Chapter 4723-23 Dialysis Technicians

4723-23-01 Definitions.

For purposes of this chapter the following definitions apply:

(A) "Delegation" means the transfer of responsibility for the performance of a selected task or activity from a licensed health care professional authorized to perform the task or activity to an individual who does not have the authority to perform the task or activity.

(B) "Dialysis care" means performing and monitoring dialysis procedures which include initiating or discontinuing dialysis, drawing blood, administering medications authorized by division (C) of section 4723.72 of the Revised Code, and responding to complications that arise in conjunction with dialysis.

(C) "Dialysis technician intern certificate" means a certificate issued to an individual who has not passed the dialysis technician certification examination but meets the requirements set forth in section 4723.76 of the Revised Code.

(D) "Dialysis training program" means a program approved by the board according to rule 4723-23-07 of the Administrative Code that consists of not less than three hundred twenty clock hours of instruction including both of the following:

(1) A minimum of one hundred clock hours of theoretical instruction in a classroom setting; and

(2) A minimum of two hundred twenty clock hours of supervised clinical experience.

(E) "Discontinue" means to cease or stop.

(F) "Inactive status" means the status of the certificate of an individual who has made a written request that the board place the certificate on inactive status. An individual with an inactive certificate does not hold a current, valid certificate and is not authorized to provide dialysis care.

(G) "Initiate" means to start or to begin.

(H) "Monitor" means to collect objective and subjective data and observe the dialysis patient for signs or symptoms of any change in physiological or psychosocial status or complications related to dialysis, to check or regulate the performance of the machines used in performing dialysis, and to report any irregularity to the physician or licensed nurse as appropriate.

(I) "Ohio certified dialysis technician" or "OCDT" means an individual who holds a certificate to practice as a dialysis technician issued by the board according to section 4723.75 of the Revised Code.

(J) "Lapsed" means the status of a certificate of an individual who did not meet all the requirements of certificate renewal, and who did not request that the board place the certificate on inactive status prior to the renewal deadline.

(K) "Site visit" means an announced or unannounced visit to a dialysis training program by a board representative to determine whether the program meets or maintains the minimum standards required by the board.

(L) "Supervise" or "supervision" means initial and ongoing direction, procedural guidance, observation, and evaluation; and, except when dialysis care is being performed in the patient's home, requires a dialysis technician to be in the immediate presence of a physician or registered nurse.

Replaces: Replaces former 4723-23-01

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.71 to 4723.79
Prior Effective Dates: 10/01/2000, 02/01/2002, 02/01/2006,

4723-23-02 Dialysis technician intern certificate.

(A) To obtain a dialysis technician intern certificate to practice as a dialysis technician, an applicant who meets the qualifications set forth in division (A) of section 4723.76 of the Revised Code shall:

(1) Submit an application on the form required by the board, located athttp://www.nursing.ohio.gov/forms.htm (revised October 2013), that includes the name and address of each dialysis training program approved by the board in which the applicant has been enrolled and the dates during which the applicant was enrolled in each program;

(2) Submit an application fee of thirty-five dollars; and

(3) As required by section 4723.091 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation the results of which indicate that the individual has not been convicted of, pleaded guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code.

(B) Prior to the board determining an applicant is eligible for a dialysis technician intern certificate, the board shall have received:

(1) Written notice of the applicant's successful completion of a dialysis technician training program, approved by the board under section 4723.74 of the Revised Code, submitted directly by the program administrator or designee; and

(2) Written attestation, submitted directly to the board by the applicant's employer, that the applicant is competent to perform dialysis care.

(C) A dialysis technician intern certificate is valid for a period of time that is eighteen months from the date on which the applicant successfully completed a dialysis training program approved by the board under section 4723.74 of the Revised Code, minus the time the applicant was enrolled in one or more dialysis training programs approved by the board. A dialysis technician intern certificate shall not be renewed.

