Syllabus for PSG-105

THERAPEUTIC INTERVENTIONS AND CLINICAL PATIENT MANAGEMENT


COURSE DESCRIPTION

Therapeutic Interventions and Clinical Patient Management is the second clinical component of the Polysomnography program. It is designed to prepare students for an entry-level role as a polysomnographic (PSG) technologist. The course provides training in the fundamental concepts of clinical patient management, including identification of respiratory events and initiation and management of therapeutic interventions for sleep-related breathing disorders including PAP, oxygen, servoventilation, and noninvasive positive pressure ventilation.

The course focuses on patient treatment and development of the skills required to identify and manage patient safety and medical emergencies in the sleep center, the delivery of patient education, and the management and optimization of therapeutic interventions. Under the supervision of a Registered Polysomnographic Technologist (preceptor), students will participate in polysomnographic recording procedures that include therapeutic intervention procedures.

The purpose of the course is to provide the student with the necessary skills to implement treatment for sleep-disordered breathing, monitor compliance with PAP therapy, manage patient safety issues and emergency situations, and educate patients and their family members with regards to sleep disorders.

COURSE OBJECTIVES

After completing this course, you should be able to:

  1. Identify the need for therapeutic intervention.
  2. Initiate and manage therapeutic interventions.
  3. Identify and manage patient safety issues.
  4. Identify and manage medical emergencies.
  5. Identify and manage environmental emergencies.
  6. Provide patient education.

COURSE MATERIALS

You will need the following textbook to do the work of the course. The required textbook is available from the College’s textbook supplier, MBS Direct.

  1. Mattice, C., Brooks, R., & Lee-Chiong, T. (Eds). (2012). Fundamentals of sleep technology (2nd ed.). Philadelphia: Lippincott Williams and Wilkins.

    ISBN-13: 978-1-4511-3203-8

COURSE STRUCTURE

Therapeutic Interventions and Clinical Patient Management is a four-credit online course consisting of eleven (11) modules. Modules include an overview, topics, study materials, and clinical activities. Module titles are listed below along with the topics covered.

  1. Module 1: The Basics of PAP Therapy
    Course objectives covered in this module: 1, 2, 6

    Topics:
  1. PAP equipment and interfaces
  2. Educating the patient
  3. Application of PAP devices
  4. PAP protocols
  5. Starting levels, upper and lower limits of PAP therapy, contraindications
  6. PAP complications
  7. Responses to PAP complications

  1. Module 2: Identifying the Need for Therapeutic Intervention of Sleep-Related Breathing Disorders
    Course objectives covered in this module: 1, 6

    Topics:
  1. Identifying respiratory events
  2. Sleep and event calculations
  3. Obstructive sleep apnea syndromes
  4. Central sleep apnea and hypoventilation
  5. Cheyne-Stokes breathing pattern
  6. Oxygen saturation and carbon dioxide monitoring
  7. Physiologic impact of PAP on the lungs and heart
  8. Setup and operation of PAP equipment
  9. Patient education
  10. Complications, tolerance, and side effects of PAP therapy
  11. The effect of sleep disruption and respiratory events on the titration process
  12. Rationale for split-night studies

  1. Module 3: Initiating and Managing Therapeutic PAP Interventions and Supplemental Oxygen Therapy
    Course objectives covered in this module: 2, 3

    Topics:
  1. Bilevel pressure titration
  2. Guidelines for supplemental oxygen therapy
  3. Oxygen titration
  4. Oxygen therapy contraindications
  5. Combined use of PAP and oxygen
  6. Bleeding oxygen into PAP devices
  7. Oxygen therapy complications
  8. Responses to oxygen complications
  9. Oximetry
  10. CO2 monitoring
  1. Module 4: Identifying and Managing Patient Safety Issues and Medical and Environmental Emergencies
    Course objectives covered in this module: 2, 3, 4, 5

    Topics:
  1. Servoventilation
  2. Noninvasive positive pressure ventilation
  3. Patient safety:
  1. medical history
  2. medical and psychological disorders that may present safety issues
  3. mental age
  4. language barriers
  5. sundowning
  6. inappropriate behaviors
  7. post-traumatic stress disorder/anxiety

