Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 117 - END STAGE RENAL DISEASE FACILITIES › Subchapter E - DIALYSIS TECHNICIANS › Section 117.63 - Competency Evaluation

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  governing body shall ensure that the core staff members of the facility review
				  the training records of each trainee, including tests and skills checklists,
				  hear comments from the training instructor(s) and preceptor(s), and validate
				  that the trainee has successfully completed the training program.
(b) An individual who completed the
				  facility's orientation program and was determined by the facility to be
				  qualified to deliver dialysis patient care may qualify as a dialysis technician
				  by passing the written examination described in §
										117.62(f)
				  of this title (relating to Training Curricula and Instructors) and
				  demonstrating competency by completion of the skills checklist described in
				  subsection (c) of this section.
(c)
				  The supervising nurse or a registered nurse who qualifies as an instructor
				  under §
										117.62(g)(2)
				  of this title shall complete a competency skills checklist to document each
				  dialysis technician trainee's knowledge and skills for the following allowed
				  acts:
(1) assembling necessary
				  supplies;
(2) preparing dialysate
				  according to procedure and dialysis prescription;
(3) assembling and preparing the dialysis
				  extracorporeal circuit correctly;
(4) securing the correct dialyzer for the
				  specific patient;
(5) installing
				  and rinsing dialyzer and all necessary tubing;
(6) testing monitors and alarms,
				  conductivity, and (if applicable) presence and absence of residual
				  sterilants;
(7) setting monitors
				  and alarms according to facility and manufacturer protocols;
(8) obtaining predialysis vital signs,
				  weight, and temperature according to facility protocol and informing the
				  registered nurse of unusual findings;
(9) inspecting access for patency and, after
				  cannulation is performed and heparin administered, initiating dialysis
				  according to the patient's prescription, observing universal precautions, and
				  reporting unusual findings to the registered nurse;
(10) adjusting blood flow rates according to
				  established protocols and the patient's prescription;
(11) calculating and setting the dialysis
				  machine to allow fluid removal rates according to established protocols and the
				  patient's prescription;
(12)
				  monitoring the patient and equipment during treatment, responding appropriately
				  to patient needs and machine alarms, and reporting unusual occurrences to the
				  registered nurse;
(13) changing
				  fluid removal rate, placing patient in Trendelenburg position, and
				  administering replacement normal saline as directed by the registered nurse,
				  physician order, or facility protocol;
(14) documenting findings and actions per
				  facility protocol;
(15) describing
				  appropriate response to dialysis-related emergencies such as cardiac or
				  respiratory arrest, needle displacement or infiltration, clotting, blood leaks,
				  or air emboli and to nonmedical emergencies such as power outages or equipment
				  failure;
(16) discontinuing
				  dialysis and establishing hemostasis:
(A)
				  inspecting, cleaning, and dressing access according to facility protocol;
				  and
(B) reporting unusual findings
				  and occurrences to the registered nurse;
(17) obtaining and recording postdialysis
				  vital signs, temperature, and weight and reporting unusual findings to the
				  registered nurse;
(18) discarding
				  supplies and sanitizing equipment and treatment chair according to facility
				  protocol;
(19) communicating the
				  patient's emotional, medical, psychological, and nutritional concerns to the
				  registered nurse;
(20) obtaining
				  current certification in cardiopulmonary resuscitation; and
(21) maintaining professional conduct, good
				  communication skills, and confidentiality in the care of patients.