Ch. 9: Post-Test Procedures & Confidentiality of Records Flashcards
What topics should be discussed during post-test counselling? 5
-The following topics should be included in post-test counselling:
• the worker’s test results
• information concerning noise and hearing
• hearing protectors (i.e., their use, care, and problems the worker may experience with them)
• follow-up, if required
• the date of the next hearing test
-These are the most common topics; however, the discussion need not be limited to these. The technician should encourage questions from the worker because discussion will indicate the worker’s level of knowledge about noise and hearing.
-The post-test discussion will also indicate the worker’s attitude toward noise and hearing protectors. The information you obtain may direct further actions you must take in the area of worker education and motivation.
When informing workers of their results, why is it so important that you, as the technician, choose your words carefully?
- When informing workers of test results, it is important to choose your words carefully so that no worker is mislabeled and each worker will understand what his or her test results mean.
- Remember that audiometry is a screening tool and not a diagnostic tool when used on its own. Therefore, you must be careful not to say that hearing loss is a result of noise. You can say that displays of hearing loss can be caused by noise exposure.
- Hearing test results should not be used to scare workers into wearing hearing protectors, however, you can express your concerns when you find an indication of significant hearing loss.
- There is a very fine line that you must observe as a technician, but if you remember to present results in a positive light first, and motivate in a positive manner, then your credibility and the credibility of the noise management program will be maintained.
Why is it a good idea to use an audiogram to help explain test results?
-The audiogram presents a picture of the worker’s test results. It is easier for the worker to understand and easier for the technician to explain results when using an audiogram rather than a cumulative record sheet.
-Before giving results to a worker, it is a good idea to explain how the graph works and what it shows. Consider the following paragraph as an example:
The numbers across the top are the different pitches of sound you heard during the test. As we go from left to right, the pitches go from a low pitch to a high pitch. The numbers down the left-hand side represent loudness. As we go from top to bottom, the loudness represented goes from very soft to very loud. The marks on the graph are the softest sounds you can hear for each different pitch. The Os are your right ear and the Xs are your left ear. Average normal hearing is shown when all marks are within a certain area across the top of the graph (0 to 25 decibels). The pitches that are used to hear speech are in a certain area on the left-hand side of the graph (500 to 2000 Hertz).
-Once your basic explanation is done, you can show the worker his or her results and talk about them. Most workers will understand this basic explanation and appreciate seeing a graph of their hearing test. A copy of the audiogram must be given to the worker. The employer is required to keep results for 10 years.
-Workers usually have tests once a year or once every two years. It is appropriate, in most cases, to explain the graph each time the worker is tested. An alternative is to ask the worker if he or she remembers how the graph works, and to ask the individual to explain the graph to you. This would test the worker’s level of knowledge and understanding of his or her test results.
When should workers be referred to a physician or audiologist? 4
Workers should be referred to a physician or audiologist in these circumstances:
• problems are identified during the ear examination
• the worker has severe tinnitus
• threshold levels are difficult to establish after conducting two tests
• results are abnormal or show an abnormal shift in hearing; in this case, only the forms are sent initially
What information might a physician or audiologist need when reviewing test results or examining a worker’s hearing?
- Reviewers need all pertinent information for a particular worker’s test.
- This information should be discussed with the reviewer and in general should include these components: all audiogram records; all information obtained during the worker’s history; noise exposure at work, which includes any sound levels; use of hearing protection; and information you have given the worker.
- The reviewer should be familiar with all aspects of the noise management program.
What should you do if a worker displays high frequency shifts and admits that they don’t wear hearing protection?
- If a worker’s hearing test results show a threshold shift, that worker should receive additional education about noise and its effects.
- This should be paired with training in the proper use and care of hearing protectors.
- The technician should listen to the reasons why the worker doesn’t wear protection and take steps to alleviate complaints about protectors that discourage their use.
- Supervisors play an important role in monitoring the use of protection. Workers who persist in refusing to wear protection required by company policy can, if policy permits, be subject to disciplinary action.
How should individual test results be regarded? 3
- Audiometric test results are a part of a worker’s health records and should be regarded, therefore, as confidential medical information and treated in the same way as other screening and monitoring test results.
- Written worker consents are needed to divulge individual test results to those outside the occupational health service unless withholding the information is a threat to the health and safety of the worker or his or her co-workers.
- Guidelines for storing, protecting, and releasing individual audiometric data can be included in the company’s policy on confidentiality.
What would you say to Peter in the counselling session after completing his first periodic test?
- First, explain to Peter how the graph works and then show him the graph with his results.
- Next, tell Peter that his hearing is good in the lower pitches, which are needed to hear speech.
- However, his hearing is down in the higher pitches, and this may be due to noise exposure.
- Say that although he may not notice this drop in hearing, it is important that he wear protection or his hearing will get worse.
- Ask Peter if he has any problems with or complaints about his hearing protection.
- Ask if he has any questions about his hearing test results.
- Tell Peter that he will be scheduled for another hearing test in a year’s time, and, in the meantime, if he has any problems he can drop in any time for help.
What would you say to Peter in the counselling session after completing his fourth periodic test?
- Explain to Peter how the graph works and show him his graph.
- Tell Peter that his hearing is still good in the lower frequencies, or pitches, except for one pitch in the left ear. Tell him that otherwise his hearing is much the same as it was with the previous tests – with a notch in the higher frequencies (or pitches).
- Ask him if he can think of any reason why his hearing could be down in the one frequency (has he had a cold, sinus problems, or a left ear infection).
- Tell Peter that his results will be sent for review to the company physician (or consulting audiologist) and he will be contacted if any follow-up is necessary.
- Ask Peter if he has any concerns or questions and encourage him to return if he has any concerns or problems regarding his hearing or his hearing protection.
What would you say to Peter in the counselling session following his fifth periodic test?
- Explain how the graph works and show him his graph at the same time.
- Tell Peter that his hearing is good in the lower pitches and that all hearing levels in this area are within the normal range.
- Explain that his hearing is down in the higher pitches of his left ear and that this drop may be due to noise exposure.
- Tell Peter that his results will be sent to the company physician (or consulting audiologist) for review, and he will be contacted if there is any follow-up to that review.
- Ask Peter about his hearing protection and find out how he maintains it and how he wears it.
- Ask him to demonstrate how he wears his hearing protection. This information will indicate what follow-up is necessary.
