Last updated on 6/10/21 | First published on 10/26/17 | Literature review current through Oct. 2024
[cite]
Authors:
Jeff Mize RRT, CHT, UHMSADS,
Tiffany Hamm BSN, RN, CWS, ACHRN, UHMSADS,
more...
Coauthor(s)
Jeff Mize, RRT, CHT, UHMSADS
Disclosures: Nothing to disclose
Tiffany Hamm, BSN, RN, CWS, ACHRN, UHMSADS
Chief Nursing Officer, Wound Reference, IncDisclosures: Nothing to disclose
Editors
PURPOSE
To clarify the necessary professional training and duties of the physician and full- and part-time staff members who staff the program.
QUALIFICATIONS
- Physicians, Nurses and Allied Health staff must have current State licensure.
- Physicians must have current state DEA and BNDD
- Physicians, Nurses, and Technologists
- Successful completion of training approved by the UHMS (Undersea and Hyperbaric Medical Society),
the (BNACB) Baromedical Nursing Association Certification Board or the NBDHMT (National Board
of Diving and Hyperbaric Medical Technologists), respectively. All team members must demonstrate
a fundamental appreciation of hyperbaric medicine with respect to:
- Knowledge of the “approved” uses, and the basis for their treatment with hyperbaric oxygen therapy.
- Knowledge of applicable gas laws.
- Knowledge of chamber fire safety.
- Knowledge of potential risks, side effects, and contraindications of hyperbaric medicine, and an ability to explain these issues to patients/ families in terms that they can understand.
- Ability to provide hyperbaric treatments and transcutaneous assessments in a safe and effective manner, with minimal discomfort to the patient.
- Knowledge of the hyperbaric chamber, associated ventilator, and all ancillary equipment, standard operating procedures, and related emergency procedures.
- Ability to recognize side effects and complications (including ear, tooth, and sinus difficulties, pneumothorax, oxygen toxicity, and hypoglycemia) and to follow up with appropriate corrective action.
- Documentation of professional and educational credentials in accordance with federal and state requirements and the Staff Competency and Compliance policy.
- Hyperbaric team members are encouraged to further their professional education and development. Specific opportunities will be provided in the field of hyperbaric and diving medicine and technology.
- Each employee is required to maintain and document competency and compliance in accordance with the Staff Competency and Compliance policy
- All nurses and technologists are required to challenge their respective certification examination within one (1) year of employment.
- Registered Nurses – exam is for Certified Hyperbaric Registered Nurse-CHRN (eligibility after 1 year of hyperbaric experience)
- Technologists – exam is for Certified Hyperbaric Technologist-CHT (eligibility after 3 months of hyperbaric experience.)
PRN/Part-Time Staffing
- The following positions may qualify as PRN/part-time staff:
- Registered Nurse, currently licensed in State of practice
- Respiratory Therapist, currently licensed in state of practice
- Hyperbaric Technologist, currently holding CHT credential
- The PRN/part-time staff reports directly to the:
- Clinical Director, and will function under direct full time employee supervision, unless they have completed formal training in hyperbaric medicine. In absence of the Clinical Director, PRN/part-time staff members will report directly to the designated staff.
- PRN/part-time Job Summary:
- To provide temporary assistance to hyperbaric facility full-time staff. PRN/part-time employees will be scheduled for a minimum of 4 hours Monday through Friday, and a minimum of 2 hours weekends, evenings, or holidays.
- Specific Duties:
- Ensure patients are appropriately prepared for hyperbaric oxygen therapy.
- Maintain patient scheduling, as posted.
- Provide hyperbaric oxygen treatments.
- Perform transcutaneous oximetry studies, as ordered.
- Maintain appropriate hyperbaric facility and chamber cleanliness in order to minimize cross contamination
of patients.
- Prepare equipment and maintain adequate supplies for ancillary equipment.
- Perform other supportive duties as assigned by the Hyperbaric Medicine Nurse Manager or full-time hyperbaric staff members.
- PRN/part-time Staff Guidelines:
- Availability of prescheduled hours for the The Hyperbaric Medicine Service will be on first-come, first-served basis, and should be checked as soon as the PRN/part-time’s principal work schedule becomes available.
- Monday through Friday shifts will consist of a 4-hour minimum.
- PRN/part-time personnel will work a minimum of two 4 hours shifts a month to maintain competency.
- PRN/part-time personnel will not be allowed to work in the hyperbaric unit if they have worked the immediate previous shift elsewhere.
