The kidneys are very important anatomical structures that allow the human body to filter excess water and waste from the blood. Like most organ systems in the body, the kidneys are highly susceptible to damage caused by illnesses such as diabetes, high blood pressure, obstructive kidney disorders, congenital disease, and many others. Some illnesses result in sudden damage while others require a long period of time. If the damage is advanced, a medical procedure known as hemodialysis may be required.
Hemodialysis is a medical procedure that uses a machine, known as a dialyzer, to remove waste and excess fluid from the body. Individuals who require dialysis are usually scheduled to visit a medical clinic at least three times each week where they receive three to five hours of treatment each time. Some patients may benefit from the ability to perform dialysis at home while they sleep. Home dialysis therapy is typically more convenient for patients and can improve overall health outcomes.
During the dialysis process, blood is directed from the blood vessels to the dialyzer through a tube. As the blood is processed by the dialyzer, it passes by a semipermeable membrane that allows toxins and excess water to leave the bloodstream. While dialysis can replace some of the filtration that would normally be performed by the kidneys, it is unable to compensate entirely for the loss in kidney function.
A hemodialysis technician is someone who works in a dialysis clinic as an important member of the healthcare team. In order to deliver comprehensive care to dialysis patients, clinics must employ a variety of medical professionals including nephrologists, nurses, social workers, dialysis technicians, and renal dietitians. These individuals each have their own area of expertise and must work together in order to ensure the health of patients and consistency of care.
Beginning in 2008, the Centers for Medicare and Medicaid Services (CMS) began requiring hemodialysis technicians and other members of the healthcare team to meet on a regular basis to share information and develop a plan of care for each individual. This requirement has dramatically improved the quality of care throughout the United States.
Technician Job Responsibilities
The role of a hemodialysis technician tends to vary depending on the state where they practice and the facility that has hired them. In some clinics, there are different types of technicians who perform slightly different jobs. A patient care dialysis technician is someone who works under the supervision of a nurse and whose job it is to provide direct patient care. A biomedical equipment technician is someone who maintains and repairs dialysis equipment including dialyzers. Equipment technicians may also be referred to as reuse technicians if they have additional responsibilities that include labeling, cleaning, and reprocessing dialyzers. Depending on the nature of employment, a hemodialysis technician may be responsible for performing any number of tasks associated with delivery of care.
Since 2008, the federal government has been working to establish well-defined standards of practice for the hemodialysis technician. As the number of individuals who suffer from kidney disease has risen, the Centers for Medicare and Medicaid Services (CMS) have acknowledged a need for an expanded scope of practice for dialysis technicians. By allowing technicians to perform tasks that do not require advanced medical knowledge, the CMS hopes to better address the growing demand for treatment in the US.
In general, a hemodialysis technician is allowed to set up dialysis machines, perform safety checks, deliver local anesthetics, cannulate with large needles, administer IV heparin and sodium chloride, monitor patients during treatment, collect vital signs, document care in the medical chart, maintain machines, reprocess dialyzers, and test water treatment equipment. Dialysis facilities in some states may be required to limit the tasks of a technician if the state has adopted regulations addressing the matter.
Training and Certification Requirements
Prior to April 2008, there were no official federal regulations that required a hemodialysis technician to complete a formal training program or become certified. In April 2008, the Centers for Medicare and Medicaid Services (CMS) adopted legislation that requires all technicians to pass a validated state or national certification exam. According to CMS Conditions for Coverage, a technician must comply with all state requirements for education, training, credentialing, competency, standards of practice, certification, and licensure. In addition, a hemodialysis technician must possess a high school diploma or equivalency, complete an approved training program, and pass a state or national certification exam. Approved training programs must include instruction covering operation of kidney dialysis machines and equipment, providing direct patient care, communication and interpersonal skills, patient sensitivity training, and caring for difficult patients. A certification exam must be passed within 18 months following the date of hire.
The setting for technician training may vary depending on where an individual wishes to work. In many cases, dialysis facilities offer their own training programs that last for a few weeks and include both classroom instruction as well as clinical experience. Some states may require technician trainees to register with the state and wear an identification badge that indicates that they are a trainee who is delivering care under the direct supervision of a registered nurse or other qualified health professional.
Some facilities may prefer for technicians to complete a training program through a local college or university. This approach allows employers to evaluate potential technician candidates prior to offering a full-time paid position. Other types of federally approved hemodialysis technician training programs might include self-directed or group study plans. These forms of training are not used as much because they can result in gaps in learning and incompetent patient care.
A career as a hemodialysis technician can be very rewarding for those individuals who have a strong desire to learn and who find satisfaction in helping patients live happier and healthier lives. Dialysis treatment can be extremely stressful for patients and can lead to a work environment that is not always comfortable or inviting. Successful technicians attempt to understand the challenges that patients are facing so that they are prepared to deal with the frustrations that will undoubtedly arise. Technicians who express empathy towards patients and who work hard to make the treatment process as comfortable for patients as possible will find that the majority of people are appreciative of the work that a technician performs and are grateful for the care.
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