1. Each program for
training a dialysis technician provided by a facility must consist of a written
curriculum that specifies the objectives for each portion of the
course.
2. The written curriculum
must include at least the following subjects:
(a) Introduction to dialytic therapies,
including:
(1) The history of
dialysis;
(2) Definitions and
terminology;
(3) Communication
skills;
(4) Ethics and
confidentiality;
(5) The
multidisciplinary process;
(6) The
roles of the members of an interdisciplinary team established pursuant to the
provisions of NAC 449.541; and
(7)
Information concerning renal organizations and resources;
(b) The principles of hemodialysis,
including:
(1) The principles of
dialysis;
(2) Access to the
circulatory system; and
(3)
Anticoagulation, local anesthetics and normal saline;
(c) Understanding a person who suffers from
kidney failure, including:
(1) Basic renal
anatomy, physiology and pathophysiology;
(2) The effect of renal failure on the
systems of the body;
(3) The
symptoms and findings related to the uremic state;
(4) The modes of renal replacement therapy,
including kidney transplantation;
(5) Basic renal nutrition;
(6) Basic psychosocial aspects of end-stage
renal disease;
(7) The medications
commonly administered to a patient who is diagnosed with end-stage renal
disease, including the manner of administering and the effects of those
medications;
(8) Confidentiality of
the personal and clinical records of a patient of a facility;
(9) Professional conduct;
(10) The rights and responsibilities of a
patient of a facility; and
(11)
Rehabilitation of a patient of a facility;
(d) Procedures relating to dialysis,
including:
(1) Using aseptic
techniques;
(2) The technical
aspects of dialysis, operation and monitoring of equipment, and the
commencement and termination of dialysis;
(3) Delivering dialysis treatment adequately
and circumstances that may result from inadequate treatment;
(4) Observing and reporting the reaction of a
patient to treatment;
(5)
Monitoring glucose and hemoglobin or hematocrit monitoring;
(6) Emergency procedures and responses,
including cardiopulmonary resuscitation, the management of an air embolism, and
the proper response to line separation and hemolysis;
(7) External and internal disasters, fire,
natural disasters and preparation for an emergency; and
(8) Safety, control of quality and
improvement of quality;
(e) Information concerning devices used for
hemodialysis, including:
(1) The theory and
practice of conventional, high efficiency and high flux dialysis;
(2) Dialysate composition, options,
indications, complications and safety;
(3) Monitoring and safety; and
(4) Disinfecting equipment;
(f) The treatment of water,
including:
(1) Standards for water treatment
used for dialysis as described in the American National Standard,
Water Treatment Equipment for Hemodialysis
Applications, adopted by reference pursuant to the provisions of NAC
449.520;
(2) Systems and
devices;
(3) Monitoring;
and
(4) The risk of harm to a
patient who uses untreated water;
(g) If the facility reuses water, information
concerning the reprocessing of water, including:
(1) Principles of reuse;
(2) Safety, control of quality, standard
precautions and water treatment; and
(3) Standards for reuse as described in the
American National Standard, Water Treatment Equipment
for Hemodialysis Applications, adopted by reference pursuant to the
provisions of NAC 449.520;
(h) Providing instruction for a patient of a
facility, including:
(1) The role of the
technician in supporting the goals of the patient concerning education;
and
(2) The principles of adult
education;
(i) Safety
and the control of infection, including:
(1)
The risk of harm to a patient from nosocomial infections and from accidents and
errors in providing treatment;
(2)
Standard precautions, aseptic and sterile techniques, and proper handling of a
specimen;
(3) Basic bacteriology
and epidemiology;
(4) The risk of
harm to an employee of a facility resulting from exposure to blood and
chemicals; and
(5) Electrical,
fire, disaster and environmental safety and hazardous substances; and
(j) The assurance and improvement
of quality, including:
(1) The role of the
dialysis technician in activities concerning the assurance of
quality;
(2) The principles of the
assurance and improvement of quality; and
(3) The importance of the assurance of
quality to ensure that safe dialysis treatments are provided to each patient of
the facility.
3. In addition to the requirements set forth
in subsection 2, if a dialysis technician intends to assist in providing
training or treatment to a patient of the facility who receives peritoneal
dialysis, the program of training for the dialysis technician must include the
following subjects:
(a) The principles of
peritoneal dialysis;
(b) Sterile
techniques;
(c) The systems for the
delivery of peritoneal dialysis;
(d) The symptoms of peritonitis;
and
(e) The complications of
peritoneal dialysis.
4.
In addition to the requirements set forth in subsection 2, if a dialysis
technician intends to cannulate a dialysis access during the treatment of a
patient of the facility or administer normal saline, heparin or lidocaine to
that patient, the program of training for the dialysis technician must include
the following subjects:
(a) Access to
circulation, including:
(1) Fistula:
creation, development, placement of needles and prevention of
complications;
(2) Grafts:
materials used, creation, placement of needles and prevention of complications;
and
(3) Symptoms to
report;
(b) Safe
administration of medications, including:
(1)
Identifying the patient;
(2)
Ensuring the proper administration of medication;
(3) Measuring the correct dose;
(4) Ascertaining the correct route to
administer the dose; and
(5)
Ensuring the correct time to administer the dose;
(c) Administration of normal saline,
including:
(1) The reasons for
administration;
(2) Potential
complications;
(3) The limits of
administration; and
(4) Information
to report and record;
(d) Administration of heparin, including:
(1) The reasons for administration;
(2) The methods of administration;
(3) The preparation of an ordered
dose;
(4) Potential complications;
and
(5) Information to report and
record; and
(e)
Administration of lidocaine, including:
(1)
The reasons for administration;
(2)
The method of administration;
(3)
The preparation of an ordered dose;
(4) Potential complications and risks;
and
(5) Information to report and
record.
5.
The instructor of a course of training provided to a dialysis technician shall:
(a) Maintain a roster of attendance for each
dialysis technician enrolled in the course; and
(b) At least once each week during the
course, evaluate each dialysis technician enrolled in the course to determine
the progress of the dialysis technician in completing the course.
6. Except as otherwise provided in
subsection 7, each dialysis technician specified in subsection 5 must complete
a written examination. The examination must include each of the subjects
specified in subsections 2 and 3. If the dialysis technician intends to
cannulate a dialysis access during the treatment of a patient of the facility
or administer normal saline, heparin or lidocaine to that patient, the
examination must include the subjects specified in subsection 4. To pass the
written examination, the dialysis technician must achieve a score of not less
than 80 percent on each of the subjects required to be included in the written
examination pursuant to the provisions of this subsection.
7. The provisions of subsection 6 do not
apply to a dialysis technician who is certified as a dialysis technician by an
organization that is approved by the Bureau.
Added to NAC by Bd. of
Health by R130-99, eff. 8-1-2001; A by R075-04,
8-5-2004
