
Network with colleagues.
How do I get started?How do I get started?
www.coarc.com
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www.coarc.comwww.coarc.comApplication for Accreditation ServicesPolicies and StandardsList of currently accredited PSG-add on programs
www.aarc.orgwww.aarc.orgSpecialty sections in sleep & education ([email protected])
www.nbrc.orgwww.nbrc.orgSDS exam content and administration; state practice acts
www.brpt.org www.brpt.org RPSGT exam content and administration
What resources are at my disposal???
www.coarc.com
CoARC Executive Office
For any questions, contact the Executive Office at:
1248 Harwood Road
Bedford, TX 76021
(817) 283-2835
www.coarc.com
Questions and Answers
www.coarc.com