W. Va. Code R. § 19-13-6 - Minimum Standards of a Dialysis Technician Training Programs

6.1. To be approved by the board, a dialysis technician training program shall meet and maintain the following standards and requirements:

6.1.a. The program shall be administered by a registered professional nurse who has:

6.1.a.1. A current, unencumbered, valid license in West Virginia to practice nursing as a registered professional nurse;

6.1.a.2. At least twenty-four (24) months experience in the practice of nursing as a registered professional nurse, of which at least twelve (12) months has been in the care of renal patients, with at least six (6) of those months in dialysis care, occurring within the last three years;

6.1.a.3. Education or experience in adult education, as supported by a portfolio submitted to the Board and,

6.1.a.4. A bachelors degree in nursing or a bachelors degree in education or a portfolio of skills and education evaluated and approved by the Board;

6.1.b. The nurse administrator shall:

6.1.b.1. Assure that the governing body of the training program establishes in writing the policies required by subdivision 6.1.g. of this rule; and,

6.1.b.2. Implement the policies as written;

6.1.c. The training program shall immediately notify the board in writing when the nurse administrator vacates the position or is replaced and provide the name and qualifications of the new or interim nurse administrator. A training program may not initiate a new class of dialysis technician trainees unless the new or interim nurse administrator meets the qualifications required by this rule.

6.1.d. The dialysis technician training program shall be taught by multidisciplinary faculty with expertise in the subject matter.

6.1.d.1. The training program shall provide the name, title, and credentials identifying the educational and professional qualifications of each instructor to the board.

6.1.d.2. The nurse administrator who is responsible for administering the program may use other health care professionals authorized to practice to assist in conducting classroom and clinical portions of the program if the other authorized health care professional relays information for which the professional has been educated and which is within the professional scope of practice as set forth in law.

6.1.d.3. The training program shall report a change in faculty to the board within thirty (30) days of the change;

6.1.e. Each training program shall develop written objectives for the training program which shall serve as the basis for planning, implementing and evaluating the program.

6.1.e.1. The objectives shall be developed by the training program faculty.

6.1.e.2. The training program objectives shall describe the knowledge and skills expected of the dialysis technician, and shall be consistent with the authorized functions of the dialysis technician.

6.1.e.3. The training program objectives shall be reviewed annually and revised as necessary by the nurse administrator;

6.1.f. The curriculum offered by the training program shall include both classroom and clinical instruction of at least three hundred twenty (320) clock hours in length and content which ensures sufficient preparation for safe and effective practice as a dialysis technician. Of the three hundred twenty (320) clock hours, at least one hundred sixty (160) clock hours shall be theoretical instruction with at least one hundred (100) hours face to face instruction in a classroom setting and a minimum of one hundred sixty (160) hours of supervised clinical experience. Supervised clinical experience shall provide opportunities for the student to apply theory and to achieve stated objectives in a patient care setting and shall include clinical learning experiences to develop the skills required by dialysis technicians to provide safe patient care. The registered professional nurse educator or clinical preceptor shall be physically present and accessible to the student when the student is in the patient care area.

6.1.f.1. Classroom instruction, which may be supported by audio visuals, shall include:

6.1.f.1.A. A review of the relevant laws and rules regulating the practice of a dialysis technician and appropriate program policies;

6.1.f.1.B. Renal anatomy and physiology;

6.1.f.1.C. Infection control, universal precautions, and Federal Regulations;

6.1.f.1.D. Basic chemistry of body fluids and electrolytes;

6.1.f.1.E. Manifestations of renal failure;

6.1.f.1.F. Basic laboratory values, including blood work and laboratory values related to dialysis;

6.1.f.1.G. Principles of dialysis;

6.1.f.1.H. Basic pharmacology of the drugs commonly used during dialysis;

6.1.f.1.I. Medication administration techniques specific to the drugs used in dialysis;

6.1.f.1.J. Management of the complications of dialysis and renal failure;

6.1.f.1.K. Principles related to vascular access;

6.1.f.1.L. The role of the dialysis technician in a dialysis setting including, but not limited to, legal and ethical considerations and concepts of delegation;

6.1.f.1.M. Water treatment relevant to dialysis;

6.1.f.1.N. Principles of patient education related to renal failure;

6.1.f.1.O. Principles of and requirements for documentation of hemodialysis care and interventions;

6.1.f.1.P. Communication and team work skills;

6.1.f.1.Q. Operation of dialysis delivery systems which includes the machines, dialysate, and dialyzer;

6.1.f.1.R. Principles of safe effective dialysis care;

6.1.f.1.S. Principles related to the nutritional considerations for patients receiving dialysis;

6.1.f.1.T. Psychosocial aspects of renal disease;

6.1.f.1.U. Principles of dialyzer reprocessing;

6.1.f.1.V. Principles for initiating, monitoring, and discontinuing dialysis; and,

6.1.f.1.W. Principles related to the adequacy of dialysis.

