This is an archived copy of the Spring 2014 Catalog. To access the most recent version of the catalog, please visit http://catalog.jccc.edu/.

Polysomnography/Sleep Technology, A.A.S.

Overview
Courses

Polysomnographic technologists perform sleep diagnostics working in conjunction with physicians to provide comprehensive clinical evaluations that are required for diagnosis of sleep disorders. By applying non-invasive monitoring equipment, the technologist simultaneously monitors EEG (electroencephalography), EOG (electro-occulography), EMG (electromyography), ECG (electrocardiography), multiple breathing variables and blood oxygen and carbon dioxide levels during sleep. Interpretive knowledge is required to provide sufficient monitoring diligence to recording parameters and the clinical events observed during sleep. Technologists provide supportive services related to the ongoing treatment of sleep related problems. The professional realm of this support includes guidance on the use of devices for the treatment of breathing problems during sleep and helping individuals develop sleeping habits that promote good sleep hygiene. PSG technologists are employed in Sleep Disorders Centers and Labs, which may be located in medical centers, hospitals, or
clinic/office settings.

The Polysomnography program is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). Graduates of the program will enter the field as Polysomnographic Technicians and be prepared to sit the national exam given by the Board of Registered Polysomnographic Technologists (BRPT) to gain the Registered Polysomnographic Technologist (RPSGT) credential.

This is a selective admission program with limited enrollment. Prospective students are encouraged to visit the program Web site or to contact JCCC program personnel for additional information and application materials at 913-469-7655.

Note: Metropolitan Community College students should seek specific counsel from the JCCC program personnel for the appropriate course plan and numbers.

Metropolitan Community College students should refer to Cooperative Program Information.

This program requires a professional liability insurance fee. Students will be notified via their JCCC student e-mail account if they are required to pay a $16 fee. The dollar amount for fees is subject to change.

Students must “pass” all clinical courses and maintain a grade of “C” or higher in all non-clinical courses to remain in the program.

(Major Code 236A; State CIP Code 51.0917)

Polysomnography

Associate of Applied Science Degree

Prior to beginning professional courses

MATH 116	Intermediate Algebra* (or higher)	3
CHEM 122	Principles of Chemistry*	5
BIOL 144	Human Anatomy and Physiology*	5-8
or BIOL 140 & BIOL 225	Human Anatomy and Human Physiology*
Total Hours		13-16

First Semester

EMS 121	CPR I - Basic Life Support for Healthcare Provider (Or current AHA BLS Health Care Provider Certification AND Health and/or Physical Education Elective)	1
HC 130	Medical Terminology for Healthcare Professions (Or satisfactory completion of a health related degree or certificate)	3
ENGL 121	Composition I*	3
PSG 125	Introduction to Sleep Medicine*	4
PSG 130	Physiology of Sleep Medicine*	3
Total Hours		14

Second Semester

PSG 140	Sleep Disorders*	4
PSG 145	Sleep Study Instrumentation*	4
PSG 150	Polysomnography I*	4
Communications Elective ^{^}		3
Total Hours		15

^	Communications Elective

Third Semester

PSG 245	Polysomnography Clinical I*	6
PSG 250	Polysomnography II*	4
Social Science/Economics Elective ^{^}		3
Total Hours		13

^	Social Science/Economics Elective

Fourth Semester

PSG 255	Polysomnography Clinical II*	6
PSG 265	Polysomnography Capstone*	3
Humanities/Art Elective ^{^}		3
Total Hours		12

^	Humanities/Art Elective

Total Program Hours: 64-70

Courses

PSG 125 Introduction to Sleep Medicine (4 Hours)

Prerequisites: Admission to the polysmonography program

Corequisites: Current AHA BLS Health Care Provider Certification

This course is an introduction to the history of sleep medicine. It also explores the role and the communication, time management, infection control, basic patient assessment, safety and professional expectations of the polysomnographic technologist. Students will have the opportunity to have direct observation in an associated sleep center or lab. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 4 hrs. integrated lecture/lab each week and 48 clinical hrs./semester.

PSG 130 Physiology of Sleep Medicine (3 Hours)

Prerequisites: Admission to the polysomnography

This course will provide a comprehensive study of neuroanatomy and physiology and normal sleep mechanisms. It will also provide an overview of the cardiovascular and respiratory anatomy and physiology as it relates to sleep medicine. This includes ECG interpretation, oxygenation and ventilation assessment, and mechanisms and basic management of breathing. 3 hrs. lecture/wk.

PSG 140 Sleep Disorders (4 Hours)

Prerequisites: PSG 125 with a grade of "C" or higher and PSG 130 with a grade of "C" or higher

Corequisites: Current AHA BLS for Health Care

This course is designed to provide the basic information related to the disease processes and conditions which adversely effect sleep. The etiologies, clinical presentation, diagnosis and therapeutic interventions will be covered for each condition. 3 hrs. lecture and 48 clinical hrs./semester.

PSG 145 Sleep Study Instrumentation (4 Hours)

Prerequisites: PSG 125 with a grade of "C" or higher and PSG 130 with a grade of "C" or higher

This course will introduce the bio-potential electrophysiologic, polysomnographic, and ancillary equipment involved in patient assessment and the conducting of sleep studies. The basic principles, set up, operation, maintenance, cleaning and troubleshooting will be emphasized. 6 hrs. integrated lecture lab./wk.

PSG 150 Polysomnography I (4 Hours)

Prerequisites: PSG 125 with a grade of "C" or higher and PSG 130 with a grade of "C" or higher

Prerequisites or corequisites: PSG 140 with a grade of "C" or higher and PSG 145 with a grade of "C" or higher

This course provides the didactic preparation that will be needed to supplement the clinical experiences of Polysomnography Clinical I. Students will develop new knowledge and skills related to patient and equipment preparation, monitoring and documentation and therapeutic interventions associated with polysomnographic procedures. 6 hrs. integrated lecture lab./wk.

PSG 245 Polysomnography Clinical I (6 Hours)

Prerequisites: PSG 140 with a grade of "C" or higher and PSG 145 with a grade of "C" or higher and PSG 150 with a grade of "C" or higher

Corequisites: Current AHA BLS Health Care Provider Certification

This course is the clinical application of entry-level sleep related diagnosis and treatment. Students will have the opportunity to work with patients under close supervision to further develop their skill and understanding of basic polysomnographic procedures. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 24 hrs. clinic/wk.

PSG 250 Polysomnography II (4 Hours)

Prerequisites: PSG 150 with a grade of "C" or higher

This course provides the didactic preparation that will be needed to supplement the clinical experiences of Polysomnography Clinical II. Students will refine knowledge and skills related to patient and equipment preparation, monitoring and documentation and therapeutic interventions associated with polysomnographic procedures. 6 hrs. integrated lecture lab/wk.

