Unit of competency details

HLT07 Version 4

HLT07 Version 5

Comments

HLTAU505B Dispense and maintain hearing devices for adults and provide communication counselling

HLTAU505C - Dispense and maintain hearing devices for adults and provide communication counselling

Unit updated in V5.

ISC upgrade changes to remove references to old OHS legislation and replace with references to new WHS legislation. No change to competency outcome.

Descriptor 

This unit of competency describes the skills and knowledge required to dispense and maintain hearing aids, assistive listening devices and other devices and provide the client, significant other and carer with communication strategies to help overcome the communication breakdown caused by hearing loss

Application 

Work performed involves prescribing and fitting hearing aids and other assistive listening devices; objective evaluation of hearing device function and use; undertaking minor repairs; and maintenance of hearing devices for adults

It also involves devising strategies to address any physical and electro-acoustic modification of hearing device/s indicated by using hardware and software options and providing appropriate instruction to the client/carer in hearing device usage and maintenance

All tasks are conducted in accordance with current industry standards, organisation policies and procedures, and infection control guidelines

Employability Skills 

This unit contains Employability Skills

Elements define the essential outcomes of a unit of competency.

The Performance Criteria specify the level of performance required to demonstrate achievement of the Element. Terms in italics are elaborated in the Range Statement.

ELEMENT 

PERFORMANCE CRITERIA 

1. Establish a positive relationship with the client

1.1 Review client case history and case management plan and explain practice/hearing service administrative procedures to client

1.2 Give client the opportunity to ask questions and discuss concerns

1.3 Clarify and address client's questions and concerns

1.4 Gain informed consent from clients

1.5 Identify and meet special needs of client

1.6 Maintain confidentiality of client information

2. Identify appropriate hearing device/s to meet client's communicative needs

2.1 Identify client's communication needs using information from client history and assessment

2.2 Develop appropriate goals and plan of action with client aimed at meeting their communication and physical needs and establishing realistic expectations of hearing device/s

2.3 Inform client of range of intervention options, including current technology and features which would meet their identified needs and any cost implications

2.4 Actively involve client in decisions regarding their hearing and communication improvement and device selection

2.5 Document agreed plan of action and services provided

2.6 Encourage client to consider the process as an exercise in improving their overall communication ability which requires commitment from all participants

3. Prescribe hearing aids

3.1 Determine the style and performance requirements of the hearing aid in consultation with the client and with reference to the client's stated goals, physical capabilities and physiological constraints to achieve a satisfactory rehabilitation outcome

3.2 Prescribe hearing device/s, including type of ear mould, using one of a range of recognised prescription formulae

4. Take ear impressions

4.1 Follow personal hygiene and infection control procedures

4.2 Identify contraindications to taking ear impressions with otoscopy

4.3 Make referral to other facilities for assessment and treatment if required

4.4 Select correct sized otoblocks for use

4.5 Prepare mould material in accordance with manufacturer's instructions

4.6 Examine ear impressions for defects and take new impression if defects found

4.7 Package ear impressions suitably and send to ear mould manufacturer

5. Prepare for dispensing of hearing aid

5.1 Ensure information, including required forms are accessible and ready for use

5.2 Prepare the environment for hearing aid fitting

5.3 Ensure equipment and instruments used in the fitting of hearing aids are checked and calibrated ready for use

5.4 Ensure personal protective equipment is available and used if required

6. Fit hearing aids

6.1 Fit hearing aids in accordance with manufacturer's recommended procedures and industry best practice

6.2 Assess occlusion effect and make appropriate modifications to minimise its effects

6.3 Determine acceptable power output and evaluate in consultation with the client

6.4 Assess hearing device for acoustic feedback and take action to minimise its effects if needed

6.5 Assess acoustic performance of hearing aids using appropriate validation technique, in accordance with relevant policies and procedures and client feedback/preference

6.6 Determine physical comfort of hearing aids and use modification techniques to ensure a comfortable fit if required

6.7 Instruct client/carer clearly on correct use and care of hearing aids, and maintenance and repair procedures/arrangements

6.8 Evaluate the success of fitting at follow-up appointment and modify the electroacoustic parameters of hearing aid where appropriate

6.9 Discuss strategies to achieve the client's goals and advise on hearing/communication tactics and ALDs

6.10 Follow up client in accordance with industry standards to identify any issues that need to be reviewed

6.11 Give client the opportunity to voice concerns in relation to hearing aid fitting and address client's concerns

6.12 Provide relevant materials to client about their device and services available

7. Clean and store equipment

7.1 Clean equipment and attachments in accordance with manufacturers' requirements and infection control procedures

7.2 Store equipment and attachments accordance with organisation policy and procedures

8. Complete and manage documentation

8.1 Complete, present and store reports and documentation in accordance with relevant policies and procedures

8.2 Make recommendations for further assessment or treatment in accordance with industry standards

8.3 Note expected short and long term outcomes of hearing aid fitting noted in report

9. Maintain and repair hearing aids

9.1 Check hearing aid and its components manually

9.2 Conduct acoustic listening check of hearing aid

9.3 Complete test box measurements as required

9.4 Conduct minor hearing aid repairs in accordance with industry standards

9.5 Arrange major hearing aid repairs when required

9.6 Inform client of the cause of and solution to the device problem and possible ways to overcome this

REQUIRED SKILLS AND KNOWLEDGE 

This describes the essential skills and knowledge and their level required for this unit.

