2019 Hyperbaric Oxygen Safety: Clinical and Technical Issues MOC

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Hyperbaric Oxygen Safety: Clinical and Technical Issues MOC

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You can use this form to claim your attendance to the 2019 Hyperbaric Oxygen Safety: Clinical and Technical Issues Pre-Course, and as a result, claim your MOC credit for your attendance. Please allow at least 10-15 minutes to answer 9 sets of 3 questions for each lecture given at the meeting as a self-study.

Once you complete this form, we will send your MOC letter to the email address you provide below. Please ensure that you enter your email address correctly and that you are able to receive emails from uhms@uhms.org.

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Name:
Please enter name including full credentials as they will be reflected on your certificate (e.g.MD, PhD, CHT, RN, NP)(*)

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Email Address:(*)

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Safety Considerations in Hyperbaric Medicine: Lessons from Aviation, Space, and Other Industries

Speaker: Gary Toups, MD(*)

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According to Dekker, human error:(*)

Can be eliminated with a "zero defects" strategy
Is a simple problem which can be controlled by compliance and paying attention
Is a problem at least as complex as the parent organization
Can be controlled by controlling people's behavior Invalid Input

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Drift into failure is:(*)

Only an aviation or maritime operations problem
A slow, incremental movement of systems operations toward the edge of their safety envelope
Is an easy impending operational failure mode for all involved agents to detect
Is correctable by doubling the number of inspection requirements for a task or system Invalid Input

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Which of the following industries has the highest incidence of fatal work injuries (2015 data)?(*)

Health services
Trade, transportation, and utilities
Mining, quarrying, and oil/gas extraction
Construction Invalid Input

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The Role of the Medical Director in the Safety Program

Speaker: Marc Robins, DO(*)

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Which of the following statements about air breaks are true?(*)

The most effective means of delivering an air break (FiO2 0.21 breathing gas) is through use of a non-rebreather (NRB) mask
The most effective means of delivering an air break (FiO2 0.21 breathing gas) is through use of an anesthesia mask with a water filled air cuff
All mask systems used for air breaks have the potential for diluting treatment gas around the patient’s head as well as failing to deliver a FiO2 0.21 gas for the break.
It doesn’t matter what system is used for air breaks, any gas dilution is insignificant Invalid Input

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Of the following statements about the Safety Checklist, choose the correct answer:(*)

They are not a legal document and therefore should never be used
They must always be a part of the patient medical record in order to be considered a legal document
They are used for precautionary safety measures and should be kept for a period of time, signed and dated to document the process
They are only considered a “legal document” if approved by Hospital HIM Invalid Input

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Which of the following statements are true about an aborted HBO2 treatment: (*)

If the treatment is ended after 60 minutes or more then it can still be considered complete
An aborted treatment is considered for any time or reason it is stopped before the prescribed dose (duration, depth and gas concentration) is achieved
A treatment that is ended early can only be billed for that portion of the treatment used
Stopping a treatment early is only considered “aborted” if it is ended for a medical emergency Invalid Input

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How to implement the Nursing Guidelines of care to improve safety in your HBO program

Speaker: Jolene Cormier, BSc, EMT, CHT, CWS, BSN, CHRN(*)

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The Baromedical Nurses Association (BNA) released their updated 2018 Guidelines of Nursing Care for the Patient Receiving Hyperbaric Oxygen Therapy. Changes from the previous release (formerly called Nursing Standards of Care) include all of the following except:(*)

New guidelines for potential vision changes in hyperbaric patients
New guidelines for unstable blood glucose levels related to hyperbaric oxygen therapy.
A discussion of the Center for Medicare and Medicaid Services (CMS) requirements and reimbursement affected by a lack of nursing supervision
An increased focus on evidence-based guidelines for care Invalid Input

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The Center for Medicare and Medicaid Services (CMS) federal regulation 42 CFR 482.23 deals with:(*)

Emergency preparedness in a hospital setting
The availability of nursing services and nursing care for patients in a hospital
Life Safety requirements for a hyperbaric facility
The benefits of having a registered nursing operating the hyperbaric chamber Invalid Input

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Nursing interventions, like those addressing altered health maintenance and wound care, may seem to be unnecessary for the hyperbaric environment because they should be addressed in the wound clinic. However, it is important to never assume these factors, which can affect the efficacy of HBO like smoking or offloading a foot ulcer, are being addressed elsewhere. In a retrospective chart review that included 96 clinics, over 11,500 patients and more than 221,000 visits Fife et. al. (2104) found that off-loading was documented in:(*)

20% of visits
40% of visits
5% of visits
2.2% of visits Invalid Input

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Human Factors That Impact Safety in Hyperbaric Operations

Speaker: Richard “Gus” Gustavson, MPH, RN, CHRNC-A, CWCN, CHT-A, CRT(*)

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Based on your understanding of the Dunning-Kruger effect, which of the following is most likely to overestimate their abilities in operating a hyperbaric chamber safely?(*)

Certified Hyperbaric Registered Nurse with 10+ years if experience in wound healing and hyperbaric medicine.
A new hyperbaric technologist with < 3 months training all under the direct supervision of an experienced tech.
A Certified Hyperbaric Tech (CHT) with >20 years’ experience operating all types of chambers.
A UHM Board certified physician with 2 years’ experience supervising hyperbaric treatments. Invalid Input