PSG 255 Polysomnography Clinical II (6 Hours)

Prerequisites: PSG 245 with a grade of "C" or higher and PSG 250 with a grade of "C" or higher

Corequisites: Current AHA BLS Health Care Provider Certification

This course is the clinical application of sleep related diagnosis and treatment. Students will have the opportunity to further refine their skills in obtaining and evaluating high quality sleep recordings and gaining clinical competence associated with advanced-level polysomnographic technology skills. Enrollment in this course requires that you be current in payment of a professional liability fee of $16.00. This fee is required once per calendar year based on enrollment in selected courses and must be in place prior to the start of classes. Students will be notified via their JCCC student email account if they are required to pay a $16 fee. 24 hrs. clinical/wk.

PSG 265 Polysomnography Capstone (3 Hours)

Prerequisites or corequisites: PSG 255 with a grade of C" or higher

This course is designed as a capstone experience to facilitate final preparation for employment and the BRPT examination for the RPSGT credential. Students will demonstrate knowledge and skill competency attainment expected of a polysomnographic technologist. Students will also be required to pass a comprehensive exam based on the current BRPT matrix. 5 hrs. integrated lecture lab./wk.

PSG 125

Title: Introduction to Sleep Medicine*
Number: PSG 125
Effective Term: Spring/Summer 2014
Credit Hours: 4
Contact Hours: 108
Lecture Hours: 60
Other Hours: 48

Requirements:

Prerequisites: Admission to the polysmonography program
Corequisites: Current AHA BLS Health Care Provider Certification

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Provide a synopsis of the history and current practice of sleep medicine.
Identify the role expectations of the polysomnographic technologist.
Describe the ethical and professional behavior expectations of the polysomnographic technologist.
Describe and demonstrate applicable personal and patient safety and comfort measures.

Content Outline and Competencies:

I. History and Overview of Sleep Medicine
   A. Summarize the scope of practice of sleep medicine and technology
   B. Describe the nosology of sleep medicine and technology, and its
evolution
   C. Define common technical terms used in the field of sleep medicine
   D. Give examples of the signs and symptoms of the major categories of
sleep disorders
   E. Discuss therapeutic modalities (mechanical, pharmacological,
behavioral, surgical) related to sleep medicine.

II. Role of the Polysomnographic Technologist 
   A. Describe the typical job responsibilities and the personal and
professional expectations of a polysomnographic technologist 
   B. Explain the purpose of the professional, accreditation and licensing
agencies associated with the sleep profession, including the AASM, APT,
CAAHEP, and BRPT.
   C. Discuss the importance of adhering to the BRPT Standards of Conduct
for polysomnographic technologist.
   D. Identify possible employment venues for the polysomnographic
technologist
   E. Determine the differences between sleep disorder centers and labs
and the associated accreditation implications.
   F. Identify the scope of services that may be offered in a sleep
disorder center or lab
   G. Describe typical staffing patterns for polysomnographic
technologists.
   H. Describe the roles of other key members of the health care team in a
sleep setting
   I. Relate knowledge of circadian rhythms to personal safety issues
associated with shift work.
   J. Practice appropriate verbal, non-verbal, and written communication
expected of a polysomnographic technologist.
   K. Adapt communication to meet the needs of special patient
populations.

III. Ethics and Professional Behavior of the Polysomnographic
Technologist
   A. Discuss the professional ethical and legal expectations of the
polysomnographic profession
   B. Discuss strategies to address ethical and legal situations that may
be encountered by the polysomnographic technologist
   C. Describe the rules, phases, and associated terminology of clinical
research.
   D. Describe the role of the polysomnographic technologist in clinical
research.
   E. Describe appropriate interactions between polysomnographic
technologist and patient and other health professionals.
   F. Identify stress factors that may be part of a polysomnographic
technologist’s work and possible mechanisms for relief.

IV. General Safety and Patient Comfort Considerations
   A. Demonstrate application of good body mechanics principles. 
   B. Describe and demonstrate appropriate patient positioning for
therapeutic procedures and patient comfort.
   C. Adapt safety and patient comfort measures to meet the needs of
special patient populations.
   D. Describe common infectious agents and the associated route of
transmission.
   E. Describe and demonstrate appropriate universal precautions, fire and
electrical safety and equipment cleaning and sterilization procedures.
   F. Recall and demonstrate, as indicated, the appropriate measures to
treat cardiopulmonary collapse according to BLS protocols.
   G. Demonstrate appropriate bag-valve-mask ventilation and oxygen
cylinder safety.
   H. Recognize situations that require the use of suction and management
of artificial airways.
   I. Describe and demonstrate adherence to maintaining medical
confidentiality and HIPAA protections. 
   J. Identify the main point to be reviewed in a patient record and
covered in a patient interview.
   K. Apply appropriate medical terminology in describing patient signs
and symptoms and assessment findings.
   L. Demonstrate the ability to assess patient vital signs.
   M. List and apply the normal ranges, units of measure, related
abbreviations and the medical terms indicating abnormal results for the
vital sign parameters.

Method of Evaluation and Competencies:

Written examinations     70-90% of total grade
Assignments              10-30% of total grade
Lab Competencies and Clinic Practice Satisfactory on Satisfactory/ Needing
Improvement evaluation by the instructor
Grading Scale:

A  =   92-100%   
B  =   83-91%   
C  =   75-82%* 
D  =   67-74% 
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students will have provided proof of health conducive to being in a health care environment. In addition, drug screening and other requirements may be imposed by clinical agencies. Students are responsible for any and all costs related to their health care or other imposed requirements.
Students will need to provide their own transportation to and from scheduled clinical activities.
Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
Students are expected to comply with the appearance, attendance and other program policies described in the Program Administrative Guideline Handbook.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Student Responsibilites:

Disabilities:

If you are a student with a disability, and if you will be requesting accommodations, it is your responsibility to contact Access Services. Access Services will recommend any appropriate accommodations to your professor and his/her director. The professor and director will identify for you which accommodations will be arranged.

JCCC provides a range of services to allow persons with disabilities to participate in educational programs and activities. If you desire support services, contact the office of Access Services for Students With Disabilities (913) 469-8500, ext. 3521 or TDD (913) 469-3885. The Access Services office is located in the Success Center on the second floor of the Student Center.

PSG 130

Title: Physiology of Sleep Medicine*
Number: PSG 130
Effective Term: Spring/Summer 2014
Credit Hours: 3
Contact Hours: 45
Lecture Hours: 45

Requirements:

Prerequisites: Admission to the polysomnography

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Describe the neuroanatomy and physiology and facets of normal sleep mechanisms.
Describe the major concepts and mechanisms of respiratory and cardiovascular anatomy and physiology.
Relate oxygen transport, carbon dioxide transport, and acid-base regulation to normal and abnormal conditions.
Relate the electrical conduction within the heart to normal and abnormal electrocardiographic (ECG or EKG) impulses.
Analyze clinical situations including arterial blood gas (ABG) and electrocardiographic (ECG or EKG) data and recommend appropriate management.

