The Importance and Recognition of Hyperbaric Certification for Technicians and Nurses
Why get certified?
It is the position of the Undersea and Hyperbaric Medical Society (UHMS) Associate Council (AC) that all operators, technicians and nurses who oversee hyperbaric oxygen therapy should achieve hyperbaric certification, that is: CHS (Certified Hyperbaric Specialist), CHWS (Certified Hyperbaric & Wound Care Specialist), CHT (Certified Hyperbaric Technologist), CHRN (Certified Hyperbaric Nurse), ACHRN (Advanced Certified Hyperbaric Registered Nurse) and CHRNC (Certified Hyperbaric Registered Nurse Clinician).[1][2]
According to the UHMS, many hyperbaric facilities have technicians and nurses who have not achieved certification, nor have they attended an approved 40-hour hyperbaric specific introductory course. In addition, there is not a consistent minimum standard of who can become certified by the various hyperbaric certifying bodies.[1]
Hyperbaric certification is important, as the certification process leads to enhanced patient safety, knowledge, skills, and practice.
The UHMS Associate Council (AC) has historically only recognized two hyperbaric
certifications CHT & CHRN. Recently more certifying bodies have started to appear around the world and within the United States. Each certifying body has different standards to achieve certification. As the hyperbaric community evolves, the UHMS AC will routinely review and recognize different hyperbaric certifications that achieve the minimum, yet high standard, we envision will help ensure quality, safety, and professionalism of the operators, technicians, and nurses in the field of hyperbaric medicine [1]:
The UHMS Associate Council (AC) believe that all operators, technicians, and nurses should
be certified. They formally recognize those that have achieved the following certifications CHS (Certified Hyperbaric Specialist), CHWS (Certified Hyperbaric & Wound Care Specialist), CHT (Certified Hyperbaric Technologist), & CHRN (Certified Hyperbaric Nurse) AND who meet the minimum standards as set below [1]:- The UHMS AC believes that each technician or nurse should attend a NBDHMT (National Board of Diving and Hyperbaric Medical Technology), UHMS, or ACHM (American College of Hyperbaric Medicine) face-to-face approved 40 Hour Introductory Hyperbaric Medicine course and achieve hyperbaric certification within 18 months or less of starting work in a hyperbaric environment
- The certified individual should maintain the primary licensure/certification within their scope of practice or be signed off by their supervising physician (i.e., non-licensed Medical Assistants)
- The certified individual must have the following minimal skill sets and annual competencies to effectively manage patients safely during hyperbaric treatment: BLS, taking Vital Signs (BP, Pulse, Respirations, Pulse Ox, & Pain level), Blood Glucose, & safely perform Patient Transfers
- The UHMS AC believes it is important to continually stay proficient and knowledgeable of the hyperbaric field of medicine by maintaining 12 hyperbaric specific CEUs annually
- Finally, the UHMS Associates recommend that nurses be certified through the BNACB (Baromedical Nurses Association Certification Board) to consistently align with nursing best practices
Recertification and Continuing Education Requirements
Certified Hyperbaric Technologists (CHTs) by the NBDHMT
- Certification is awarded for a period of 2 years [3]
- Besides other clinical work requirements, CHTs must present proof of a minimum of 24 (minimum of 12 Category “A”) continuing education (CE) hours during the prior 2 years.[3]
- Of note, at least 12 CE credits must be "Category A", defined as education and training directed related to technical, operations and safety aspects of hyperbaric or hypobaric operations.[3]
- Examples of other suitable Category A topics include infection control/universal precautions, recognition and immediate management of barotrauma, recognition and immediate management of CNS oxygen toxicity, other chamber related complications, tissue oximetry testing, and inside attendant duties and decompression procedures.[3]
- If not all of the 24 hours are Category A, the balance beyond 12 can be made up with Category B credits. They are defined as courses, programs and other learning opportunities related to allied health professional knowledge and skills in general and the clinical and compliant practice of undersea, hyperbaric or hypobaric medicine in particular. Examples include clinical assessment and case management of the hyperbaric referral, emerging technologies, potential new uses of the hyperbaric chamber, related compliance expectations and standards, and BLS/ACLS/PALS certification/recertification.[3] Example:
- Option 1: 24 Category A Credits satisfies renewal requirements
- Option 2: 12 Category A Credits & 12 Category B credits likewise satisfies renewal requirements
- CHT’s who formally present at meetings where CEU’s are offered are eligible for credits. For participation in development of a Poster Presentation, the NBDHMT will award two (2) credits (A or B depending upon the topic). Oral presentations, regardless of length, earn six (6) A or B credits. For those who serve as UHMS Facility Accreditation Surveyors, the NBDHMT allows a one-time award of five (5) Category A credits, upon receipt of supporting documentation from the lead surveyor.
Certified Hyperbaric Specialist (CHWS) by the American Board of Wound Healing (ABWH)
The ABWH Certified Hyperbaric & Wound Care Specialist Examination is endorsed by the American College of Hyperbaric Medicine and the American Professional Wound Care Association. Successful completion of the examination process allows the special recognition and distinction as a Certified Hyperbaric & Wound Care Specialist, and use of the designation CHWS.
- Certification is awarded for a period of 2 years.[4]
- CME requirements for recertification: 20 CME credits during prior two years.
- 5 of these credits must be directly related to the practice of hyperbaric medicine, with 5 being directly related to wound care practice.
- 10 credits from CME category 1 or 2, including but not limited to: completion of approved hyperbaric safety director course, peer to peer HBOT training and/or mentorship including onboarding of new employees, presentation of safety bulletins, attendance of wound care/HBOT professional conference, attendance of wound care/ HBOT inservice (attested by employer).