(D) An individual who holds a dialysis technician intern certificate shall not:

(1) Act as a trainer or preceptor in any dialysis training program; or

(2) Provide dialysis care in a patient's home.

(E) The holder of a dialysis technician intern certificate may place the certificate on inactive status by notifying the board in writing of the intent to place the certificate on inactive status. Upon receipt by the board of the request, the time during which the certificate is considered current shall be tolled or suspended. When an individual submits written notification to the board requesting reactivation of the intern certificate and a reactivation fee of thirty-five dollars, the board shall reactivate an intern certificate. Once reactivated, the intern certificate shall remain active for the length of time for which it was originally issued, minus the amount of time for which it previously was on active status.

(F) If an applicant for a dialysis technician intern certificate is not determined eligible for a certificate within one year from receipt of the application, the application shall be considered void and the fee forfeited. The application shall state the circumstances under which this forfeiture may occur.

(G) The board may propose to deny certification as a dialysis technician intern pursuant to an adjudication under Chapter 119. of the Revised Code. Based on the results of the adjudication, the board may issue the certificate, deny certification, or condition certification on the applicant's successful correction of the area of deficiency identified by the board.

Replaces: Replaces former 4723-23-02

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.751 , 4723.76
Prior Effective Dates: 10/01/2000, 02/01/2002, 02/01/2003, 02/01/2004, 02/01/2006

4723-23-03 Dialysis technician certificate.

(A) To obtain a certificate to practice as an Ohio certified dialysis technician an applicant who meets the qualifications set forth in section 4723.75 of the Revised Code shall:

(1) Submit an application on a form specified by the board, located athttp://www.nursing.ohio.gov/forms.htm (revised October 2013), that includes the name and address of each dialysis training program approved by the board in which the applicant has been enrolled and the dates during which the applicant was enrolled in each program;

(2) Submit an application fee of thirty-five dollars; and

(3) As required by section 4723.75 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation the results of which indicate that the individual has not been convicted of, pleaded guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code.

(B) Prior to the board determining an applicant is eligible for a dialysis technician certificate, the board must receive documentation that demonstrates the applicant is competent to practice as a dialysis technician. This may be established by one of the following routes:

(1) The board has received:

(a) Written notice of the applicant's successful completion of a dialysis technician training program, approved by the board under section 4723.74 of the Revised Code, submitted directly by the program administrator or designee;

(b) Written attestation, submitted directly to the board by the applicant's employer or employers, that the applicant has performed dialysis care for not less than twelve months immediately prior to the date of application for certification; and

(c) Written notice, submitted to the board directly by a testing organization approved by the board, that the applicant has passed a certification examination demonstrating competence to perform dialysis care not later than eighteen months after successfully completing a dialysis training program approved by the board under section 4723.74 of the Revised Code, as required by division (B)(1)(b) of section 4723.75 of the Revised Code. For purposes of calculating the eighteen-month period, the board shall subtract the total amount of time the applicant was enrolled in one or more training programs approved by the board from the eighteen-month period.

(2) The board has received:

(a) Written notice, submitted to the board directly by a testing organization approved by the board, that the applicant has passed a certification examination in another jurisdiction demonstrating competence to perform dialysis care;

(b) Written attestation, submitted directly to the board by the applicant's employer or employers, that the applicant has been employed to perform dialysis care in another jurisdiction for not less than twelve months immediately prior to the date of application for certification; and

(c) Evidence satisfactory to the board that the applicant has completed two contact hours of education that is directly related to Chapter 4723. of the Revised Code or rules adopted by the board, and that meets the requirements set forth in paragraph (C) of rule 4723-14-01 of the Administrative Code for category A education.

For purposes of this paragraph, the word "immediately" means not more than sixty days prior to the date the individual submits an application for a dialysis technician certificate to the board.