Content Outline and Competencies:

I. Neuroanatomy and Physiology and Normal Sleep Mechanisms
   A. Review the normal structure and function of the nervous system and
the associated voluntary and involuntary controlled responses.
   B. Explain brain structure and function as it relates to the generation
of sleep, including  circadian sleep/wake rhythms and the electrical brain
wave/eye movement activity seen during sleep
   C. Describe the neurological control of breathing and the heart.
   D. Identify the stages of normal sleep
   E. Describe the characteristics of normal sleep architecture
   F. Summarize the benefits of sleep and consequences of sleep
deprivation
   G. Give examples of age-specific sleep patterns
   H. Identify normal and abnormal EEG patterns.

II. Respiratory Anatomy and Physiology
   A. Review the respiratory anatomy and physiology of breathing
   B. Describe physiologic humidification of inspired gas.
   C. Define capacity as it relates to lung volumes and identify the lung
volumes included in each lung capacity.
   D. Explain the significance of functional residual capacity (FRC) and
describe the impact of an increased or decreased FRC.
   E. Describe the mechanics of normal inspiration and expiration which
result in gas flow into and out of the thorax.
   F. Describe the changes in lung volumes and capacities and expiratory
flows with restrictive or obstructive lung disease.
   G. Explain the physiology of the hypoxic and hypercapnic mechanisms of
ventilatory drive
   H. Explain the mechanics of breathing and mechanisms of upper airway
collapse.
   I. Describe normal and abnormal breathing patterns.

III. Cardiovascular Anatomy and Physiology
   A. Review the structures and function of the cardiovascular system.
   B. Describe pulmonary and systemic responses to hypoxia, hypocapnea and
hypercapnea.
   C. Describe the function of the erythrocytes, leukocytes and
thrombocytes of the plasma.
   D. Describe how blood volume affects blood pressure, stroke volume,
heart rate, and cardiac output.
   E. Describe the components of the pulmonary and systemic vascular
systems.
   F. Trace blood flow beginning at the superior and inferior vena cavae
through the valves and chambers of the heart.
   G. Explain the relationship of systole and diastole to the cardiac
cycle.
   H. Describe sympathetic and parasympathetic effects as they relate to
the heart.
   I. Briefly describe the electrical forces involved in membrane
potentials of the heart.

IV. Gas Transport and Acid-base Regulation
   A. Describe internal and external gas exchange.
   B. Describe oxygen and carbon dioxide transport.
   C. Describe the four types of hypoxia and explain potential causes of
each.
   D. Differentiate between PaO2 and CaO2 and discuss their respective
roles in oxygen delivery.
   E. Relate oxygen saturation with oxygen partial pressure using the
oxyhemoglobin dissociation curve (OHDC). 
   F. List factors causing the OHDC to shift left or right and identify
the changes in O2 and Hb affinity that occur with as associated shift. 
   G. Define acidosis and alkalosis; acid and base; and buffers.
   H. Describe how H+ and HCO3 are regulated by the kidney in acid-base
states.
   I. Identify the four types of acid-base disturbance and state
representative causes for each type.
   J. Describe how the respiratory and renal systems each compensate for
an imbalance in pH.
   K. Interpret arterial blood gas studies for acid-base balance and
oxygenation status.
   L. Associate possible causes for identified ABGs based on ABG
interpretation and patient history.
   M. Determine the appropriate therapeutic action (s) given a clinical
situation.

V. Electrocardiography Recognition and Management
   A. Describe the electrical conduction within the heart and relate this
conduction to the resultant EKG impulses.
   B. Describe the placement of electrodes for 12 lead EKG, and for
monitoring leads.
   C. Determine the cardiac rate and recognize normal sinus rhythms and
arrhythmias, including:
      1. atrial
      2. junctional or nodal
      3. heart blocks
      4. ventricular
      5. pulseless electrical activity
      6. asystole
      7. pacemaker
      8. specific changes associated with certain conditions 
   D. Differentiate between life threatening and non-life threatening
cardiac rhythms.
   E. Determine the appropriate therapeutic action (s), (BCLS, electrical
and pharmacological), given a clinical situation and rhythm.

Method of Evaluation and Competencies:

Written examinations                                       70-90% of total grade
Assignments                                             10-30% of total grade

Grading Scale:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.

Student Responsibilites:

Disabilities:

PSG 140

Title: Sleep Disorders*
Number: PSG 140
Effective Term: Spring/Summer 2014
Credit Hours: 4
Contact Hours: 93
Lecture Hours: 45
Lab Hours: 24
Other Hours: 24

Requirements:

Prerequisites: PSG 125 with a grade of "C" or higher and PSG 130 with a grade of "C" or higher
Corequisites: Current AHA BLS for Health Care

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Provide an overview of the pathophysiology and classifications of conditions associated with sleep disorders.
Provide the general indications, contraindications, limitations, and mechanisms of action associated with diagnostic and therapeutic interventions related to sleep medicine.
Describe the etiology, clinical presentation, diagnosis and therapeutic interventions associated with sleep related disorders or conditions.

Content Outline and Competencies:

Overview of the Pathophysiology and Nosology of Sleep Disorders
   A. Explain human anatomy and physiology as it relates to sleep
disorders, and how sleep disorders affect anatomy and physiology
   B. Demonstrate basic understanding of the pathology that may impact
data acquisition, therapeutic interventions, and/or patient safety during
polysomnographic procedures.
   C. Identify the major categories of sleep disorders according to the
International Classification of Sleep Disorders
   D. Describe the signs and symptoms associated with major categories of
sleep and arousal disorders
   E. Summarize the major categories of sleep and arousal disorders based
on age-specific criteria
   F. Describe the component parts of a complete polysomongram.

II. Overview of Diagnostic and Therapeutic Interventions Related to Sleep
Medicine
   A. Describe the types of surgical, non-surgical and behavioral
treatment modalities commonly used to treat disorders
   B. Describe the purpose, indications, contraindications and
complications associated with oxygen and PAP therapy. 
   C. Identify the commonly used pharmacological interventions used to
treat sleep disorders, including narcolepsy, restless leg syndrome, and
periodic leg movements
   D. State the general indications, contraindications, potential side
effects and mechanism of action for each of the drug classifications
related to sleep disorders
   E. Describe the ways in which medications can affect the sleep/wake
cycle or alter the recorded sleep/wake data
   F. Differentiate between the drugs used to treat sleep/wake disorders
and drugs that commonly alter the recorded sleep/wake data

