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Amplification I > Lecture 3 > Flashcards

Lecture 3 Flashcards

1
Q

What are the 5 steps in the HA fitting process?

A
  1. Assessment
  2. Selection
  3. Fitting and Verification
  4. Orientation
  5. Validation
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2
Q

What are 3 common assessment goals?

A
  1. Is the patient a candidate for amplification?
    - Audiological profile
    - Communication needs
    - Motivation
  2. What hearing aid parameters and technology level should be fitted?
  3. What are the patient’s post-fitting rehabilitation needs?
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3
Q

What should we ask ourselves after an audiological assessment? How?

A
  • What have we completed up to this point? What have we considered in our testing?
  • Pure tone (CHL, SNHL), speech scores, speech in noise, MCL UCL, tinnitus
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4
Q

What should we ask ourselves about patient communication needs and motivation? How?

A
  • What have we done to gauge our patient’s needs and motivation?
  • Interviewed patient, hearing handicap inventory, asked them about their own motivation (COSI)
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5
Q

What is the main goal of the selection process?

A

Audiologist must determine what model(s) /style(s) are appropriate for the patient.

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6
Q

What are the 5 components of the decision making process?

A
  1. Manufacturer (guided by clinic, clinician preference, features of the devices)
  2. Technology level (i.e entry level vs. advanced)
  3. Features and options (user controls, telecoil, microphone configurations, multi-programs, accessories)
  4. Electroacoustic parameters (gain and output of hearing aid to meet hearing loss needs with prescriptive targets)
  5. Other considerations may include financial means, warranties offered, cosmetic preferences
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7
Q

Who are the big 5 Manufacturers?

A
  1. GN Resound
  2. WS Audiology (Widex, Signia, Siemens)
  3. William Demant (Oticon, Bernafon, Sonic)
  4. Starkey
  5. Sonova (Phonak, Kirkland, Unitron)
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8
Q

Once a model is selected, we must determine if the coupling to the ear is ____ or ____

A

custom, non-custom

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9
Q

If the hearing aid itself or earpiece is deemed to be custom, an ____ of the ear is taken.

A

impression

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10
Q

What 6 HAs need impressions?

A
  1. IICs
  2. CICs
  3. ITCs
  4. ITEs
  5. RIC custom shells
  6. BTE earmolds
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11
Q

What 2 HAs do not need impressions?

A
  1. RICs
  2. RITAs with use of domes
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12
Q

What do custom made products allow for?

A

Custom made products allow for a better seal, gain, and sound quality

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13
Q

Mild-moderate HL typically just need a ____

A

dome

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14
Q

Often times ____ feel more comfortable (however…)

A

domes, there isn’t always a perfect seal which can cause whistling)

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15
Q

How to communicate with a HA manufacturer (selection and ordring)

A
  • Multiple ways to “order” hearing aids and accessories
  • Each manufacturer will provide clinician/business with an account (number)
  • Manufacturers will have courier, fax, email, or online portals to communicate between themselves and the clinicians
  • Customer service departments, lab technicians, and audiology support services can be of great help— and they are willing to assist!
  • Turnaround time being ordering a receiving devices can be varied- very short for non-custom pieces, usually within 1-2 weeks for custom products
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16
Q

When the devices arrive in clinic, what do you do before the patient arrives?

A
  • Ensure order is correct!
  • Review invoice/specification sheets (quality control measures)- more on ANSI testing in later unit
  • Pre-set devices for a “first-fit”
    • Connect to software through Noah, input acoustic parameters (domes, venting option, receiver wire lengths, etc.), set any features you wish to do in advance
    • Collect any other items (cleaning tools, wax filters, etc. that will be helpful during the initial fitting appointment)
17
Q

What software produces the NOAH software platform?

A

HIMSA: Hearing Instrument Manufacturers’ Software Association

18
Q

What is the wireless interface?

A
  • NoahLink, or proprietary programming devices
  • Eg. iCubeII/SurfLink/nEARcom
19
Q

What is the wired interface?

A

Hi-Pro, connect devices with programming cables

20
Q

What happens after the patient comes in to get their HAs?

A

We can verify the quality of the devices, and the means to which they suit/adequately fit the patient from both a physical and acoustic standpoint.

21
Q

Explain quality control measures

A

Does the hearing aid pass QC, and how does the device performance measure to the manufacturers specifications?