(C) If an applicant for a dialysis technician certificate under paragraph (B)(1) of this rule did not pass the certification examination within the eighteen-month period required by division (B)(1)(b) of section 4723.75 of the Revised Code, as calculated according to paragraph (B)(1)(c) of this rule, the applicant is not eligible to be certified as a dialysis technician by the board unless the applicant repeats the entire training and application process, as follows:

(1) The applicant enrolls in or re-enrolls in, and successfully completes, a dialysis training program approved by the board under section 4723.74 of the Revised Code;

(2) The applicant applies for and is issued a dialysis technician intern certificate as set forth in section 4723.76 of the Revised Code and rule 4723-23-02 of the Administrative Code;

(3) The applicant submits an application to the board, as specified in paragraph (A) of this rule, including submitting another criminal records check completed by the bureau of criminal identification and investigation the results of which indicate that the individual has not been convicted of, pleaded guilty to, or had a judicial finding of guilt for any violation set forth in section 4723.092 of the Revised Code;

(4) The applicant meets all of the requirements set forth in paragraph (B)(1) of this rule.

(D) If an applicant for a certificate to practice as an Ohio certified dialysis technician is not determined eligible for a certificate within two year from receipt of the application, the application shall be considered void and the fee forfeited. The application form shall state the circumstances under which this forfeiture may occur.

(E) A certificate to practice as an Ohio certified dialysis technician shall be considered current until the next scheduled renewal period for an Ohio certified dialysis technician certificate. When a certificate to practice as an Ohio certified dialysis technician is issued on or after January first of an odd numbered year, that certificate shall be considered current through March thirty-first of the next odd numbered year.

(F) The board may propose to deny certification as a dialysis technician pursuant to an adjudication under Chapter 119. of the Revised Code. Based on the results of the adjudication, the board may issue the certificate, deny certification, or condition certification on the applicant's successful correction of the area of deficiency identified by the board.

Replaces: Replaces former 4723-23-03

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.75 , 4723.751
Prior Effective Dates: 10/01/2000, 02/01/2003, 02/01/2004, 02/01/2006

4723-23-04 [Rescinded]Procedures for obtaining a certificate to practice as an Ohio certified dialysis technician by endorsement.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.75
Prior Effective Dates: 10/01/2000, 02/01/2003, 02/01/2006,

4723-23-05 Renewal of a certificate to practice as an Ohio certified dialysis technician.

(A) The board shall provide to each holder of a current, valid certified dialysis technician certificate an application for renewal, except when the board is aware that the individual may be ineligible for renewal for any reason, including those reasons set forth in section 4723.092 of the Revised Code. Failure of the certificate holder to receive an application for renewal from the board does not excuse the holder from the requirements of section 4723.77 of the Revised Code and this rule.

(B) To renew a certificate to practice as an Ohio certified dialysis technician a holder of a current, valid certificate shall:

(1) Submit a completed renewal application on the form specified by the board, located at http://www.nursing.ohio.gov/forms.htm (revised January 2013);

(2) Submit a renewal fee of thirty-five dollars; and

(3) Meet the continuing education requirements set forth in rule 4723-23-06 of the Administrative Code.

(C) If a completed renewal application is not postmarked, renewed on-line, or otherwise received by the board on or before March first of odd numbered years, the application shall be considered late and a late fee shall be imposed according to division (A)(13) of section 4723.08 of the Revised Code.

(D) A certificate holder who does not intend to practice as an Ohio certified dialysis technician in Ohio may request that the certificate be placed on inactive status as follows:

(1) At time of renewal, by checking the appropriate box on the certificate renewal application that indicates the certificate holder wants to place the certificate on inactive status; or

(2) At any time prior to the expiration of the current certificate, by submitting to the board a written statement requesting that the certificate be placed on inactive status.

(E) A certificate holder who has requested that their dialysis technician certificate be placed on inactive status is not required to pay a renewal fee unless the holder seeks to reactivate the certificate. If the certificate holder placed a certificate on inactive status after March first of the year in which the certificate was to be renewed, and then notifies the board on or before March thirty-first of the same renewal year of the intent to reactivate, the certificate holder must still pay the late processing fee required by paragraph (B) of this rule.

