Medication Administration by Hemo Technicians

THE RENAL NETWORK, INC.
Approved – November 14, 1990/Network Coordinating Council
Revised – September 10, 1997/Medical Review Board/Board of Trustees
Revised – November 5, 2003/Medical Review Board/Board of Trustees

POSITION STATEMENT
THE ROLE OF THE PATIENT CARE TECHNICIAN IN DIALYSIS

The Renal Network, Inc. acknowledges the role of the Patient Care Technician (PCT) in dialysis to perform all of the basic procedures required to provide a hemodialysis and/or peritoneal dialysis treatment plus the ability to initiate and terminate the dialysis process regardless of the access site and to administer specific medications to patients undergoing in-center hemodialysis treatments, under the direct supervision of a licensed registered nurse or physician.

ACCESS SITES

Initiation and termination of dialysis should be performed according to carefully designed protocols approved by the facility’s governing body. The PCT can perform the following procedures:

  1. Venipuncture of a fistula or artificial graft placed for hemodialysis.
  2. Connection, disconnection and care of a previously inserted venous catheter placed for hemodialysis or peritoneal catheter.

MEDICATIONS

Medication administration activities should be performed according to carefully designed protocols approved by the facility’s governing body. It is considered appropriate for hemodialysis patient care technicians to prepare and administer only the following medications via the specified route, involved in the dialysis process per written protocol as delegated by and under the direct supervision of a RN or physician.

  1. Heparin – Intravenous and Intraperitoneal
  2. Normal Saline – Intravenous
  3. Lidocaine – Intradermal for cannulation
  4. Ethyl Chloride – Topical
  5. Peritoneal dialysate – Intraperitoneal
  6. Dialysate Concentrate – Extracorporeal

TRAINING REQUIREMENTS

Patient Care Technicians should be trained by the dialysis facility which employs them. The training program should include these components:

  1. Formal Training Program. The program of initial and ongoing training for the PCT must exist and be documented. This should be conducted by each facility according to a formal, written protocol that has been approved by the facility’s governing body.
  2. Protocols and Documentation. The training protocols and documentation of training process should specifically address the theoretical issues, policies, procedures, and equipment of the particular unit involved. The training should match the scope of services the PCT will deliver.
  3. Verification of Competency. Competency of the PCT must be verified and documented upon completion of training and annually according to the facility policy approved by the facility’s governing body.
  4. Monitoring. The training program, documentation of training process, and PCT performance should be monitored through the facility’s internal quality improvement program. The monitoring process should be formal, written, and approved by the facility’s governing body.

REFERENCES AND RESOURCES

  1. "E.S.R.D. Network 5 Position on Use of Dialysis Technicians (draft)", Medical Review Board of Network 5, March, 1990.
  2. "The Use of Unlicensed Personnel in Dialysis Facilities for Direct and Indirect Patient Care," Position Statement, American Nephrology Nurses Association, North Woodbury Road, Pitman, New Jersey 08071, March 1990.
  3. Law Regulating the Practice of Nursing, Chapter 4723, Ohio Revised Code, June 1988.
  4. Indiana State Board of Nursing, 1987 edition.
  5. Kentucky Nursing Practice Act, annotated 1987, Kentucky Board of Nursing.

The Renal Network, Inc.
911 E. 86th Street, Suite 202
Indianapolis, IN 46240
Phone: (317) 257-8265
Fax: (317) 257-8291
Patient Line:
1 (800) 456-6919
Email: [email protected]

Last updated on: February 29, 2008