III. Sleep Disorders and Associated Conditions
   A. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with insomnias, to include:
      1. Psychophysiologic insomnia
      2. Idiopathic insomnia
      3. Insomnia due to medical disorder/condition
      4. Inadequate sleep hygiene 
      5. Behavioral insomnia of childhood
   B. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with sleep related breathing
disorders, to include:
      1. Central Sleep Apnea Syndromes
      2. Obstructive Sleep Apnea Syndromes
      3. Sleep-Related Hypoventilation/Hypoxemic Syndromes
   C. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with hypersomnias of central origin,
to include:
      1. Narcolepsy
      2. Recurrent Hypersomnia
      3. Idiopathic Hypersomnias
      4. Behaviorally Induced Insufficient Sleep Syndrome
      5. Hypersomnia Due to Medical Condition, Drug or Substances
   D. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with circadian rhythm sleep
disorders, to include:
      1. Advanced/Delayed Sleep Phase Types
      2. Irregular Sleep-Wake Type
      3. Shift Work Type
      4. Associated with Medical Condition
   E. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with parasomnias, to include:
      1. Disorders of arousal
      2. Parasomnias usually associated with REM sleep
      3. Other Parasomnias
   F. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with sleep related movement
disorders, to include:
      1. Restless Legs Syndrome
      2. Periodic Limb Movement Disorder
      3. Sleep Related Leg Cramps
      4. Sleep Related Bruxism
      5. Sleep Related Rhythmic Movement Disorder
      6. Associated with Medical Condition, drugs or substances
   G. Describe the etiology, clinical presentation, diagnosis and
therapeutic interventions associated with other variant conditions
associated with sleep disorders, to include:
      1. Long/short sleeper
      2. Snoring
      3. Sleep Starts
      4. Sleep Talking--Phonation
      5. Hypnagogic foot tremor and alternating leg muscle activation
      6. Excessive fragmentary myoclonus
      7. Sleep Related Epilepsy
      8. Sleep Related Gastroesophageal Reflux Disease
      9. Fibromyalgia
     10. Mood, anxiety, and psychotic disorders
   H. Correlate etiology, clinical presentation, diagnosis, and
therapeutic interventions with observed sleep study activities.

Method of Evaluation and Competencies:

Written examinations       70-90% of total grade
Assignments             10-30% of total grade
Lab Competencies        Satisfactory on Satisfactory/ Needing Improvement
evaluation by the instructor

Grading Scale:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =   0 - 66%

*minimum required to continue in program

Caveats:

Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.

Student Responsibilites:

Disabilities:

PSG 145

Title: Sleep Study Instrumentation*
Number: PSG 145
Effective Term: Spring/Summer 2014
Credit Hours: 4
Contact Hours: 90
Lecture Hours:
Other Hours: 90

Requirements:

Prerequisites: PSG 125 with a grade of "C" or higher and PSG 130 with a grade of "C" or higher

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Describe the function, features and adjunct equipment options of the bio-potential electrophysiologic, polysomnographic, therapeutic intervention and ancillary equipment involved in patient assessment and the conducting of sleep studies.
Demonstrate the ability to set up, check for correct function, and troubleshoot as indicated, the bio-potential electrophysiologic, polysomnographic, therapeutic intervention and ancillary equipment involved in patient assessment and the conducting of sleep studies.
Describe the cleaning, disinfecting and sterilizing methods used with the bio-potential electrophysiologic, polysomnographic, therapeutic intervention and ancillary equipment and methods used to evaluate the effectiveness of these techniques.
Describe issues regarding safe use of bio-potential electrophysiologic, polysomnographic, therapeutic intervention and ancillary equipment, to include equipment selection, preventive maintenance, quality improvement and practitioner competency.

Content Outline and Competencies:

I. Bio-Potential Eletrophysiologic Equipment
   A. Explain the principles of electrical conduction, grounding,
polarity, frequency, voltage, and impedance as they relate to sleep
diagnostics.
   B. Explain the principles of sensitivity, amplitude, filters, and
common mode rejection as they relate to sleep diagnostics.
   C. Summarize the process of measuring the electromechanical functions
of the human body, including extra-cellular potentials created by cardiac,
brain, muscle, and integumentary cells
   D. Explain the principles of the function and handling of electrodes,
electrolytic substances and fixatives
   E. Explain the frequency and voltage characteristics of EEG, EOG, EMG,
and ECG
   F. Explain impedance measurements and impedance meters
   G. Describe and demonstrate proper measurement and placement of EEG
electrode sites according to the International 10-20 system.
   H. Describe the cleaning, disinfecting and sterilizing methods used and
methods used to evaluate the effectiveness of these techniques.
   I. Describe issues regarding safe use of equipment, to include
equipment selection, preventive maintenance, quality improvement and
practitioner competency.

II. Polysomnographic Instrumentation
   A. Prepare sample montages indicating the channel derivation and how
they differ for referential and bipolar recordings
   B. Explain signal calibration, electrical baseline, and mechanical
baseline
   C. Discuss the origins of artifact and artifact elimination
   D. Summarize the effect of different time bases on the PSG signal
display
   E. Explain the principles of operation for amplifiers, transducers,
airflow sensors, respiratory and abdominal effort sensors, snore sensors,
position sensors, capnometers, and oximeters as they related to sleep
diagnostics.
   F. Give examples of interfacing devices with the acquisition system
   G. Discuss the impact of sampling rate, Nyquist theory (Shannon’s
sampling theorem), aliasing, horizontal/vertical resolution and screen
size on signal display quality
   H. Give examples of methods of data storage and retrieval
   I. Describe the cleaning, disinfecting and sterilizing methods used and
methods used to evaluate the effectiveness of these techniques.
   J. Describe issues regarding safe use of equipment, to include
equipment selection, preventive maintenance, quality improvement and
practitioner competency.

III. Ancillary Equipment
   A. Distinguish the variety of ancillary equipment devices used in
polysomnography and their principles of operation, including capnometers,
esophageal pressure monitors, audio-visual equipment, esophageal pH
meters, actigraphy, audiovisual equipment, and extended EEG
   B. Choose ancillary equipment with respect to various contexts
(referring diagnoses, patient characteristics, and PSG protocols)
   C. Connect ancillary equipment to the acquisition system according to
hardware and software specifications, and to the patient in a manner
appropriate to the patient (re: age, gender, medical & psychological
conditions)
   D. Differentiate normal vs. abnormal, or erroneous vs. true data
recorded by ancillary equipment 
   E. Recommend amplifier parameters for ancillary equipment, appropriate
to various contexts (patient's medical history/condition, polysomnographic
events and artifacts)
   F. Describe the cleaning, disinfecting and sterilizing methods used and
methods used to evaluate the effectiveness of these techniques.
   G. Describe issues regarding safe use of equipment, to include
equipment selection, preventive maintenance, quality improvement and
practitioner competency.

IV. Therapeutic Intervention Equipment
   A. Explain the principles of oxygen and PAP theory and application,
including calibrating the devices with the acquisition system
   B. Select supplemental oxygen therapy and PAP protocols and equipment
according to various contexts (patient indications and contraindications,
as well as polysomnography evidence thereof)
   C. Manipulate oxygen and PAP titration protocols according to various
contexts (pressure modality, polysomnographic indicators, side effects,
patient history indications and contraindications)
   D. Describe the cleaning, disinfecting and sterilizing methods used and
methods used to evaluate the effectiveness of these techniques.
   E. Describe issues regarding safe use of equipment, to include
equipment selection, preventive maintenance, quality improvement and
practitioner competency.