(F) ) A dialysis technician certificate shall lapse if a certificate holder fails to renew a certificate to practice as an Ohio certified dialysis technician on or before March thirty-first of odd numbered years, and has not requested inactive status according to paragraph (E) of this rule.

(G) An individual who holds an inactive or lapsed certificate shall not represent or imply to the public that the individual is authorized to practice as an Ohio certified dialysis technician and shall not provide dialysis care.

(H) An individual who continues to practice as an Ohio certified dialysis technician or who performs dialysis care with an inactive or lapsed certificate may be subject to disciplinary action in accordance with section 4723.28 of the Revised Code.

(I) An Ohio certified dialysis technician with an inactive certificate to practice may reactivate the certificate by submitting to the board all of the following:

(1) A completed reactivation application on the form specified by the board, located at http://www.nursing.ohio.gov/forms.htm (revised 2013);

(2) A reactivation fee of thirty-five dollars; and

(3) Documentation of compliance with the continuing education requirements set forth in paragraph (B) of rule 4723-23-06 of the Administrative Code.

(J) An Ohio certified dialysis technician with a lapsed certificate may reinstate the certificate by submitting to the board all of the following:

(1) A completed application to reinstate a lapsed certificate on the form specified by the board, located at http://www.nursing.ohio.gov/forms.htm (revised 2013);

(2) A renewal fee of thirty-five dollars plus a reinstatement fee of one hundred dollars as provided in division (A)(18) of section 4723.08 of the Revised Code; and

(3) Documentation of compliance with the continuing education requirements set forth in paragraph (C) of rule 4723-23-06 of the Administrative Code.

(K) A dialysis technician certificate holder, who submits a renewal application on March first or later, or whose certificate lapsed, due to the holder's service in the armed forces of the United States, or in the national guard or in a reserve component, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(13) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(18) of section 4723.08 of the Revised Code, if the following are met:

(1) The certificate holder presents the board with satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the certificate holder was honorably discharged or separated under honorable conditions;

(2) The certificate holder is not suffering a mental or physical impairment that may affect the individual's ability to provide safe care; and

(3) The certificate holder meets the requirements for certificate renewal required by section 4723.77 of the Revised Code and this rule.

(L) A certificate holder, who submits a renewal application on March first or later, or whose certificate lapsed, due to the holder's spouse's service in the armed forces of the United States, or in the national guard or in a reserve component, shall be eligible for renewal and reinstatement without payment of the late application fee required by division (A)(13) of section 4723.08 of the Revised Code, and the reinstatement fee required by division (A)(18) of section 4723.08 of the Revised Code, if the following are met:

(1) The certificate holder presents the board with satisfactory evidence that the certificate holder did not renew their certificate because their spouse's military service caused them to be absent from the state of Ohio;

(2) The certificate holder presents the board satisfactory evidence that, not more than six months prior to the date the evidence is submitted to the board, the certificate holder's spouse was honorably discharged or separated under honorable conditions; and

(3) The certificate holder meets the requirements for license renewal required by section 4723.77 of the Revised Code and this rule.

Replaces: Replaces former 4723-23-05

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.77
Prior Effective Dates: 10/01/2000, 02/01/2006

4723-23-06 Continuing education requirements.

(A) Except in the case of the first renewal of an active certificate to practice as an Ohio certified dialysis technician, renewal of an active certificate shall require that the certificate holder have obtained fifteen contact hours of continuing education approved by the board in accordance with Chapter 4723-14 of the Administrative Code and this rule. The required fifteen contact hours shall include both of the following:

(1) At least ten hours directly related to dialysis care; and

(2) At least one hour directly related to the law and rules governing the provision of nursing or dialysis care as set forth in Chapter 4723. of the Revised Code, and rules adopted by the board.