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Which of the following human factor traits contribute to safety issues?(*)

Complacency – “Hyperbaric medicine is very safe! We have never had an adverse event.”
Confirmation Bias – “I don’t know what I don’t know!”
Multi-Tasking – “I can enter data, watch the movie and operate both chambers at the same time.”
Distractions – “Fighting with my significant other via text on my phone is not a safety issue!”
All the above Invalid Input

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Optimizing the Pediatric Hyperbaric Oxygen Therapy Plan: Tandem Therapy

Speaker: Nicholas Marosek, RN, CHRN(*)

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What advantage is not afforded by the parent or guardian receiving hyperbaric oxygen therapy (HBOT) in tandem with the pediatric patient in the monoplace chamber?(*)

Ability to comfort or soothe the patient
Reduction in risk of pressure-related injury
Ability to facilitate the air break
Both a and c Invalid Input

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What assessment data may be revealing of a barrier to the parent or guardian receiving HBOT in tandem with the pediatric patient in the monoplace chamber?(*)

Confinement anxiety
Upper respiratory illness
Obesity
All of the above Invalid Input

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Safety-related Trends Revealed from the UHMS Facility Accreditation Program

Speaker: Tom Workman, CHT(*)

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How many clinical hyperbaric medicine facilities have been accredited by the UHMS since the program began? (*)

250
300
267
345 Invalid Input

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How many hyperbaric medicine facilities were accredited with distinction at the end of 2018? (*)

200
Approximately 50
Less than 25
100 Invalid Input

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What is the most troubling safety related trend that has been noted in the UHMS Hyperbaric Facility Accreditation Program? (*)

Failure to provide oversight of the status of bulk oxygen systems.
Failure to conduct the full complement of operational and medical emergency procedures.
Designating a Safety Director who is not qualified to assume the responsibilities of the position.
Not performing an annual worse-case scenario fire drill as required by NFPA 99. Invalid Input

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Assessing the Safety of Diver Recompression Chamber Facilities. A Retrospective Review of the Most Common Safety Concerns Encountered at a Range of Recompression Facilities Over a Period of 13 Years

Speaker: Francois Burman(*)

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An operating risk at a recompression chamber facility may be defined as:(*)

A potentially harmful situation
Something that will lead to an accident
The possible exposure to a hazard that leads to a harmful consequence
A term essentially interchangeable with the word hazard Invalid Input

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The common safety shortcoming at the range of assessed facilities was:(*)

Lack of air supply analysis or quality control
Undocumented standard operating procedures
Undocumented emergency operating/medical procedures
Safety drills not practiced Invalid Input

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The most influential factors associated with the relative risk status of a recompression chamber are:(*)

Type of facility, training and number of patients treated annually
Availability (operating hours), geographical location and age.
Treatment protocols used, patient care medical equipment and medical supervision
Type of chamber, maintenance status and funding. Invalid Input

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Safety versus Compliance

Speaker: Kip Posey, CHT(*)

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Which of the following is a benefit of periodic policy and procedure reviews? (*)

Presents staff an opportunity to give feedback on policies that need revision.
Allows staff to refresh knowledge of all hospital policies; especially non routine information.
Informs staff of the latest policy changes, additions, and deletions.
All the above. Invalid Input

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Considering the difference between compliance and safe practice, which of the following is not safe? (*)

Allowing an untested and unapproved wound dressing inside the hyperbaric chamber during treatment.
Walking across a street outside the crosswalk, after checking for traffic and verifying there is no traffic approaching from any direction.
Completing the pretreatment patient safety checklist from memory then documenting in the electronic medical record (EMR).
Both A & C. Invalid Input

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Which statement(s) reflect the best action(s) to take after a non-injury incident? (*)

No action or change to procedures required as long as no one was injured.
The procedure must be changed and new controls added to guarantee the incident never occurs again.
The Medical Director, Safety Director, and staff should evaluate the incident.
The Safety Director is solely responsible to decide all changes to safety policies and procedures.
Punish anyone who reports an incident that caused you to write an incident report. Invalid Input

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International Survey of Equipment Used in Hyperbaric Facilities

Speaker: Marc Pullis, EMT, CHT(*)

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According to both 2016 and 2019 survey results, what is the most commonly used ventilator for the monoplace chamber?(*)

Uni-Vent Eagle 754
Neptune
Sechrist 500A
Baxter Sigma Invalid Input

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In 2019, how many responses were collected for the MONOPLACE survey?(*)

5
43
100
250 Invalid Input

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Biomedical Devices in the Hyperbaric Environment

Speaker: Ian Millar, MD(*)

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Which of the following is an important Medical Device standard relevant to hyperbaric practice? (*)

NFPA 88
ISO 14971
ASME PCC-2
USCG Circular 48 Invalid Input

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With regards hyperbaric electrical safety: (*)

Static electricity is irrelevant
Less than 24 volts DC is safe
5 volt USB supplies can cause problems
Devices must be purged with nitrogen Invalid Input

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Variability in drug delivery from syringe driver devices is often due to: (*)

"Stiction"
Corrosion
Coagulation
Drive motor commutator design Invalid Input

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We want to thank you for your feedback on 2019 Hyperbaric Oxygen Safety: Clinical and Technical Issues. Based upon your attendance to the meeting, and the questions you answered for sessions you attended, you will be awarded the MOC credit hours shown below.

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