Full time Medical Instrument Technician provides the VA Northern California Health Care System (VANCHCS), Medical Service with all functions specific to the Neurology Sleep Clinic, BiPAP/CPAP, sleep apnea DME, neurodiagnostic studies and other duties as needed. The incumbent serves under the clinical direction specialty physicians and the administrative direction of the Clinical Care Coordinator. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Physical Requirements. See VA Directive and Handbook 5019, Employee Occupational Health Services. This position requires to undergo a pre-employment medical examination/physical, TB test, and other medical related requirements. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with chapter 2, section D, paragraph 5a, this part. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-6(a) Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled.In addition, the candidate must demonstrate the following KSAs:(b) Demonstrated Knowledge, Skills, and Abilities1. Knowledge of standard, computerized polysomnographs for recording continuous all night physiological data including EEG, EOG, EKG, EMG and respiratory parameters.2. Knowledge of standard devices such as oximeters, respiratory effort devices, nasal pressure devices, thermistors, thermocouples, continuous positive airway pressure (CPAP) machines, and laboratory computers including the ability to calibrate and operate the equipment and recognize and eliminate recording artifacts.3. Knowledge of medical terminology and medical record organization to review medical records, sleep study orders, consent forms, medical charts, etc.4. Knowledge of polysomnographic procedural protocols (including overnight sleep studies, MSLT,MWT, PAP, etc.).5. Knowledge of basic anatomy and physiology and the international 10-20 electrode placement systemin order to conduct the sleep studies. GS-7(a) Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. This would be experience which provided the individual with the knowledge, skills, and abilities to independently conduct difficult but standardized polysomnography examinations.In addition, the candidate must demonstrate the following KSAs:(b) Demonstrated Knowledge, Skills, and Abilities1. Knowledge of CPAP function and operation to select and fit appropriate PAP patient interface devices.2. Ability to independently titrate and document PAP level to achieve therapeutic goals.3. Knowledge of indications, complications, and contraindications of CPAP therapy.4. Knowledge of Bi-Level pressure titrations.5. Ability to recognize changes seen during the PSG tracing and identify all stages of sleep. This includes the ability to score and analyze sleep stages in clinical polysomnography recordings. GS-8(a) Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. This would be experience which provided a knowledge of the more complex procedures as well as knowledge of the uncommon and/or rare sleep disorders. In addition, the candidate must demonstrate the following KSAs:(b) Demonstrated Knowledge, Skills, and Abilities1. Advanced knowledge or the International Classification of Sleep Disorders and the ability to recognize uncommon and/or rare sleep disorders.2. Ability to summarize and report polysomnographic data in narrative form.3. Knowledge of event characteristics (e.g., respiratory, cardiac, sleep stage, seizures, etc.) and ability to take appropriate action.4. Ability to provide briefings and orientation to hospital staff including physicians. References: VA HANDBOOK 5005/15 PART II APPENDIX G27 II-G27-47 Appendix I - Medical Instrument Technician (Polysomnography) The full performance level of this vacancy is GS-08. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-06 to GS-08. Physical Requirements: See VA Directive and Handbook 5019. This position requires to undergo a pre-employment medical examination/physical, TB test and other related other medical related requirements ["The incumbent will perform all duties and procedures in maintaining an effective Sleep Clinic including working closely with patients and families, physicians, techs and other departments as needed. Specifically, the incumbent performs the following:\nThis represents the full performance level. At this level Technicians are able to interact fully with the patient and physician to diagnose sleep disorders and CPAP complications including those that are uncommon or rare. They are able to conduct full sleep studies including sleep study-interface-ambulatory PAP (Positive Airway Pressure Titration) studies and MSLT (Multiple Sleep Latency Test). Follows universal precautions to clean and sterilize EEG equipment. Able to evaluate the relationship of events, body position, sleep stages, and possible medical conditions or medications which influence or result from events occurring during sleep. They anticipate problems likely to occur during the sleep study and prepare for such situations, make changes in established procedures, or recommend alternative courses of action. They are able to mentor lower graded technicians.\n- Portable Sleep Apnea Study. Setting up patient with monitors to record multiple respiration parameters for diagnosing sleep apnea with nasal and oral airflow, respiratory effort, body position, oximetry and snoring. Validate recording succeeded. Download and electronically transfer for scoring and processing.\n- Educate patients and caregivers about sleep-disordered breathing and how portable sleep studies can identify sleep apnea\n-Scoring: The technician will score portable and/or attended sleep studies prior to specialist review; and alert specialist of critical findings. Creates sleep study report for specialist's review.\n- Continuous Positive Airway Pressure (CPAP) portable titration with and without interface. This includes selecting and fitting patient with appropriate interface devices. Demonstrate how to use masks and equipment to assure appropriate function. Instructs patients and their significant other or caregiver in BiPAP/CPAP set-ups for overnight portable sleep testing, ensure full understanding of the procedure and function of PAP unit. Provides patient supplies including filters, hoses, masks, chinstraps and headgear for home PAP testing. Able to identify indications, complications and contraindications of CPAP therapy. Able to complete titration with interface between sleep recorder and CPAP for extensive titration. Able to interface PAP with home oximetry monitor for follow-up evaluation of efficacy. Receives posttest BiPAP/CPAP units and downloads sleep data via smartcard, submit to licensed Sleep provider for review. Create electronic chart note that documents a summary of posttest download data for specialist review.\n- CPAP/ DME Clinic. Able to independently program, set-up and adjust settings on PAP equipment based on prescription, working with a variety of brands and types of PAP (CPAP, BiPAP, ASV, AVAPS and others). Demonstrate to patient how to use, clean and maintain masks and equipment to assure proper function and extended use. Troubleshoot machine and/or mask to determine patient barriers to use and correct them. Downloads data and creates electronic chart documentation of download results. Takes appropriate immediate action based on download results including correcting leaks and minor pressure adjustments.\n- Patient education: Teach patient/caregiver about what sleep apnea is, how PAP therapy improves sleep apnea, electrical safety and how to order new supplies for personal unit; can be done in group or individual settings. - Ensures separation of clinical supplies versus Prosthetics disposable supplies due to different fund control points.\n- Processes data entry for documentation of visit and actions, then enters consults for supplies issued.\n- Performs mask fittings to ensure comfort and minimal leak. - Enters patient data entry documenting all procedures performed and clinical interactions including phone or secure messaging. Work Schedule: Monday - Friday; 8:00am - 4:30pm\nTelework: Not available\nVirtual: This is not a virtual position.\nFunctional Statement #:\nRelocation/Recruitment Incentives: Not authorized\nPermanent Change of Station (PCS): Not authorized\nFinancial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.