  1. Medical emergencies:
  1. cardiorespiratory emergencies
  2. arrhythmias that constitute a medical emergency
  3. severe respiratory distress
  4. seizures
  5. parasomnias
  6. psychiatric emergencies
  7. when to call a physician
  8. medical backup
  9. electrical safety

  1. Environmental emergencies:
  1. emergency plan
  2. fire safety
  3. disaster plan
  1. Module 5: Initiating and Managing Therapeutic PAP Interventions
    Course objectives covered in this module: 2

    Topics:
  1. Fitting PAP interfaces
  2. PAP acclimation
  3. Humidification
  1. Module 6: PAP Titration
    Course objectives covered in this module: 1, 2

    Topic:
  1. PAP Titration

  1. Module 7: Oxygen and PAP Titration
    Course objectives covered in this module: 1, 2

    Topics:
  1. Oxygen titration
  2. PAP and oxygen titration

  1. Module 8: Initiating and Managing Therapeutic Servoventilation and Noninvasive Positive Pressure Ventilation
    Course objectives covered in this module: 1, 2

    Topics:
  1. Bilevel PAP
  2. Servoventilation
  3. NIPPV

  1. Module 9: Patient Education and Optimizing PAP Therapy
    Course objectives covered in this module: 2, 6

    Topics:
  1. General sleep education
  2. Sleep hygiene instruction
  3. Insomnia treatment options
  4. PAP education
  1. Monitoring PAP compliance
  2. PAP downloads and reports
  3. PAP complications
  4. Resources for patients with PAP complications
  5. Documenting outcomes
  6. Role of auto-PAP

  1. Module 10: Advanced PAP Titration
    Course objectives covered in this module: 1, 2, 3, 4, 5, 6

  1. Module 11: Advanced PAP Titration
    Course objectives covered in this module: 1, 2, 3, 4, 5, 6

ASSESSMENT METHODS

For your formal work in the course, you are required to participate in scheduled clinical sessions and complete associated module activities (Laboratory and Clinical checklists and Clinical Experience Summary Logs), take four graded quizzes and an ungraded capstone examination, and pass five technical competency evaluations. See below for details.

Consult the course Calendar for due dates.

Clinical Activities

Therapeutic Interventions and Clinical Patient Management affords you the opportunity, while working under the supervision and guidance of a Registered Polysomnographic Technologist (your preceptor), to observe and practice the competencies you need to demonstrate on the five technical competency evaluations. The activities associated with clinical sessions supervised by your preceptor include working through and submitting module Laboratory and Clinical Checklists and Clinical Experience Summary Logs. Your preceptor will complete these checklists and logs and return them to you along with her or his feedback.

Quizzes and Capstone Examination

You are required to take four (4) online quizzes. Each quiz consists of 15 multiple-choice questions covering module topics. You will have 20 minutes to complete each quiz.

In addition to the four graded quizzes, you are required to take a closed-book, unproctored online capstone examination. The capstone examination serves as a comprehensive survey and evaluation of the clinical, technical, and procedural aspects of training in polysomnography, and not as a pass/fail exit for successfully completing this course. You will receive 10% of your final grade simply for taking the exam, and the results will be used for curriculum improvement, not for grading purposes.

The capstone exam encompasses all topics and objectives covered in PSG-101, PSG-102, PSG-103 (Modules 6–10), PSG-104 (Modules 7–10), PSG-105, and PSG-200. It is two hours long and consists of 125 multiple-choice questions.

Please consult the course Calendar for quiz due dates and the timing of the Capstone Examination.

Statement about Cheating

You are on your honor not to cheat during the exam. Cheating means:

  1. Looking up any answer or part of an answer in an unauthorized textbook or on the Internet, or using any other source to find the answer.
  2. Copying and pasting or in any way copying responses or parts of responses from any other source into your online test. This includes but is not limited to copying and pasting from other documents or spreadsheets, whether written by yourself or anyone else.
  3. Plagiarizing answers.
  4. Asking anyone else to assist you by whatever means available while you take the exam.
  5. Copying any part of the exam to share with other students.
  6. Telling your mentor that you need another attempt and the exam because your connection to the Internet was interrupted when that is not true.

