W. Va. Code R. § 19-13-3 - Standards for Delegation of Safe Dialysis Care

3.1. The dialysis technician shall provide hemodialysis in accordance with W. Va. Code § 30-7C-1 et seq. and the rules of the board which require the delegation of authority to the technician by a licensed physician or registered professional nurse.

3.2. The dialysis technician may not begin dialysis care until a registered professional nurse or physician has first assessed the patient upon entering the dialysis unit to assure that he or she is stable and then delegated dialysis care to the dialysis technician.;

3.3. The dialysis technician shall evaluate the patient pre-dialysis, including vital signs, volume assessment and evaluation of the vascular access, and report any abnormality to the responsible registered professional nurse or physician, who shall then further evaluate the patient problem before the dialysis technician proceeds with vascular access to begin the procedure.

3.4. The registered professional nurse may not delegate medication administration to the dialysis technician trainee until medication administration competencies have been validated.

3.5. The registered professional nurse who is delegating to the dialysis technician shall assure that:

3.5.a. The activity or task does not require the substantial, specialized knowledge, judgement, skill and decision making of a registered professional nurse;

3.5.b. The registered professional nurse has completed an assessment prior to delegating any nursing intervention in accordance with the standards outlined in the board's rule, Standards for Professional Nursing Practice, 19CSR10;

3.5.c. The nurse administrator has validated the dialysis technician's competency in performing the delegated task;

3.5.d. The registered professional nurse performs ongoing evaluation and assessment of the person receiving the care;

3.5.e. The staffing in the treatment facility provides for adequate supervision of the delegated tasks;

3.5.f. The dialysis technician maintains knowledge of the duties, responsibilities, and accountabilities of a dialysis technician and practices in accordance with the following:

3.5.f.1. The laws regulating the provision of dialysis care;

3.5.f.2. The rules of the board;

3.5.f.3. Any other applicable federal and state laws and rules; and,

3.5.f.4. Applicable standards .

3.5.g. The dialysis technician shall demonstrate competence and accountability in all areas of dialysis care in which the dialysis technician is engaged. The dialysis technician shall:

3.5.g.1. Consistently perform all aspects of dialysis care according to acceptable standards;

3.5.g.2. Appropriately recognize, refer, or consult and intervene when a complication arises in conjunction with dialysis or when a change in patient status occurs;

3.5.g.3. Accurately maintain any patient record or any other documents prepared in the course of or in conjunction with the provision of dialysis care;

3.5.g.4. Implement measures to provide a safe environment for the patient;

3.5.g.5. Establish and maintain professional boundaries with each patient;

3.5.g.6. Not engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient, or in behavior that may reasonably be interpreted as physical, verbal, mental or emotional abuse;

3.5.g.7. Not misappropriate a patient's property, engage in behavior to seek or obtain personal gain at the patient's expense, or engage in behavior that constitutes inappropriate involvement in a patient's personal relationships. The patient is always presumed incapable of giving free, full, or informed consent to these behaviors;

3.5.g.8. Not engage in sexual misconduct or in conduct that may reasonably be interpreted as sexual or in any verbal behavior that is or may reasonably be interpreted as seductive or sexually demeaning to a patient. The patient is always presumed incapable of giving free, full or informed consent to these behaviors; and;

3.5.g.9. Treat each patient with courtesy, respect, and with full recognition of the dignity of each individual.

3.5.h. The dialysis technician shall timely:

3.5.h.1. Implement the prescribed dialysis care order for a patient, or clarify the order if the dialysis technician believes or should have reason to believe that the prescribed order is inaccurate, not properly authorized, not current or valid, harmful or potentially harmful to the patient, or contraindicated by other documented information. When clarifying the prescribed dialysis care order, the dialysis technician shall:

3.5.h.1.A. Timely consult with a physician or registered professional nurse; and,

3.5.h.1.B. Accurately, timely, and completely document and report to the appropriate practitioner all errors in or deviations from the prescribed dialysis care regimen; and

3.5.h.2. Initiate dialysis care after assuring that the equipment has been properly prepared and the environment is safe according to current state and federal requirements for dialysis facilities; and

3.5.i. The dialysis technician may not submit or cause to be submitted any false, misleading, or deceptive statements, information, or documentation to the board, to current employers, or to any future employers for positions requiring a certificate to practice dialysis care.

3.6. A dialysis technician employed in West Virginia through a temporary agency shall meet the requirements of this rule.

3.7. A registered professional nurse delegating inappropriately to a dialysis technician is subject to disciplinary action by the board.

Notes

W. Va. Code R. § 19-13-3