- If PRN/part-time personnel are scheduled and cannot do the assigned time, the hyperbaric Clinical Director is to be notified at least 12 hours in advance.
- If PRN/part-time personnel are not needed for the assigned time, that person will be notified at least 4 hours in advance.
- PRN/part-time personnel will comply with hyperbaric program dress code.
- PRN/part-time personnel will work under the supervision of the Clinical Director, unless that PRN/part-time person has had at least one (1) year experience and has completed the Primary Hyperbaric Training Course.
- Breaks and mealtimes will be as allowed by patient scheduling.
Additional guidance - staff training, competency and compliance
Hyperbaric Technologists
Technologists may become certified as Certified Hyperbaric Technologist-CHT (eligibility after 3 months of hyperbaric experience.) For more details on duties, education, experience, training and performance expectations see topics "
Certified Hyperbaric Technologist" and "
Hyperbaric Chamber Operator".
CERTIFIED HYPERBARIC TECHNOLOGIST - CHT
The NBDHMT Resource Manual descri
bes the training and competencies needed to become a Certified Hyperbaric Technologists (CHT), as well as the acceptable qualifying pathways.[1] The CHT is not a licensure, but rather an additional certification beyond the individual's qualifying profession.[1]
The acceptable qualifying pathways for CHT certification are:
- Respiratory Therapist
- Physician Assistant
- Active Duty Military Corpsman
- EMT/Paramedic
- Registered Nurse or LPN
- Nurse Practitioner
- Physician
In addition to the qualifying pathway the NBDHMT provides specific guidelines for training and competency for CHTs beyond the initial Introductory Hyperbaric Medicine Course. Guidelines include
[1]:
- Be at least 18 years of age with a high school diploma or equivalent.
- CHT applicants must have completed a National Board of Diving & Hyperbaric Medical Technology (NBDHMT) approved hyperbaric medicine introductory training course within three years of intended CHT test date.
- As part of the clinical internship, the CHT must complete the Transcutaneous Oxygen Monitoring (TCOM) Module.
- In order to facilitate entry for certification in hyperbaric technology, the NBDHMT has established a set of clinical internship guidelines [1]:
- Upon completion of an approved course, CHT applicants must undergo a clinical work experience of 480 hours in undersea, hyperbaric medicine or aviation medical technology. Forty (40) hours of this requirement must be a supervised direct and physically present clinical internship. The Board must be notified in writing of the name of the preceptor prior to commencing the internship. The preceptor should be either a CHT or a CHRN with a minimum of two years of undersea/clinical hyperbaric/aviation medicine experience. The Board must be notified in writing (www.CHTPreceptorshipnotificationform.com) of the name of the preceptor prior to commencing the supervised preceptorship.
- Clinical internship guidelines provided by the NBDHMT are general in nature. They are divided into five categories, with specific topics listed for each category. The objectives for each topic are described under the heading “Internship Objectives”. Some of the topics have been expanded to include “Additional Objectives.” Interns are encouraged to achieve each of the additional objectives in whichever topics are of particular interest, or most applicable to their situation. This approach allows individuals with varied skills and backgrounds to utilize a common program of clinical training.
- These internship guidelines are not specific to a particular facility or method of delivery of hyperbaric oxygen therapy. Rather, they provide the broadest possible subject matter so that each center can tailor these guidelines to best fit their respective resources and areas of expertise. The objective of the clinical internship is to provide the intern with a broad-based general knowledge. Each center should develop specific training material(s) with regard to precise objectives, subject matter and teaching methods.
- For a structured framework and tool to facilitate the clinical internship, please refer to the WoundReference competency templates 'HBOT Certified Hyperbaric Technologist Internship' and 'HBOT TCOM Monitoring' in the "Competency Tool".
- Military personnel must complete 1000 clinical hours in addition to required, approved, training received in the military (unless 480 hours of approved clinical internship can be completed at an NBDHMT approved facility)
- Maintain a minimum 24 continuing education credits every two years with at least 12 of those specific to undersea, hyperbaric, or aviation medicine
Hyperbaric Clinical Registered Nurse
For details on duties, education, experience, training and performance expectations see topic "Hyperbaric Registered Nurse"
Staff Physician
For details on duties, education, experience, training and performance expectations see topic "Staff Physician"
REVIEW/REVISION OF POLICY
This policy shall be reviewed and, if necessary, revised at least every year.
Medical Director Date
Reviewed Date:
Revised Date:
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NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.