Method of Evaluation and Competencies:

Written examinations       70-90% of total grade
Assignments             10-30% of total grade
Lab Competencies        Satisfactory on Satisfactory/Needing Improvement
evaluation by the instructor

Grading Scale:
A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Student Responsibilites:

Disabilities:

PSG 150

Title: Polysomnography I*
Number: PSG 150
Effective Term: Spring/Summer 2014
Credit Hours: 4
Contact Hours: 90
Lecture Hours:
Other Hours: 90

Requirements:

Prerequisites: PSG 125 with a grade of "C" or higher and PSG 130 with a grade of "C" or higher
Prerequisites or corequisites: PSG 140 with a grade of "C" or higher and PSG 145 with a grade of "C" or higher

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Prepare the patient and equipment associated with polysomnographic procedures.
Describe and demonstrate monitoring and documentation of polysomnographic procedures.
Describe the indication, contraindications, and complications associated with therapeutic interventions.
Describe and demonstrate the set-up, application, titration, cleaning, maintenance and troubleshooting associated with therapeutic interventions.

Content Outline and Competencies:

I. Patient and Equipment Preparation Procedures
   A. Determine which components of the medical and physical history are
necessary to recognize a sleep-related complaint in patients of all age
ranges
   B. Give examples of categories of medications and substances that have
an effect on sleep architecture and sleep-disordered breathing
   C. Verify the medical order and protocol and evaluate the
appropriateness of ordered procedures and treatments.
   D. Demonstrate the ability to gather the appropriate medical and
physical history necessary in preparing for a sleep related study
   E. Conclude which types of patients may require special precautions
   F. Give examples of routine patient safety precautions
   G. Explain the routine PSG protocols including PSG, MSLT, MWT, PAP PSG,
as applied across all age ranges
   H. Describe pre-testing, testing, and post-testing procedures to the
patient in terms appropriate for the patient’s age, physical, mental,
emotional or cognitive status.
   I. Give examples of signs and behaviors that determine the patient's
level of toleration and cooperation
   J. Describe the assessment of the patient necessary to correlate the
clinical presentation with the medical record and history.
   K. Determine electrode location for EEG, EOG, ECG, EMG across patient
age ranges and conditions
   L. Summarize the principles of site preparation and attachment of
electrodes across patient age ranges and conditions

II. Monitoring and Documentation
   A. Differentiate between an overnight PSG, a split night study and a
portable PSG
   B. Set-up a sleep montage consistent with the type of test requested.
   C. Describe and demonstrate the location and attachment of sensors and
routine ancillary equipment to the patient
   D. Summarize the indications, contraindications and limitations
associated with the use of particular types of sleep recording/monitoring
devices.
   E. Select the appropriate equipment monitors required for
practitioner-ordered testing
   F. Prepare, calibrate and adjust equipment required for testing to
assure proper function
   G. Describe the purpose and procedure for performing a bio
calibration.
   H. Verify appropriate function for each electrode and make appropriate
corrective action, as indicated.
   I. Interface electrodes, sensors, and ancillary equipment to the data
acquisition and recording system.
   J. Label recordings with appropriate demographic and study
information.
   K. Follow “lights out” procedures to establish and document
baseline values, such as body position, oxyhemoglobin saturation,
respiratory and heart rates.
   L. Identify and describe polysomnographic events and their associated
characteristics.
   M. Describe the procedure for documenting and reporting routine
observations, clinical events, changes in procedure/protocol, and other
significant events.
   N. Describe the purpose and procedure of making adjustments to the time
base on the polysomnograph signal display during the monitoring phase.
   O. Describe and demonstrate appropriate removal of electrodes and other
equipment.
   P. Describe and demonstrate proper procedure for cleaning and
maintaining sleep monitoring equipment.
   Q. Communicate and conduct post-study assessments with the patient.

III. Therapeutic Interventions
   A. Describe the purpose, contraindications and complications associated
with oxygen and PAP therapy. 
   B. Describe and demonstrate the set-up and application of oxygen and
PAP devices for sleep-related breathing disorders
   C. Describe and demonstrate titration techniques associated with the
application of oxygen and PAP devices.
   D. Describe the prominent patient care issues relating to PAP devices,
such as patient compliance and fit of masks.
   E. Describe and demonstrate the procedure for properly cleaning and
maintaining therapeutic equipment

Method of Evaluation and Competencies:

Written examinations       70-90% of total grade
Assignments             10-30% of total grade
Lab Competencies        Satisfactory on Satisfactory/ Needing Improvement
evaluation by the instructor

Grading Scale:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Student Responsibilites:

Disabilities:

PSG 245

Title: Polysomnography Clinical I*
Number: PSG 245
Effective Term: Spring/Summer 2014
Credit Hours: 6
Contact Hours: 312
Lecture Hours:
Other Hours: 312

Requirements:

Prerequisites: PSG 140 with a grade of "C" or higher and PSG 145 with a grade of "C" or higher and PSG 150 with a grade of "C" or higher
Corequisites: Current AHA BLS Health Care Provider Certification

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Gather and analyze the appropriate patient care data to develop or determine the appropriateness of the requested protocol or procedure.
Assess and orient patients in preparation for polysomnographic procedures.
Gather, prepare, set-up, calibrate, and check for proper function the appropriate equipment necessary for the requested protocol or procedure.
Monitor, document, and respond to events and conditions associated with the polysomnographic procedure or protocol.
Determine and implement appropriate therapeutic interventions.
Demonstrate personal behaviors consistent with professional and employer expectations, to include dependable attendance and punctuality, appropriate professional appearance and preparedness, positive interaction skills, adaptability to interruptions and participation in continuing education activities.
Identify and integrate logistical approaches to improve timing, efficiency and decision making without compromise to patient care in completing assigned activities.

Content Outline and Competencies:

I. Patient Chart Review
   A. Verify the medical order and protocol
   B. Assess the history, physical information, medications, procedure
request, and study protocol to determine completeness and
appropriateness.
   C. Determine special precautions related to infection control and other
patient-specific factors
   D. Recognize and clarify unclear, inappropriate, or contradictory
orders. 