If there is evidence that you have cheated or plagiarized in your exam, the exam will be declared invalid, and you will fail the course.

Technical Competency Evaluations

Therapeutic Interventions and Clinical Patient Management requires you to successfully complete five (5) technical competency evaluations. They are:

  1. Competency Evaluation 1: Maintenance, Cleaning, and Safety Precautions in Polysomnographic Technology
  2. Competency Evaluation 2: Monitoring Pulse Oximetry in Polysomnographic Technology
  3. Competency Evaluation 3: Supplemental Low Flow Oxygen Titration in Polysomnographic Technology
  4. Competency Evaluation 4: CO2 Monitoring in Polysomnographic Technology
  5. Competency Evaluation 5: PAP Titration in Polysomnographic Technology

To pass the course, you must pass all five competencies, that is, achieve the minimum competency score or higher on each of the five competency evaluations. Failure to achieve competency on any of the five competency evaluations will result in a failing grade for the course.

Competency is met when you perform the competency according to accepted standards and guidelines. For every “Needs Improvement” (NI) you receive, your preceptor will enter a comment outlining the specific issue. To achieve a minimum passing score (see the Scoring Key for each competency evaluation), you must meet standards on 80% of the items listed as individual competencies and submit all accompanying files (screen captures and photos) identified.

You will be given two (2) chances to pass each competency.

GRADING AND EVALUATION

To pass the course, you must successfully complete all five technical competency evaluations (i.e., achieve the minimum competency score or higher on each competency evaluation). If you successfully complete the five competency evaluations (50%), then the rest of your grade will be determined by your scores on the four quizzes (20%), your completion of the capstone examination (10%), and your completion of the module lab and clinical activities (checklists and summary logs, 20%). Regardless of your scores on the quizzes and your completion of module activities and the capstone examination, failure to successfully complete all five competency evaluations will result in a failing grade (F).

  1. Module clinical activities (graded Complete/Incomplete)—20%
  1. Laboratory Checklists (3%)
  1. Clinical Checklists (12%)
  1. Clinical Summary Logs (5%)

  1. Quizzes (4, scored numerically)—20%
  1. Quiz 1 (covering Modules 1 and 2)
  2. Quiz 2 (covering Modules 3, 4, and 5)
  3. Quiz 3 (covering Modules 6, 7, and 8)
  4. Quiz 4 (covering Modules 9, 10, and 11)

  1. Capstone Examination (graded Complete/Incomplete)—10%

  1. Competency Evaluations (5, graded Pass/Fail)—50%
    The precise scheduling of competency evaluations will vary from site to site depending on appropriate patient availability. This will give the clinical site more leeway in terms of actual scheduling of the competency.

  1. Competency Evaluation 1: Maintenance, Cleaning, and Safety Precautions in Polysomnographic Technology
  2. Competency Evaluation 2: Monitoring Pulse Oximetry in Polysomnographic Technology
  3. Competency Evaluation 3: Supplemental Low Flow Oxygen Titration in Polysomnographic Technology
  4. Competency Evaluation 4: CO2 Monitoring in Polysomnographic Technology
  5. Competency Evaluation 5: PAP Titration in Polysomnographic Technology

Your final grade in the course will be a letter grade. Letter grade equivalents for numerical grades are as follows:

A

=

93–100

C+

=

78–79

A–

=

90–92

C

=

73–77

B+

=

88–89

C–

=

70–72

B

=

83–87

D

=

60–69

B–

=

80–82

F

=

Below 60

To receive credit for the course, you must successfully complete all five technical competency evaluations and earn a letter grade of C or higher on the weighted average of all assigned course work (e.g., labs, clinicals, quizzes, capstone exam, and competency evaluations). You will receive a score of 0 for any work not submitted.

