Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter D - MINIMUM STANDARDS FOR PATIENT CARE AND TREATMENT › Section 117.46 - Qualifications of Staff

Current through Reg. 49, No. 28; July 12, 2024
(a) The dialysis
				  facility's staff (whether employees or contractors) shall meet the personnel
				  qualifications and demonstrated competencies necessary to serve collectively
				  the comprehensive needs of the patients. The dialysis facility's staff shall
				  have the ability to demonstrate and sustain the skills needed to perform the
				  specific duties of their positions.
(1) The
				  facility shall have a written orientation program to familiarize all new
				  employees (including office staff) with the facility, its policies, and job
				  responsibilities. The orientation program shall be developed and
				  implemented.
(2) The facility shall
				  ensure that each new direct care staff member (whether employee or contractor)
				  is provided sufficient time to become familiar with the facility. The
				  orientation program provided by the facility shall be a minimum time of two
				  weeks for individuals with previous dialysis experience. For new direct care
				  staff members with no previous dialysis experience, the orientation program
				  shall be two weeks plus additional orientation time as determined by the
				  facility.
(3) The facility shall
				  ensure that, in facilities with similar policies and equipment, experienced
				  staff oriented to one facility may be shared with another facility after a
				  shorter orientation period. Documentation of current competency of any shared
				  staff and delegation by that facility's medical director to unlicensed
				  technicians shall be on file in each facility where the shared employee
				  works.
(4) The facility shall
				  ensure that registered nurses with no previous dialysis experience shall be
				  provided an orientation program of a minimum of six weeks. For these registered
				  nurses, the six-week orientation program shall contain at least the following
				  subject content specific to the management of the end stage renal disease
				  patient and appropriate to the population served by the facility:
(A) fluid, electrolyte and acid-base
				  balance;
(B) kidney disease and
				  treatment;
(C) dietary management
				  of kidney disease;
(D) principles
				  of dialysis;
(E) dialysis
				  technology;
(F) venipuncture
				  technique;
(G) care of the dialysis
				  patient;
(H) psychological, social,
				  financial, and physical complications of long-term dialysis;
(I) prevention of hepatitis and other
				  infectious diseases; and
(J) risks
				  and benefits of reuse (if reuse is practiced).
(5) The facility shall ensure that each
				  licensed nurse and dialysis technician demonstrate competency through written
				  and skills testing after the completion of the training program and annually
				  thereafter. Evidence of competency shall be documented in writing and
				  maintained in personnel files. Current certification by a nationally recognized
				  board may substitute for the annual written test. All dialysis technicians must
				  be certified under a national commercially available certification program,
				  within 18 months of being hired as a dialysis technician.
(6) The facility shall ensure that
				  documentation shall be maintained to demonstrate that each staff member
				  providing patient care completes at least five hours of continuing education
				  related to end stage renal disease annually. Continuing education may be
				  provided by facility staff. Documentation shall include the title, duration,
				  and the author or instructor of the continuing education course.