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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 AC formally recognizes those who obtained the certifications mentioned above AND met the minimum standards as set below [1]:

  • 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: Basic Life Support (BLS), taking Vital Signs (BP, Pulse, Respirations, Pulse Ox, & Pain level), Blood Glucose,& safely perform Patient Transfers
  • The certified individual continually stays proficient and knowledgeable of the hyperbaric field of medicine by maintaining 12 hyperbaric specific CEUs annually
  • Nurses should 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 must be "Category A", defined as education and training directly related to the practice of undersea, hyperbaric or hypobaric medicine.[3]
    • Of these 12 credits, at least 9 (75%) must relate to ‘core competency’, namely technical, operational and safety aspects of the hyperbaric/hypobaric delivery system.
    • If not all of the 24 hours are Category A, the balance can be made up with Category B credits. These are defined as those programs and courses that provide more generalized information  related to allied health care professional knowledge and skills. Examples include BLS and ACLS certification/recertification, clinical practice and compliance updates, emerging technologies,  potential new uses, etc. 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 present at meetings where CE’s are offered are also eligible for credits. For a Poster Presentation two (2) credits are awarded (‘A’ or  ‘B’, depending upon the topic). For an Oral  Presentation, regardless of length, six (6) ‘A’ or ‘B’ credits are award.

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.     
      • 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)


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.
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.
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.”
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