Name: ________________________________________
Date: _________________________________________
Procedure 38-8:
Assisting with Audiometry
Objective: Perform audiometric test without error.
Equipment and Supplies: Audiometer with headphones; quiet room or small, enclosed cubicle;
patient’s record; pen
Affective Behaviors: Affective behaviors provide a professional approach to a skill that enhances
the patient encounter. These behaviors may also display sensitivity to a patient’s rights and
enhance communication. Pay close attention to these skills, which will be in bold, italicized font.
Skills Assessment Requirements
Read and familiarize yourself with the procedure. Complete each procedure within a reasonable
amount of time, with a minimum of 85% accuracy.
Documentation
Use the area below for any documentation needed to complete the procedure.
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GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
1. Check the physician’s orders.
2. Perform hand hygiene.
3. Prepare the equipment.
4. Test the equipment and make
sure the power is on.
5. Identify the patient, and explain
the procedure.
6. Establish a signal response
that the patient will give if no
automatic button is available;
nodding head and holding up
a finger are acceptable signals
(Figure A).
7. Have the patient assume a
comfortable position.
8. Place headphones over the
patient’s ears.
9. Begin with low frequency and
watch the patient for indication
that the sound is heard; push the
button to record if the machine
does not do it automatically.
10. Gradually increase the frequency
until the test is completed in the
first ear.
11. Proceed to the other ear and
repeat the entire procedure.
12. Remove the headphones.
13. Clean the equipment following the
manufacturer’s instructions.
POINT VALUE
= 3–6 points
= 7–9 points
Name: ________________________________________
Date: _________________________________________
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GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
14. Perform hand hygiene.
15. Document the procedure
appropriately.
GRADING
Points Earned
Points Possible 108 108
Percent Grade (Points Earned/
Points Possible)
PASS: YES
NO
N/A
YES
NO
N/A
Instructor Sign-O
Instructor: ______________________________________________ Date: _________________________
POINT VALUE
= 3–6 points
= 7–9 points
Name: ________________________________________
Date: _________________________________________
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