6.1.f.2. The program shall develop written tests for each unit in the curriculum, including a final test, and shall conduct a skills performance evaluation.

6.1.f.2.A. Examines may be administered by paper/pencil or by computer;

6.1.f.2.B. A score of eighty five percent (85%) or greater is required on each unit test with an opportunity to retake each unit test one time without additional instruction. If the student fails a unit test a second time, additional instruction is required before further testing is allowed.

6.1.f.3. Supervised clinical instruction shall:

6.1.f.3.A. Provide the dialysis technician trainee with the opportunity to practice the cognitive, psychomotor, and effective skills required for the safe performance of dialysis care by the dialysis technician;

6.1.f.3.B. Meet the learning needs of each trainee;

6.1.f.3.C. Meet the established program objectives or outcomes;

6.1.f.3.D. Be provided concurrently with the related classroom theory instruction;

6.1.f.3.E. Maintain a faculty to student ratio not to exceed one to four (1:4) in the clinical setting. A one to one (1:1) ratio is required for skills performance evaluation. The clinical preceptor to student ratio is one to two (1:2); and

6.1.f.3.F. Include a registered professional nurse or a dialysis technician preceptor with at least one (1) year of experience in providing dialysis care in the previous two (2) years;

6.1.g. The nurse administrator shall establish and adopt written program policies which address:

6.1.g.1. Criteria for trainee admission and continuation in the program which require, at a minimum, that each individual enrolled in the program has a high school diploma or equivalent, is at least eighteen (18) years of age and is able to safely perform the essential functions of a dialysis technician;

6.1.g.2. Criteria for trainee re-enrollment in the program;

6.1.g.3. Criteria for successful completion of the program;

6.1.g.4. A process for determining achievement of the skills required for the safe performance of dialysis care which shall include, at a minimum, written verification, signed by both a registered professional nurse and the trainee, that the trainee has been taught the required skills;

6.1.g.5. A process for maintaining trainee records. The records shall include, but not be limited to, the date the trainee began the program, the date the trainee completed the three hundred twenty (320) hour program, and the trainee's competency check lists;

6.1.g.6. An accurate, timely process for notifying the board regarding enrollment and program completion which includes, but is not limited to, the following:

6.1.g.6.A. Requirements for successful completion of the training program shall be clearly specified. The requirements shall include demonstration of clinical competency and successful completion of a comprehensive, written final examination. The nurse administrator shall adopt a policy regarding a trainee who fails to successfully complete the training program. The statement of policy adopted by the training program shall include requirements that a person:

6.1.g.6.A.1. Shall not be enrolled in a training program more than two (2) times

6.1.g.6.A.2. Shall show continuing progress toward completion of the program; and

6.1.g.6.A.3. Who fails to successfully complete the program within twenty (20) calendar weeks shall cease functioning as a trainee until that person is reenrolled in a subsequent training program if that opportunity still exists;

6.1.g.6.B. At a minimum, the following records shall be maintained by the program:

6.1.g.6.B.1. The provider's name and the date and site of the training program

6.1.g.6.B.2. The program code number issued by the board; and

6.1.g.6.B.3. A trainee roster, with a minimum of the trainee's name, date of birth, Social Security number, and program completion date;

6.1.g.6.C. An individual who successfully completes the training program shall receive a certificate of completion that documents the following:

6.1.g.6.C.1. The name of the individual;

6.1.g.6.C.2. The title of the training program, date of completion, and location;

6.1.g.6.C.3. The provider's name;

6.1.g.6.C.4. The dialysis technician training program code number issued by the board; and

6.1.g.6.C.5. The name and signature of the dialysis technician training program administrator;

6.1.g.6.D. The criteria required for making modifications in the dialysis technician training program or in the testing components of the dialysis technician training program to meet the learning needs of individual trainees who are re-enrolling or who have previous training or experience in dialysis care;

6.1.g.6.E. Those persons who have authority to notify the board regarding trainee enrollment, reenrollment, and completion of the dialysis technician training program; and,

6.1.g.6.F. A procedure for dealing with the unexpected vacancy of the nurse administrator;

6.1.h. When a decision is made to close a training program, the program shall notify the board in writing of the decision at least ninety (90) days prior to the anticipated closing date. The notice shall include the tentative date of closing; the location of the dialysis technician training program's records, including but not limited to, trainees' records; and the name and address of the custodian of the records;

6.1.i. If any changes are made to the training program previously approved by the board when a facility changes ownership, the training program may only be approved as a new program;

6.1.j. Records maintained shall include documentation of the following:

6.1.j.1. Each trainee enrolled in the program, including documentation of performance, and the date and reason the trainee withdrew or the date the trainee failed or completed the program;

6.1.j.2. Each individual teaching the dialysis technician training program, including qualifications and nursing experience;

6.1.j.3. The curriculum plan and revisions; and

6.1.j.4. Any test administered.

Notes

W. Va. Code R. § 19-13-6