Essential knowledge:

The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes knowledge of:

• A wide range of hearing device types and styles and their performance characteristics
• Detailed understanding of linear and non-linear amplification systems and the principles of at least one of the recognised prescription techniques for both linear and non-linear hearing devices
• Detailed understanding of the various electronic features of digitally programmable and digital hearing devices and their effect on the amplification provided e.g compression ratio, compression threshold/kneepoint, multi-channel compression, directional and omni-directional microphones, feedback management and cancellation systems, noise suppression systems.
• Ear mould acoustics, including venting and tubing, and its effect on hearing device prescription
• MCL and UCL and their effects on hearing aid selection
• Strategies to resolve problems encountered in hearing device fitting according to industry best practice

Essential skills:

It is critical that the candidate demonstrate the ability to:

• Accurately analyse and evaluate the acoustic performance of a hearing device/s and determine whether this meets specifications using insertion gain and test box equipment
• Apply a range of strategies to resolve problems encountered in hearing device fitting according to industry best practice
• Complete reports that accurately reflect the fitting and are tailored to the intended reader
• Demonstrate at least one linear and non-linear recognised prescription techniques eg: NAL NL1 NAL RP, Fig 6, DSL-IO, POGO
• Establish effective working relationships with external agencies
• Fit hearing device/s to ensure maximum client comfort and acoustic benefit
• Instruct client/carer on correct use, management and care of hearing device/s
• Maintain and carry out simple repairs on hearing devices
• Modify acoustic features of ear moulds and tubing to achieve real ear prescription targets and or improve listening comfort
• Operate all equipment and attachments correctly and in accordance with manufacturer's instructions, including clinical calibration of equipment
• Perform MCL and UCL assessments or evaluate maximum power comfort levels
• Prescribe hearing device/s using the client's communicative needs and audiometric results
• Set listening programs in multiple memory hearing devices to meet client's needs in different listening environments
• Take ear impressions accurately
• Undertake hearing device fitting in accordance with industry standards
• Vary electronic features of digitally programmable and digital hearing devices to achieve real ear prescription targets and or improve listening comfort e.g compression ratio, compression threshold/kneepoint, multi-channel compression, directional and omni directional microphones, feedback management and cancellation systems, noise suppression systems
• Vary the electroacoustic characteristics to achieve hearing device/s prescriptive targets

In addition, the candidate must be able to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role

This includes the ability to:

• Apply numeracy skills, including the ability to interpret data and record client results
• Apply problem solving skills required include an ability to use available resources and determine accuracy of test results

continued ...

Essential skills (contd)

Ability to:

• Use interpersonal skills to relate to people from a range of social, cultural and religious backgrounds and physical and mental abilities
• Use oral communication skills-language competence required to fulfil job role in a safe manner and as specified by the organisation. Assessors should look for skills in asking systematic questions, providing clear information, listening to and understanding client areas of concern, and demonstrating ethical practice and procedures in dealing with clients. Effective verbal and non verbal communication skills with a range of internal and external persons are essential together with competence in English or a community language, depending on the client group
• Use reading and writing skills-literacy competence required to fulfil job roles safely and effectively. The level of skill required involves reading and documenting clinical information and understanding procedure manuals
• Work with others

EVIDENCE GUIDE 

The evidence guide provides advice on assessment and must be read in conjunction with the Performance Criteria, Required Skills and Knowledge, the Range Statement and the Assessment Guidelines for this Training Package.

Critical aspects for assessment and evidence required to demonstrate this competency unit:

• The individual being assessed must provide evidence of specified essential knowledge as well as skills
• Observation of workplace performance is essential for assessment of this unit
• Consistency of performance should be demonstrated over the required range of situations relevant to the workplace
• Where, for reasons of safety, space, or access to equipment and resources, assessment takes place away from the workplace, the assessment environment should represent workplace conditions as closely as possible
• It is recommended that assessment should be undertaken by more than one assessor

Access and equity considerations:

• All workers in the health industry should be aware of access and equity issues in relation to their own area of work
• All workers should develop their ability to work in a culturally diverse environment
• In recognition of particular health issues facing Aboriginal and Torres Strait Islander communities, workers should be aware of cultural, historical and current issues impacting on health of Aboriginal and Torres Strait Islander people
• Assessors and trainers must take into account relevant access and equity issues, in particular relating to factors impacting on health of Aboriginal and/or Torres Strait Islander clients and communities

Context of and specific resources for assessment:

