DreamStation BiPAP Pro and Auto BiPAP

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DreamStation BiPAP Pro and Auto BiPAP Homecare provider competency checklist

Just the essentials

Full-featured flexibility

Assessed:_____________________________________ Assessor:______________________________________ Date:___________ Goals Principles of operation

Date goals met

1. Describe the intended use of the device: n Designated patient populations n Describe appropriate delivery environments

2. Explain the purpose of each: n IPAP n Auto-on n EPAP n SmartRamp n Auto bi-level n Rise time n Bi-Flex n Auto-off

n EZ-Start

Setup and operation

1. Identify the circuit components of the DreamStation: n 6’ tubing n Power supply n Optional bacterial filter n Ultra-fine and pollen filters n Modular humidifier 2. Demonstrate assembly of device with filters, power supply, and patient circuit including the set-up and adjustment of the humidifier. 3. Demonstrate the steps to access and utilize the Provider Mode screen. n Power the device n Configure device to access the Provider Mode screen n Select Auto bi-level prescribed therapy settings n Set a System One resistance setting for prescribed interface n Set a prescribed graduated ramp

Assessor

Goals The clinician will be able to:

Date goals met

Assessor

4. Demonstrate how to verify compliance. Specifics:

n VIC n AHI n Phone-in n Days>4

n Blower hours n System leak n Periodic breathing

5. Demonstrate steps to adjust Patient settings. n Power the device n Set-up and change device settings n View patient information n Adjustment of flex settings n Adjust humidification 6. Describe the various methods of obtaining data from the device. 7. Describe the method and issues involved with adding supplemental oxygen. Alert conditions and troubleshooting

1. Demonstrate understanding of device alarms/alerts, including possible causes, and corrective action. Cleaning and care Specific alarms/alerts: n Service required n SD card n Modem n Patient reminder Cleaning and care

1. Demonstrate the method of cleaning the device, interface, and replacement of the filters. Assessed signature______________________________________Assessor signature ______________________________________

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CAUTION: US federal law restricts these devices to sale by or on the order of a physician. e-doc Clay Com TC 7/19/16 MCI 4107613

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