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Aud.licensure

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According to the Audiology and Speech-language pathology advisory Committee Laws...
The Practice of Audiology is?
the nonmedical and nonsurgical application of principles, methods and procedures of measurement, testing, evaluation , consultation , counseling, instruction, and habilitation or rehabilitation related to hearing, its disorders and related communication impairments for the purpose of nonmedical diagnosis, prevention, identification, amelioration or modification of these disorders and conditions in individuals or groups of individuals with speech, language or hearing handicaps
Biennial licence renewal fee is how much?
$170.00

late fee of $50.00

Requirements for licensure
(must be submitted to the Comittee for proof)
-Graduated with a doctoral degree program in audiology -- bachelor's degree from an acredited university
- Achieved a score of 500 on the Praxis
-must complete a clinical internship in accordance with the provisions of NJAC 13:44
-at least 30 hours in audiology
six hours in hearing disorders and hearing evaluation, 6 hours in speech language,
-25 hours observation and treatment of children
- 350 hours of supervised clinical experience





Requirements for cinical internship
Professional employment means direct clinical work with patients, consultations, recordkeeping, and any other duties relevant to a bona fide program of clinical work
- full time = minimum of 30 hours of work per week
-the clinical internship shall comprise no less than nine months of full-time employment
- the internship must be completed within a maximum period of 18 consecutive months
-Clinical internship shall be under the direct supervision of a person licensed to practice audiology and have CCCs (ASHA)



Licence renewal
Biennial
-must have evidence of 20 documented hours of Continuing Professional Educaton for renewal
Credit for continuing professional ed will be granted as the following:
- giving a lecture or seminar which you have never given before
- teach a new graduate course (max 12 hours)
-publication in a national journal (max 6 hours)
-Attendence at seminars or lectures
-home study courses (max 10 hours)
-successful completion of graduate course max 15 hours
- reading journal articles max 6 hours
-successful completion of online seminar max 10 hours






What is a statute?

What is a regulation

S = framing of law, not easy to change, only through legislature

R = can be changed, updated has more detail

What do you need when applying for temporary AuD licence?
-license from another state
-valid for 18 months
Who develops the rules and regulations for HIPAA?
The department of health and human services
What is HIPAA
Health Insurance Portability & accountablity Ace
- protects the privacy of health care information
-sets rules about how it can be used
- 1st attempt to create uniform national rules with health care information


What is a CPT code?

What does it reach?

"Current Procedural Terminology"
- each procedure performed by health care provider is assigned a code
-the code assigned reaches approved amount for reimbursement

What forms the CPT code?

What does it go according to?

- based on "Relative Value Units"
-assigns relative weighting factor to each CPT procedure
-weighting arrived at according to physician, practice overhead expenses, & malpractice liability

5 provisions of HIPAA
-use codes & standard transactions
- Use NPI codes for national provider identification
-Use electronic signatures
-Privacy rules - establishes who has access to health information
-- Security rules - ensuring access to those who have access



Who must comply with HIPAA?
All covered Entities (CEs)
- health care plans
- health care payers
- health care clearing house
- certain health care providers like audiologists & SLP, pharmacies



What is the difference between Quality, performance & outcome?
-Quality is what we continually strive to provide the patient, attempt to provide best outcome, eliminate waste & satisfy the customer
-performance is how well the patient does with the provided intervention
-outcome is the improvement accomplished as a result of the intervention

What is the goal of outcome measures?
-to provide objective information to customers & promote data driven decision making by managers
-evaluate patients status as a result of audiological intervention
Why are outcomes so important?
We have increased accountability because of shrinking health care resources
-to demonstrate to the patient the benefit of our intervention
-this information is requested by 3rd party payers

In audiology, outcomes are used in the area of ?
hearing aid fittings
-adjustment must be made during fitting to individualize fitting
-for use when counseling patients
-to document patient satisfaction


How do we show that what we are doing works?
We use evidence based practice
How do we choose which outcomes to use?
Choice is based on goals
- classification of WHO -1977
What are the domains of WHO 1997
-Impairment - effect of the disorder at the level of the body
- Activity limitation - at the level of the person
- Participation limitation - at the societal level

What is the goal of alleviating impairment? how is this done?
The goal is to alleviate impairment as much as possible from the disorder, to improve functioning level of hearing
Done by:
- obtaining thresholds
-use of HA parameters (ensuring electroacoustic characteristics as close as possible to those prescribed by root mean squared difference between target & measured gain at 500Hz 1,2,4KHz)
-using the articulation Index to get an estimate of speech intelligibiity - patient acceptability



What is the goal of reducing activity limitations?
Goal is to improve a patient's ability to hear/understand speech. Enabling better communication
What is used in the evaluation of patient perception with participation?
self report measures
How can we verify the goals at the activity & participation levels
- Obtain objective performance on tests like hearing in noise test (HINT)or Quick SIN
- administer self report measures like "Hearing Handicap for the Elderly & the COSI (Client oriented scale of improvment or the Glasglow hearing aid benefit profile
How do we measure patient's "perception" of benefit from hearing aid use?
Use Health related Quality of Life Questionnaires

HQL

What are 4 domains of HQL?

How can these measures be categorized?

1. physical & occupational function
2. psychological function
3. social interaction
4. somatic sensation

categorized as disease specific or generic




What are 4 types of reports?
1.Diagnostic - history, findings, assessment recommendations
2. progress notes - reflects outcome of patient contact
3.treatment plan - goals & objectives for patient
4. oral report


What does SOAP stand for?
S=Subjective -complaint history, observation, rational for visit
O = Objective - results from diagnostic testing
A = Assessment - synthesizing subjective & objective information - Brief documentation
P = Plan - recommendations for patient


What are the regulatory agencies involved in infection control?
OSHA = Occupational Safety & Health Administration
- governed by dept. of Labor
-regulates the work place to ensure sage & healthful working conditions by authorizing enforcement of standards developed under 1970 act
JCAHO - Joint Commission for the Accreditation of Health Care Organizations
- voluntary accreditation program
- establishes stds and conduct
CARF - Commission for the Accreditation of Rehabilitation Facilities
- stds for organizations providing services to persons with disabilities
EPA - Environmental Protection Agency - safe guard the natural environment
FDA - Food and Drug Admin








Why is infection control practice important to audiology?
Our equipment has parts that come in contact with multiple patients
- possibliity of spreading infectious material
4 modes of transmission?
1. Airborn - droplet transmission
2. Vector - insect transmission
3. Direct Contact
4. Vehicle - ingestion of contaminated food


What is the goal of infection control?
To reduce or eliminate opportunities for direct or indirect transmisson of micro organisms from person to person
What is included in the infection control process?
-Universal Standard Precautions
-Intrument sterilization
-Written infection control plan
-IC procedures for audiology
-records of training in infection control



What are some ways to control the source of human infection/reduce infection?
1. Wash hands
2. take case history
3. use of protective garment, glasses, covers, masks
4. vaccination
5. proper waste management



Contraindications for cerument management
- Aids
- diabetes
- perforated TM
- Ear surgery within last 6 months
- bony exostosis
- hearing in only 1 ear
- inflammation
- on blood thinners






3 types of cerumen removal are?
1.Mechanical - use of curet, wire loops forceps (most common method)
2. Suction - need at least 21 inch vaccuum. Have cup of warm water available incase suction gets clogged. Very loud can cause threshold shift
3. Water irrigation - used for complete occlusion when cerumen is hard/dry. Must be careful not to damage TM with high pressure

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