• Relevant organisation policy, guidelines, procedures and protocols
• Relevant professional bodies policies and guidelines on the conduct of dispensing hearing aids
• Relevant legislative and regulatory documents
• Relevant publications of the National Acoustic Laboratories
• Access to professional library for accurate and current relevant information
• Manufacturers' specifications for the use and storage of equipment

Method of assessment

• Observation in the work place
• Written assignments/projects or questioning should be used to assess knowledge
• Case study and scenario as a basis for discussion of issues and strategies to contribute to best practice and integration of skills
• Clinical skills involving direct client care are to be assessed initially in a simulated clinical setting (laboratory). If successful, a second assessment is to be conducted during workplace application under direct supervision
• Written examination

Related units:

This unit is to be assessed in conjunction with the following related units:

• HLTAU506B Develop, implement and evaluate an individual hearing program
• HLTAU507B Apply hearing device technology
• HLTAU508B Identify needs for referral

Holistic assessment practice with other audiometry units of competency is necessary

To develop and evaluate an individual hearing rehabilitation program for adults, the individual must link the identification of the communication goals, with the development of realistic expectations, the prescription and fitting of a hearing device/s subsequent to the assessment of hearing and the client's hearing and communication history

RANGE STATEMENT 

The Range Statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Add any essential operating conditions that may be present with training and assessment depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts.

Information may include:

• Client medical history
• Referral letter
• Correspondence
• Consent forms
• Current standards
• Current Research
• Information for clients

Environment may include:

• Consulting room
• Acoustically treated sound field room

Equipment and instruments may include:

• Otoscope (hand held and video)
• Recorded speech material
• CD player
• Stand alone audiometer with capability of doing tests sound-field
• Computer with software capability for audiometric testing sound field
• Real-ear measurement audiometer
• Computer with appropriate platform for enabling hearing aid software
• Programming capability to link hearing aids to computer
• Hearing aid test box
• Hearing aid cleaning and dehumidifying machine
• Handheld motor tool (grinder)
• Bench grinder fitted with polishing wheel

Equipment checking must include:

• Acoustic calibration and integrity check of an audiometer and real ear measurement equipment
• All parts are assembled correctly

Personal protective equipment may include:

• Gloves
• Masks
• Eye protection
• Gown

Clients may include:

• Adults
• Aged persons

Informed consent may include:

• Written
• Verbal
• Implied

Confidentiality of client information may include:

• Legal and ethical requirements
• Secure location for written records
• Telephone conversations
• Offering a private location for discussions
• Information disclosed to an appropriate person consistent with the responsibility of this position
• Adherence to the Privacy Act

Appropriate recognised prescription technique may include:

• NAL RP
• Fig6
• NAL NL-1
• DSL I-O
• POGO
• Manufacturer's proprietary technique

Personal hygiene/infection control procedures may include:

• Washing hands
• Current National Health and Medical Research Council (NHMRC) guidelines for infection control in health care settings
• Standard Precautions and Additional Precautions as defined by the NHMRC
• Current Australian Standards
• Local Government ordinances
• Organisation standards
• Other legislative requirements

Contraindications to taking ear impressions must include:

• Excessive cerumen
• Foreign body
• Discharge from ear
• Signs of infection
• Atresia
• Mastoid cavity
• Recent surgery to ear canal

Referral agencies may include:

• Audiologist
• Medical practitioner
• Medical facilities
• Rehabilitation centres
• Self help organisations
• Other allied health professionals

Modification techniques must include:

• Reshaping of ear mould
• Reshaping of hearing aid shell
• Insertion or enlarging of vents
• Reduction of vents
• Replacement and alteration of tubing
• Selection of appropriate ear moulds and shells
• Recoating of ear moulds and shells

Validation techniques may include:

• Real-ear measurement
• Sound field aided threshold assessment
• Assessment of aided benefit using recorded and live voice speech material
• Manufacturer's proprietary validation techniques

Relevant policies and procedures may include:

• Organisation
• Industry standards (state and national)
• Office of Hearing Services
• Privacy Act
• Research organisations e.g. National Acoustic Laboratory (NAL)
• Relevant state/territory WHS bodies
• Industry professional bodies
• Relevant Australian standards

Manual checking of hearing aid and components may include:

• Identification of wax blockage
• Inspection of tubing for defects including hardening, deforming and perforations
• Filter blockage
• Inspection of ear mould, hearing aid case or shell
• Inspection and check of operation of electrical components for defects e.g. switches, volume controls and operation of remote control
• Acoustic examination

Test box measurements may include:

• Assessment of acoustic performance
• Determination of battery consumption
• Comparison of acoustic performance against manufacturer's specifications to determine if hearing aid is working to specification
• Setting coupler gain targets

Minor hearing aid repairs may include:

• Removal of wax
• Replacement of earhook
• Replacement of tubing
• Dehumidifying hearing aid
• General clean
• Change of battery door
• Replacement of wax filter
• Replacement of acoustic filter

Additional information provided to client during follow up may include:

• Telephone use and telecoil function in hearing aids
• Assistive listening devices
• Information on support groups
• Communication tactics/strategies