II. Patient Assessment and Orientation Techniques
   A. Obtain and review the sleep history and pre-sleep questionnaires
   B.   Confirm patient’s medications and identify caffeine or alcohol
intake
   C. Assess and respond to the patient's special needs (age, cognitive
level, physical or emotional discomfort, ability to cooperate, etc.)
   D. Recognize and anticipate any special testing considerations or
medical interventions that may be needed based on patient assessment.
   E. Explain pre-testing, testing and post-testing procedures to a
patient in terms appropriate for the patient’s age and mental or
cognitive status
   F. Orient the patient to the sleep center, including their sleep room
and bathroom/changing area and where to access food, water, and medication
storage
   G. Orient the patient to their preparation/testing schedule based on
the physician's orders

III. Prepare, Organize and Apply Necessary Equipment and Monitors
   A. Determine, gather and prepare the necessary equipment and supplies
needed to conduct the specified study or protocol.
   B. Correctly measure, apply and connect electrodes, sensors and
monitors based on patient specific order/procedure and
internationally-accepted standards
   C. Check for proper function and appropriate signal according to
accepted standards
   D. Interface electrodes and ancillary equipment to data acquisition and
recording system.
   E. Label recording with patient demographic information, study
information, sleep location and technologist identification
   F. Set up a correct montage based on patient orders/procedure and
verify that proper filter and sensitivity settings are selected
   G. Calibrate all necessary equipment for the procedure as ordered
   H. Implement equipment and physiologic (bio)calibrations
   I. Verify proper electrode impedance values and signal quality of all
channels
   J. Adjust equipment to achieve proper function and report deviations
from the ordered procedure

VI. Monitoring and Documentation
   A. Monitor and document events, including:
         a. lights out/on, out of bed, body positions, and PAP pressures
         b. patient heart rate, respiratory rate and pattern, and Sp02
values
         c. patient behaviors: snoring, vocalizations, movements,
complaints, etc.
         d. manipulations and adjustments of amplifier settings and
deviations, equipment malfunctions and corrective actions
         e. parameters that ensure the integrity and quality of the
recording
         f. interventions and treatments
   B. Distinguish between EEG patterns to accurately document sleep onset
and sleep stages
   C. Adjust and document conditions of the testing environment required
for optimal recording quality and patient comfort
   D. Recognize events and determine appropriate action
   E. Differentiate artifact from expected signal
   F. Administer a post-sleep questionnaire
   G. Maintain accurate and timely documentation
   H. Score and generate reports

V. Therapeutic Interventions
   A. Determine appropriate therapeutic interventions in response to
events
   B. Recognize complications and contraindications of prescribed
therapeutic interventions
   C. Orient and prepare patient for the therapeutic intervention.
   D. Assemble, apply, titrate and troubleshoot, as indicated the applied
therapeutic interventions.

VI. Professional Standards and Patient Safety and Emergency Procedures
   A. Comply with the BRPT Standards of Conduct
   B. Follow laboratory and procedural protocols, guidelines, and
standards regarding safety and infection control issues
   C. Demonstrate effective written, non-verbal and verbal communication
skills
   D. Maintain a professional demeanor and interactions at all times with
staff, supervisor, patients and other health care professional
   E. Maintain professional responsibilities as it relates to attendance,
punctuality, appearance, conduct and continuing education activities.
   F. Recognize personal limitations and demonstrate ability to follow
directions
   G. Recognize and respond to patient safety and emergency situations
   H. Demonstrate proper techniques for infection control
   I. Integrate logistical approaches to improve timing, efficiency, and
decision making without compromise to patient care in completing assigned
activities.

Method of Evaluation and Competencies:

Performance                                        60-75%
Case Presentations and project assignments      10-20%
Professional habits and attitudes               10-20%

Grade Criteria:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students will have provided proof of health conducive to being in a health care environment. In addition, drug screening and other requirements may be imposed by clinical agencies. Students are responsible for any and all costs related to their health care or other imposed requirements.
Students will need to provide their own transportation to and from scheduled clinical activities.
Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
Students are expected to comply with the appearance, attendance and other program policies described in the Program Administrative Guideline Handbook.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Student Responsibilites:

Disabilities:

PSG 250

Title: Polysomnography II*
Number: PSG 250
Effective Term: Spring/Summer 2014
Credit Hours: 4
Contact Hours: 90
Lecture Hours:
Other Hours: 90

Requirements:

Prerequisites: PSG 150 with a grade of "C" or higher

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Describe and demonstrate implementation of protocols for monitoring and scoring polysomnographic studies.
Discern common errors and take appropriate corrective measures.
Compare and contrast the indications, criteria, methods, techniques, and troubleshooting related to sleep studies.
Describe and demonstrate appropriate patient care and therapeutic interventions based on clinical scenarios.
Demonstrate the ability to set-up, administer, titrate, and troubleshoot therapeutic interventions.

Content Outline and Competencies:

I. Protocols for Monitoring and Scoring
   A. Differentiate between hypopnea and apnea.
   B. Describe the general characteristics of UARS, primary snoring,
Cheyne-Stokes, and periodic breathing
   C. Categorize abnormal respiratory events according to the definitions
and sub-classifications of apnea, hypopnea, hypoventilation, periodic
breathing, Cheyne-Stokes respiration and UARS
   D. Describe the methods and techniques for scoring cardiac-related and
respiratory-related events
   E. Distinguish between central, mixed, and obstructive apnea.
   F. Differentiate between normal and abnormal oxyhemoglobin saturation
using oximetry data.
   G. Differentiate artifact from arousals and abnormal results on
cardiac-related and respiratory-related tracings and in identifying
epileptiform or seizure activity.
   H. Discuss common errors in evaluating respiratory and cardiac events
on a PSG study.
   I. Devise a plan to troubleshoot causes of artifact and common
equipment problems
   J. Describe and differentiate characteristics of the various complexes,
spindles, waves, and activity associated with sleep study activity.
   K. Explain various types of adult and pediatric procedures for advanced
PSG monitoring including bilevel PAP, NIPPV, Pes, pH, parasomnia and
seizure investigation
   L. Apply professionally accepted guidelines to differentiate between
sleep stages, wake and sleep sub-classifications, arousals and in the use
of scoring criteria 
   M. Integrate new information such as age-specific EEG characteristics,
EEG arousals, and alpha-intrusion to customize the sleep scoring rules to
each clinical scenario
   N. Integrate sleep staging data, events-related data, and arousal data
to calculate indices for report generation
   O. Calculate sleep onset, percent sleep stages, total recording time,
total movement time, REM onset, and arousals using sleep/wake data
   P. Identify common errors in performing calculations on sleep/wake
data
   Q. Verify the accuracy of a computer generated report by manually
calculating latencies, percentages, and indices
   R. Explain the components of a polysomnographic report
   S. Demonstrate the ability to prepare a sleep report for interpretation
by the physician.
   T. Differentiate between the pathophysiologic disorders based on their
associated clinical and polygraphic signs and symptoms

II. Arousals and Periodic Limb Movement
   A. Differentiate between artifact, movement-related, RERAs, respiratory
and spontaneous arousals
   B. Describe the methods and techniques for monitoring and scoring
periodic limb movement  and non-PLM related events
   C. Apply professionally accepted criteria to classify limb movements
associated with arousals
   D. Apply professionally accepted scoring criteria for arousals and
sleep/wake data