22
Q

Explain the physical fit of the HA

A

Does the device/custom piece/dome earmold fit comfortably, and is it fitting well on/in the ear? Can the patient position the aid correctly?

23
Q

Hearing aid performance based on what audiological need?

A

REAL EAR MEASURES (REMs)/PROBE MIC MEASURES (PMMs) or test box measures

24
Q

What are sound-field aided speech measures?

A
  • Fit hearing aids, put them back in the booth to see how they are fitting
  • Not done anymore (not as good as REMs)
25
Q

What does verification and fitting ensure?

A
  • Are the amplification “targets”, for SOFT, AVERAGE, and LOUD speech met?
  • Testing aided speech with stimuli with varying levels inputs
26
Q

What are the 5 parts of the REM?

A
  1. Probe tube
  2. Probe module
  3. Retention cord
  4. Probe microphone
  5. Reference microphone
27
Q

Hearing instrument oriention - what are the 7 things you need to teach the patient?

A
  1. Left vs. Right
  2. Microphone ports (i.e. where the sound is coming in)
  3. Receiver (i.e where the sound is coming out)
  4. How to clean- review cleaning tools
  5. How to change parts of hearing aids
  6. Storage
  7. Batteries/Charger
28
Q

What are 5 important things to remember when adjusting a patient to amplification?

A
  1. Is our patient a new or experienced user?
  2. What will sound different? Environmental noise vs. speech vs. own voice
  3. Adjusting to wearing- how can we set up success initially?
  4. Handouts/Apps to guide patients
  5. Opportunity to reaffirm appropriate expectations, and give additional communication strategies
29
Q

How long is a typical HA trial?

A

Trial with hearing instruments over a 30, 60, or 90 day period

30
Q

What 3 things does a trial period ensure?

A
  1. Both patient and audiologist are happy with selection, that the patient can handle the device/s, and that they are beneficial in aiding hearing loss
  2. Follow-ups are often necessary during the trial period to ensure progress is on- track, or clinicians can be proactive in meeting concerns
  3. Financial considerations: transaction of funds, third party claims, insurance, supplements, financing plans, warranty repair dates, loss and damage
31
Q

What is the main goal of validation?

A

Is amplification making a difference in the patient’s life?

32
Q

Validation is different from ____

A

Verification

33
Q

What are the 3 questions we should ask ourselves with verification?

A
  1. Is the disability or handicap of hearing loss reduced?
  2. Is the patient meeting the goals they have set? COSI
  3. Is the patient experiencing less “activity limitations” and “participation restrictions”
34
Q

The COSI assesses the benefits of amplification in what 2 ways?

A
  1. Degree of Change: Improvement provided by the hearing aids is rated as better or worse in a continuum
  2. Final Hearing Ability: An absolute measure of communication ability (percentage of ability to hear in identified situations.
35
Q

What are the two different processes a patient can get amplification in?

A
  1. Patient A: first tested in a public setting (hospital audiology clinic)
  2. Patient B: first tested in a private setting
36
Q

Explain the 7 steps of a patient going to a public setting

A
  1. Testing
  2. Patient seeks dispenser (audiologists in a hospital cannot dispense HAs)
  3. Selection
  4. Ear impression
  5. Order
  6. HAs arrive in clinic
  7. Fitting appointment
37
Q

Explain the 6 steps of a patient going to a private setting

A
  1. Testing
  2. Selection (audiologists in a private practice can diagnose and dispense HAs)
  3. Ear impression
  4. Order
  5. HAs arrive in clinic
  6. Fitting appointment
38
Q

How does a follow up work?

A
  • Follow-up first by phone call/message
    • 24-48 post-fitting
  • Follow-up in clinic/ or through telepractice
    • 2-4 weeks following fitting
    • Outcome measures may be reviewed
    • Adjustments, Counselling, Review Datalogging
  • Final follow-up before trial period ends**
    Report back to physician, or other referring source
39
Q

How does an ongoing follow up work?

A
  • Annual evaluation (any changes to audiogram)
  • Review hearing health, changes in other health domains, discuss hearing aid benefit, discuss communication needs
  • Clean and check hearing aids and accessories, ensure patient has cleaning tools, wax filters, batteries
  • Review settings, possibly perform REMs

Amplification I (14 decks)

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