PURPOSE AND SCOPE:

Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP).

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Patient Related

Education:

• Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access.

Treatment:

• Welcome assigned patients and inquire as to their wellbeing since their last treatment.
• Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law.
• Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment
• Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).         
• Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.
• Monitor patients’ response to dialysis therapy. 
• Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.
• Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure
• Obtain Hemostasis and apply appropriate dressings.   
• Evaluate the patient prior to discharge.
• Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification      
• Responsible for calculating and entry of individual patients’ dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed.      
• Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160.         
• Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification         
• Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes.        
• Report any significant information and/or change in patient condition directly to the registered nurse or supervisor.    
• Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor.  
• Perform and document any intervention for unusual patient status and document patients' response to intervention.
• Evaluate patients’ vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor.
• Obtain all prescribed laboratory testing and prepare specimens for collection.   
• Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.         
• Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage.     
• Monitors patients performing self-care under the supervision of RN. Assists patients in performing self-care as applicable

Staff Related

• Participates in the recruitment process for new clinical staff
• Assists with clinical orientation and on-going training of all appropriate direct patient care personnel as well as the orientation of all facility staff to organization.
• May function as a preceptor in direct patient care training, as determined by state specific guidelines and regulations, to support the delivery of quality patient care as per the standards set forth in the organization Clinical Services Clinical Training Manual(s), organization policies and procedures, and organization training standards.
• Delivers and maintains on-going competency evaluations/audits to ensure ongoing performance of other PCT’s.
• Collaborates with the Clinical Manager and Education Coordinator in driving organization quality standards through education regarding all ESRD regulatory and legal requirements and the practice of Continuous Quality Improvement.
• Assists in training of applicable direct patient care staff on appropriate programs  under the supervision of a nurse.
• Provides developmental support to applicable clinical and facility staff. 

Education/Communication:

• Partners with RN and IDT staff to educate the appropriate personnel regarding the integrity and safety of the facility water systems, as allowed by local regulations. 
• Partners with RN and IDT staff to educate the appropriate personnel regarding the maintenance of environmental integrity, including patient and staff safety, of the facility.
• Ensures a strong communication process between the Clinical Managers, Education Coordinators, direct patient care staff, and all support staff at the facility regarding appropriate training and organizational development programs and initiatives  
• Participates in implementing and potentially designs creative educational programs for PCT staff including contests and other team-based programs.       
• Collaborates with Clinical Managers and Education Coordinators in the scheduling and implementation of training programs and processes as directed.  
• Monitors processes in the delivery of patient care through regular Continuous Quality Improvement (CQI) activities.       
• Ensures all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices      

• Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.
• Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy.
• Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate, and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).
• Initiate Solution Delivery System (SDS) system.

RECORD KEEPING:

• Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.
• Enters all treatment data into the designated clinical application in an accurate and timely manner.
• Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. 
• Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.        
• Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination.      
• Collect, label, appropriately prepare and store lab samples according required laboratory specifications.   
• Ensure collection of lab specimens by appropriate lab courier.   

INFECTION CONTROL:

• Assists with facility QAI infection control audits.
• Acts as a change agent for infection control practices within clinic. Under the direction of the CM or designee monitors staff and patient adherence to infection control practices.         
• Reinforces new hire employee adherence to infection control Policies and Procedures
• Supports ongoing staff and patient engagement on infection control practices under the direction of CM or designee for example participation in patient lobby days and staff meetings to reinforce infection control practice.
• Quarterly and under the direction of the CM reinforces patient and staff adherence to infection control Policies and Procedures through visual media such as posters, flyers, or bulletin boards.
• Under the direction of the Education Dept. participates in education response to internal and external facility surveys.
• Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law

TRANSITIONAL CARE UNIT:

• Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care   
• Reinforces all education and care related matters as it relates to the new patient as allowed by state law
• Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan.        
• Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them.      
• Sets and preforms a treatment on all machines used in the transitional care unit.
• Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up.
• Assists with coordination of transition to patient’s modality choice.         
• Assists with supply ordering and inventory for TCU

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee

encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable

individuals with disabilities to perform the essential functions.

• Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the

Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable

accommodations can be made.

• Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required.
• The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials  
• The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist” devices for the heavier items.

EDUCATION AND LICENSES:

• High School diploma or G.E.D. required. Bachelor’s degree preferred
• Must have a valid PCT national certification or state specific certification as defined by Center for Medicaid/Medicare (CMS)All appropriate state licensure, education, and training (if any) required.
• Demonstrated commitment to organization culture, values, and customer service standards
• Attendance and active participation in all applicable preceptor training programs as established by education leadership      
• Attends Fresenius and publicly offered skill-based training as assigned by Clinical Manager.      

EXPERIENCE AND REQUIRED SKILLS:

• At least five years patient care experience in a hospital setting or a related facility preferred.       
• Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification.

ACKNOWLEDGEMENT:

I acknowledge that I have read and accepted this job description. I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative.

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ADDENDUM:

Home Therapies Program (Not Home Assist)

This list pertains to task performed in the Home Therapies program under the direct supervision of the Home Therapies registered nurse (HT RN)  and in compliance with state laws.

• May assist HT RN on Home Visit as directed    
• Reinforces PD/HHD patient education under supervision of HT Registered Nurse as permitted under state law         
• Schedules and contacts patients regarding appointments         
• Weigh patient and obtain vital signs     
• Collect patient’s treatment records and review for completion. Notify RN of incomplete / missing records.
• Cleaning and prepping treatment room; preparing charts prior to clinic visit        
• Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations)    
• Clerical duties as assigned (faxing, mailing to physician offices etc.)      
• Set-up of the home hemodialysis machine and PD Cycler         
• Assist with exit site care when directed by HT RN         
• Warm dialysate solution when directed by the HT RN    
• Obtain home hemodialysis water and dialysate samples and process for testing as directed by HT RN
• Creates and sends patient reminders (supply inventory for order, Kt/V collection, bringing meds to clinic visit for review)           
• Prepare initial patient chart for admission. Complies and maintains medical records according to company policy and procedure and in compliance with all appropriate regulatory requirements       
• Maintains logs as directed and applicable        
• Support patient registration and use of connected health
• Provide patient home support as indicated and permissible under state law and applicable regulations

Inventory of Home Program

• Maintains par levels of home department supplies