III. Pediatric/Infant Sleep Studies
   A. Discuss normal developmental aspects of infant and children sleep
   B. Discuss methods used to interpret pediatric/infant sleep studies
   C. Describe the criteria used to score pediatric/infant sleep studies
   D. Identify the types of sleep studies that can be performed on a
pediatric/infant
   E. Discuss the major challenges and limitations associated with
performing a sleep study on a pediatric/infant
   F. Describe the most commonly encountered sleep disorders in infants
and children
   G. Discuss the most common types of therapies and interventions used to
treat infants and children with sleep disorders

IV. Multiple Sleep Latency Testing/Maintenance of Wakefulness Testing
   A. Describe the indications for performing a MSLT/MWT
   B. Describe the procedure for preparing a patient for a MSLT or MWT
   C. Describe the similarities and differences between the MSLT and MWT
   D. Describe the procedure for performing MSLT or MWT
   E. Describe the criteria for terminating, evaluating, and scoring
MSLT/MWT 
   F. Identify common errors in evaluating sleep/wake MSLT/MWT data
   G. Compare MSLT/MWT results to established norms and determine clinical
significance of analysis results
   H. Apply professionally accepted scoring guidelines to MSLT/MWT

V. Therapeutic Interventions
   A. Describe the types of surgical, non-surgical and behavioral
treatment modalities commonly used to treat sleep disorders.
   B. Recommend intervention and titration of O2 and/or PAP therapy based
on written protocols when given a clinical scenario
   C. Describe the indications for administering and titrating oxygen and
PAP levels using established clinical protocols
   D. Demonstrate the ability to set-up, administer, and titrate oxygen
and PAP levels based on clinical protocols
   E. Describe the artifacts commonly seen during the therapeutic phase of
the study
   F. Determine and take appropriate corrective action to assure proper
signal display during the therapeutic phase of the study
   G. Differentiate between lethal and non-lethal ECG dysrhythmias
   H. Initiate emergency procedures, such as CPR and airway management,
based on a clinical scenario
   I. Assess individual patient care needs with regard to age, cognitive
needs, emotional needs, level of cooperation, disease processes, and risk
of infection

Method of Evaluation and Competencies:

Written examinations       70-90% of total grade
Assignments             10-30% of total grade
Lab Competencies        Satisfactory on Satisfactory/ Needing Improvement
evaluation by the instructor
Grading Scale:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Student Responsibilites:

Disabilities:

PSG 255

Title: Polysomnography Clinical II*
Number: PSG 255
Effective Term: Spring/Summer 2014
Credit Hours: 6
Contact Hours: 252
Lecture Hours:
Other Hours: 252

Requirements:

Prerequisites: PSG 245 with a grade of "C" or higher and PSG 250 with a grade of "C" or higher
Corequisites: Current AHA BLS Health Care Provider Certification

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Assess the physician’s polysomnographic request in order to determine its completeness and appropriateness in ensuring valid data collection.
Assess the patient’s medical history and interview the patient to anticipate the nature and likelihood for special testing requirements or medical intervention.
Orient the patient in preparation for polysomnographic procedures and possible interventions.
Select, calibrate, apply, maintain and troubleshoot polysomnographic related equipment to ensure valid data collection and in accordance with established guidelines.
Acquire, verify, and document and respond to calibrations, events and conditions associated with the polysomnographic procedure or protocol.
Determine and implement appropriate therapeutic interventions according to established guidelines.
Follow policies and procedures in establishing patient safety measures and in responding to emergency situations.
Score sleep stages and arousals and related respiratory, movement and miscellaneous events to facilitate interpretation of sleep study results.
Generate and validate a report of the scoring of objective and subjective data in order to summarize the polysomnographic procedure.
Demonstrate personal behaviors consistent with professional and employer expectations, to include dependable attendance and punctuality, appropriate professional appearance and preparedness, positive interaction skills, adaptability to interruptions and participation in continuing education activities.
Identify and integrate logistical approaches to improve timing, efficiency and decision making without compromise to patient care in completing assigned activities.

Content Outline and Competencies:

I. Pre-Tesing Phase
   A. Verify the medical order and protocol
   B. Assess the history, physical information, medications, procedure
request, and study protocol to determine completeness and
appropriateness.
   C. Determine special precautions related to infection control and other
patient-specific factors
   D. Recognize and clarify unclear, inappropriate, or contradictory
orders.
   E. Obtain and review the sleep history and pre-sleep questionnaires
   F. Confirm patient’s medications and identify caffeine or alcohol
intake
   G. Assess and respond to the patient's special needs (age, cognitive
level, physical or emotional discomfort, ability to cooperate, etc.)
   H. Recognize and respond to any special testing considerations or
medical interventions that may be needed based on patient assessment.
   I. Explain pre-testing, testing and post-testing procedures to a
patient in terms appropriate for the patient’s age and mental or
cognitive status
   J. Orient the patient to their preparation/testing schedule and the
sleep center, including their sleep room and bathroom/changing area and
where to access food, water, and medication storage

II. Prepare, Organize and Apply Necessary Equipment and Monitors        
   A. Determine, gather, and prepare the necessary equipment and supplies
needed to conduct the specified study or protocol.
   B. Correctly measure, apply and connect electrodes, sensors and
monitors based on patient specific order/procedure and
internationally-accepted standards
   C. Check for proper function and appropriate signal according to
accepted standards
   D. Interface electrodes and ancillary equipment to data acquisition and
recording system.
   E. Label recording with patient demographic information, study
information, sleep location and technologist identification
   F. Set up a correct montage based on patient orders/procedure and
verify that proper filter and sensitivity settings are selected
   G. Calibrate all necessary equipment for the procedure as ordered
   H. Implement equipment and physiologic (bio)calibrations
   I. Verify proper electrode impedance values and signal quality of all
channels
   J. Adjust equipment to achieve proper function and report deviations
from the ordered procedure

III. Monitoring, Documentation, and Therapeutic Interventions
   A. Adhere to procedural protocols, to include MSLT, MWT, parasomnia
studies, PAP therapy and supplemental oxygen titration.
   B. Demonstrate the procedure for documenting and reporting routine
observations, therapeutic levels, clinical events, changes in procedure,
and other significant events to facilitate scoring and interpretation of
polysomnographic results
   C. Determine and take appropriate corrective action to assure proper
signal display during the monitoring and therapeutic phases of the study.
   D. Report any adverse clinical conditions through the use of
appropriate monitoring and assessment skills.
   E. Perform routine PAP mask sizing, mask fitting, and headgear
adjustment.
   F. Titrate therapeutic interventions to achieve optimal and safe
clinical outcomes.
   G. Follow lights-on procedures to verify integrity of collected data
and complete the data collection process.
   H. Demonstrate appropriate removal, maintenance, and cleaning of sleep
monitoring and therapeutic equipment.
   I.Administer a post-study questionnaire and finalize documentation of
required paperwork.