STRATEGIES FOR SUCCESS

First Steps to Success

To succeed in this course, take the following first steps:

  1. Read carefully the entire Syllabus, making sure that all aspects of the course are clear to you and that you have all the materials required for the course.
  2. Take time to read the entire Online Student Handbook. The Handbook answers many questions about how to proceed through the course and how to get the most from your educational experience at Thomas Edison State College.
  3. Familiarize yourself with the learning management systems environment—how to navigate it and what the various course areas contain. If you know what to expect as you navigate the course, you can better pace yourself and complete the work on time.
  4. If you are not familiar with Web-based learning be sure to review the processes for posting responses online and submitting assignments before class begins.

Study Tips

Consider the following study tips for success:

  1. To stay on track throughout the course, begin each week by consulting the course Calendar. The Calendar provides an overview of the course and indicates due dates for submitting assignments, posting discussions, and scheduling and taking examinations.
  2. Check Announcements regularly for new course information.

ACADEMIC INTEGRITY

Students at Thomas Edison State College are expected to exhibit the highest level of academic citizenship. In particular, students are expected to read and follow all policies, procedures, and program information guidelines contained in publications; pursue their learning goals with honesty and integrity; demonstrate that they are progressing satisfactorily and in a timely fashion by meeting course deadlines and following outlined procedures; observe a code of mutual respect in dealing with mentors, staff, and other students; behave in a manner consistent with the standards and codes of the profession in which they are practicing; keep official records updated regarding changes in name, address, telephone number, or e-mail address; and meet financial obligations in a timely manner. Students not practicing good academic citizenship may be subject to disciplinary action including suspension, dismissal, or financial holds on records.

Academic Dishonesty

Thomas Edison State College expects all of its students to approach their education with academic integrity—the pursuit of scholarly activity free from fraud and deception. All mentors and administrative staff members at the College insist on strict standards of academic honesty in all courses. Academic dishonesty undermines this objective. Academic dishonesty takes the following forms:

  1. Cheating
  2. Plagiarizing (including copying and pasting from the Internet without using quotation marks and without acknowledging sources)
  3. Fabricating information or citations
  4. Facilitating acts of dishonesty by others
  5. Unauthorized access to examinations or the use of unauthorized materials during exam administration
  6. Submitting the work of another person or work previously used without informing the mentor
  7. Tampering with the academic work of other students

Academic dishonesty will result in disciplinary action and possible dismissal from the College. Students who submit papers that are found to be plagiarized will receive an F on the plagiarized assignment, may receive a grade of F for the course, and may face dismissal from the College.

A student who is charged with academic dishonesty will be given oral or written notice of the charge. If a mentor or the College official believes the infraction is serious enough to warrant referral of the case to the academic dean, or if the mentor awards a final grade of F in the course because of the infraction, the student and the mentor will be afforded formal due process.

If a student is found cheating or using unauthorized materials on an examination, he or she will automatically receive a grade of F on that examination. Students who believe they have been falsely accused of academic dishonesty should seek redress through informal discussions with the mentor, through the office of the dean, or through an executive officer of Thomas Edison State College.

Plagiarism

Using someone else’s work as your own is plagiarism. Although it may seem like simple dishonesty, plagiarism is against the law. Thomas Edison State College takes a strong stance against plagiarism, and students found to be plagiarizing will be severely penalized. If you copy phrases, sentences, paragraphs, or whole documents word-for-word—or if you paraphrase by changing a word here and there—without identifying the author, then you are plagiarizing. Please keep in mind that this type of identification applies to Internet sources as well as to print-based sources. Copying and pasting from the Internet, without using quotation marks and without acknowledging sources, constitutes plagiarism. (For information about how to cite Internet sources, see Online Student Handbook > Academic Standards > “Citing Sources.”)

Accidentally copying the words and ideas of another writer does not excuse the charge of plagiarism. It is easy to jot down notes and ideas from many sources and then write your own paper without knowing which words are your own and which are someone else’s. It is more difficult to keep track of each and every source. However, the conscientious writer who wishes to avoid plagiarizing never fails to keep careful track of sources.

Always be aware that if you write without acknowledging the sources of your ideas, you run the risk of being charged with plagiarism.

Clearly, plagiarism, no matter the degree of the intent to deceive, defeats the purpose of education. If you plagiarize deliberately, you are not educating yourself, and you are wasting your time on courses meant to improve your skills. If you plagiarize through carelessness, you are deceiving yourself.

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