Certified Hyperbaric Nurses (CHRN, ACHRN, CHRNC) by the NBDHMT and the BNA
- Certification is awarded for a period of 4 years [2]
- During the previous 4 years, besides other requirements, hyperbaric nurses must complete [2]:
- Certified Hyperbaric Registered Nurses (CHRN): 40 hours of continuing education credits (hours), with at least 20 of those credits in the field of hyperbaric oxygen therapy - Category A.
- Advanced Certified Hyperbaric Registered Nurses (ACHRN): 60 hours of continuing education credits (hours) per previous four years, with at least 30 of those credits in the field of hyperbaric oxygen therapy - Category A.
- Certified Hyperbaric Registered Nurse Clinician (CHRNC): 60 hours of continuing education credits (hours) per previous four years, with at least 30 of those credits in the field of hyperbaric oxygen therapy - Category A.
- Of note, Category A credits must be directly related to undersea, hyperbaric or aviation medicine. [2]
- CE submitted must be approved by a [2]:
- a. Professional organization such as the BNA, the UHMS, ACHM, NBDHMT, Wound Ostomy and Continence Nurses Society, Association for the Advancement of Wound Care, etc. AND/OR State NursingPractice Board (and related to hyperbaric oxygen therapy).
- b. State Nursing Practice Board
Where can Category A Continuing Education Credits be obtained?
- WoundReference HBO Knowledge Base (Premium PRO+HBO Plan) offers topics that have been reviewed and approved by the National Board of Diving and Hyperbaric Medical Technology (NBDHMT) for Category A Credits. You can now earn up to 12 National Board Hyperbaric Medical Technology Approved Category A Credits on WoundReference! See details on 'HBOT Category A at the Point-of-Care' or browse our Category A eligible topics available with a (Premium PRO+HBO Plan):
Resources
About the Authors
Elaine Horibe Song, MD, PhD, MBA
Dr. Song is a Co-Founder and Chief Executive Officer of WoundReference, Inc., a clinical and reimbursement decision support & telemedicine platform for wound care and hyperbaric clinicians. With a medical, science and business background, Dr. Song previously served as medical director for a regenerative medicine-focused biotech company in California, and for a Joint Commission International-accredited hospital network. Dr. Song also served as a management consultant for Kaiser Permanente, practiced as a plastic surgeon in private practice and academia, and conducted bench and clinical research in wound healing, microsurgery and transplant immunology. Dr. Song holds a position as Affiliate Professor, Division of Plastic Surgery, Federal University of Sao Paulo, and is a volunteer, Committee Chair of the Association for the Advancement of Wound Care. She has authored more than 100 scientific publications, book chapters, software registrations and patents.
Jeff Mize, RRT, CHT, UHMSADS
With over four decades of healthcare experience, Jeff currently holds the position of Principal Partner at Midwest Hyperbaric LLC and the Co-founder and Chief Clinical Officer of Wound Reference.
Jeff has excelled in critical care throughout his career, devoting almost a decade as a Flight Respiratory Therapist/Paramedic for the Spirit of Kansas City Life Flight. In 1993, Jeff transitioned into the field of Hyperbaric Medicine and Wound Care, where he committed 21 years of his career to serving as the Program Director for a 24/7 Level 1 UHMS Accredited facility with Distinction. In this role, he continued to provide patient care while overseeing all administrative, clinical, and daily operations within the Wound Care and Hyperbaric Facility.
Jeff is a Registered Respiratory Therapist and a Certified Hyperbaric Technologist (CHT). He has also undergone training as a UHMS Safety Director and a UHMS Facility Accreditation Surveyor.
Jeff currently serves as a member of the UHMS Accreditation Council, the UHMS Accreditation Forum Expert Panel, and the UHMS Safety Committee. Additionally, he is an esteemed member of the NFPA 99 Hyperbaric and Hypobaric Facilities Technical Standards Committee.
Jeff's dedication to the field has earned him numerous prestigious awards. In 2010, he received the Gurnee Award, which honored his outstanding contributions to undersea and hyperbaric medicine. Three years later, in 2013, he was awarded the Paul C. Baker Award for his commitment to Hyperbaric Oxygen Safety Excellence. Most recently, in 2020, Jeff was honored with "The Associates Distinguished Service Award (UHMSADS)," a recognition reserved for exceptional Associate members of the Society who have demonstrated exceptional professionalism and contributions deserving of the highest accolades.
Tiffany Hamm, BSN, RN, CWS, ACHRN, UHMSADS
An Advanced Certified Hyperbaric Registered Nurse and Certified Wound Specialist with expertise in billing, coding and reimbursement specific to hyperbaric medicine and wound care services. UHMS Accreditation Surveyor and Safety Director. Principal partner of Midwest Hyperbaric LLC, a hyperbaric and wound consultative service. Tiffany received her primary and advanced hyperbaric training through National Baromedical Services in Columbia South Carolina. In 2021, Tiffany received the UHMS Associate Distinguished Service Award. "This award is presented to individual Associate member of the Society whose professional activities and standing are deemed to be exceptional and deserving of the highest recognition we can bestow upon them . . . who have demonstrated devotion and significant time and effort to the administrative, clinical, mechanical, physiological, safety, technical practice, and/or advancement of the hyperbaric community while achieving the highest level of expertise in their respective field. . . demonstrating the professionalism and ethical standards embodied in this recognition and in the UHMS mission.”