IV. Polysomnographic Record Scoring and Report Generation
   A. Review study-related documentation that may impact record scoring
procedures, including technologist worksheets and comments, patient
history and questionnaires, and calibration data.
   B. Evaluate sleep architecture and micro-architecture by comparing
sleep/wake data obtained from the study to typical findings.  
   C. Identify sleep onset, percent sleep stages (Wake, I, II, III, IV,
and REM), total recording time, total movement time, REM onset, and
arousals using sleep/wake data obtained from the study.  
   D. Score a PSG, PAP titration study, and MSLT/MWT according to
professionally accepted guidelines.
   E. Apply arousal scoring criteria to sleep/wake data according to
professionally accepted guidelines.
   F. Apply movement-related (PLM, non-PLM, and body) event scoring
criteria to sleep/wake data according to professionally accepted
guidelines.
   G. Apply cardiac-related (potentially life-threatening abnormalities)
event scoring criteria to sleep/wake data according to professionally
accepted guidelines.
   H. Apply respiratory-related (apnea, hypopnea, periodic breathing,
snoring, Cheyne-Stokes breathing, SpO2 desaturation events, event-related
CO2 changes, and upper airway resistance) event scoring criteria to
sleep/wake data according to professionally accepted guidelines.
   I. Identify other sleep-related activities, such as seizure activity,
alpha-delta sleep, drug spindles, and other significant EEG
abnormalities.
   J. Utilize data from PSGs, PAP titrations, MSLTs, MWTs and other
diagnostic and therapeutic procedures to determine the following
parameters:
      1. Lights-out/lights-on times.
      2. Total recording and total sleep time.
      3. Sleep efficiency.
      4. Amount and percentage of stages of sleep, REM sleep, NREM sleep,
movement, and wake time.
      6. Initial sleep latency and latency to each sleep stage.
      8. REM sleep episode assessment (# of episodes and REM density).
      9. Arousal (RERA, respiratory, spontaneous, limb movement) analysis
(in     both REM and NREM).
     10. Range and averages for heart and respiratory rate.
     11. Percent of apneic sleep time
     12. Apnea index, hypopnea index, and combined apnea/hypopnea index
(AHI) in both REM and NREM).
     13. Respiratory disturbance index (RDI).
     14. Respiratory events per body position for total sleep (in both REM
and NREM).
     15. Range and averages for oxygen saturation level (in both REM and
NREM).
     16. Range and averages for respiratory event duration per total sleep
(in both REM and NREM).
     17. Number of periodic limb movements per total sleep (in both REM
and NREM).
     18. PLM index with and without arousal.
   K. Retrieve, save, and archive patient information, sleep/wake data and
test results into the computer.
   L. Recognize and correct invalid patient information, sleep/wake data
and test results.
   M. Generate and verify accurate computerized reports by tabulating
sleep/wake and clinical event data.

V. Technologist Professional Standards and Patient Safety and Emergency
Procedures
   A. Comply with the BRPT Standards of Conduct
   B. Follow laboratory and procedural protocols, guidelines, and
standards regarding safety and infection control issues
   C. Demonstrate effective written, non-verbal and verbal communication
skills
   D. Maintains a professional demeanor and interactions at all times with
staff, supervisor, patients and other health care professional
   E. Maintains professional responsibilities as it relates to attendance,
punctuality, appearance, conduct and continuing education activities.
   F. Recognize personal limitations and demonstrate ability to follow
directions
   G. Recognize and respond to patient safety and emergency situations
   H. Demonstrate proper techniques for infection control
   I. Integrate logistical approaches to improve timing, efficiency, and
decision making without compromise to patient care in completing assigned
activities.

Method of Evaluation and Competencies:

Performance                                        60-75%
Case Presentations and project assignments      10-20%
Professional habits and attitudes               10-20%

Grade Criteria:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students will have provided proof of health conducive to being in a health care
environment. In addition, drug screening and other requirements may be imposed by clinical agencies. Students are responsible for any and all costs related to their health care or other imposed requirements.
Students will need to provide their own transportation to and from scheduled clinical activities.
Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
Students are expected to comply with the appearance, attendance and other program policies described in the Program Administrative Guideline Handbook.
A grade of “C” or better is required for the course for program promotion to subsequent polysomnography course work.
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.

Student Responsibilites:

Disabilities:

PSG 265

Title: Polysomnography Capstone*
Number: PSG 265
Effective Term: Spring/Summer 2014
Credit Hours: 3
Contact Hours: 50
Lecture Hours: 50

Requirements:

Prerequisites or corequisites: PSG 255 with a grade of C" or higher

Description:

Course Fees:

None

Textbooks:

http://bookstore.jccc.edu/

Supplies:

Refer to the instructor's course syllabus for details about any supplies that may be required.

Objectives

Demonstrate the ability to collect, comprehend, apply, evaluate and communicate information relevant to the role of a polysomnographic technologist.
Demonstrate technical proficiency in all the skills necessary to fulfil the role of a polysomnographic technologist.
Demonstrate personal behaviour consistent with professional and employer expectations as a polysomnographic technologist.

Content Outline and Competencies:

I. Polysomnographic Knowledge Domain
   A. Demonstrate the necessary knowledge related to analyzing pre-testing
information.
   B. Demonstrate the necessary knowledge to perform and score
polysomnographic studies
   C. Demonstrate the necessary knowledge to provide patient support and
education
   D. Demonstrate the necessary knowledge for site management

II. Polysomnographic Skill Domain
   A. Demonstrate the necessary skills to analyze pre-testing
information.
   B. Demonstrate the ability to perform and score polysomnographic
studies
   C. Demonstrate the ability to provide patient support and education
   D. Demonstrate the ability to manage the site

III. Polysomnographic Behavior Domain
   A. Comply with the BRPT Standards of Conduct
   B. Follow protocols, guidelines, and standards regarding
polysomnographic procedures and safety and infection control issues
   C. Demonstrate effective written, non-verbal and verbal communication
skills
   D. Maintain a professional demeanor and interactions at all times with
staff, supervisor, patients and other health care professional
   E. Maintain professional responsibilities as it relates to attendance,
punctuality, appearance and conduct.
   F. Recognize personal limitations and demonstrate ability to follow
directions
   G. Recognize and respond appropriately to patient safety and emergency
situations

Method of Evaluation and Competencies:

80-100%   Cognitive, Psychomotor &Affective Domain Competency
Assessments                              
0-20%     Case Presentations and Project Assignments                                    

Grade Criteria:

A  =   92-100%          
B  =   83-91%   
C  =   75-82%*  
D  =   67-74%   
F  =    0 - 66%

*minimum required to continue in program

Caveats:

Students are expected to comply with the JCCC Student Code of Conduct as detailed in the JCCC College Catalog. Failure to comply may result in a faculty decision regarding program promotion and constitute a reason to fail the course.
Students will be required to pass all competency assessments in order to pass the course
Students will need basic word processing and Internet skills for the completion of some papers, exercises and projects.