(B) An Ohio certified dialysis technician who requests that a certificate to practice as a dialysis technician be placed on inactive status shall not be required to meet the continuing education requirement for the period of time the certificate is on inactive status. To return to active status the dialysis technician shall complete fifteen hours of continuing education during the twenty-four months immediately preceding application to reactivate the certificate. The fifteen hours of continuing education shall comply with the requirements set forth in paragraph (A) of this rule.

(C) When a certificate to practice as an Ohio certified dialysis technician is lapsed the holder of the certificate shall complete fifteen hours of continuing education during the twenty-four months immediately preceding application to reinstate the certificate. The fifteen hours of continuing education shall comply with the requirements set forth in paragraph (A) of this rule.

(D) An Ohio certified dialysis technician shall verify completion of the continuing education required by this rule on the application for certificate renewal provided by the board, and at the discretion of the board, may be required to show proof of completion of the approved continuing education. Failure to so verify or provide such proof shall result in ineligibility to renew, reactivate, or reinstate a certificate to practice as an Ohio certified dialysis technician until the continuing education requirements are met.

(E) An Ohio certified dialysis technician who earns in excess of the number of contact hours of continuing education required for a single reporting period shall not apply the excess hours to satisfy future continuing education requirements.

(F) An Ohio certified dialysis technician, who is ineligible to renew, reactivate, or reinstate a certificate to practice as a dialysis technician in Ohio due to failure to meet the continuing education requirements, may be required to show completion of up to thirty contact hours of continuing education, that meets the requirements of this rule, before being issued a current certificate by the board. The continuing education shall be obtained within the forty-eight months immediately preceding renewal, reactivation, or reinstatement of the certificate.

(G) An Ohio certified dialysis technician may use a waiver to satisfy the continuing education requirement only one time, and the dialysis technician shall notify the board in writing requesting the waiver. Once the dialysis technician notifies the board of the intent to use the waiver, the waiver shall not be rescinded and use of the waiver shall be documented on the dialysis technician's certificate.

(H) Notwithstanding paragraph (G) of this rule, the holder of a lapsed or inactive Ohio dialysis technician certificate may not use the one time continuing education waiver when reinstating a lapsed certificate or reactivating an inactive certificate.

(I) Contact hours based on credit hours earned in an academic institution shall be calculated according to paragraph (B) of rule 4723-14-04 of the Administrative Code.

(J) Educational activities that satisfy the requirements of this rule are the same as those set forth in rule 4723-14-05 of the Administrative Code.

(K) The board may conduct a retrospective audit of any holder of a certificate to practice as an Ohio certified dialysis technician to determine compliance with this rule. The audit shall be conducted according to rule 4723-14-07 of the Administrative Code. An Ohio certified dialysis technician shall retain proof of completion of approved continuing education for a period of six years.

(L) A dialysis technician certificate holder who is engaged in active military duty and is deployed for more than twelve months to an area where military hostilities are ongoing, is not required to satisfy the continuing education requirements in section 4723.77 of the Revised Code in order to renew the certificate the first time following the end of the deployment. A certificate holder may be required to provide to the board proof of military and deployment status.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.77
Prior Effective Dates: 10/01/2000, 02/01/2004, 02/01/2006

4723-23-07 Procedures for obtaining approval or reapproval as a dialysis technician training program.

The board shall approve and reapprove dialysis technician training programs as follows:

(A) A dialysis technician training program that seeks to be approved by the board shall:

(1) Submit to the board a completed application on a form specified by the board which includes the following:

(a) Identifying information;

(b) Information regarding administrative processes of the program;

(c) A description of the record-keeping system to be used by the training program to assure accurate reporting to the board of individuals who have enrolled in and who did or did not successfully complete the program;

(d) A copy of the policies required by rule 4723-23-08 of the Administrative Code; and

(e) Any other information requested by the board;

(2) Submit payment of a program approval fee of three hundred dollars. No more than one hundred twenty days after receipt of a complete application for approval, the board shall make a determination regarding the approval status of the training program;

(B) Approval shall be current for two years provided the program demonstrates that the standards set forth in rule 4723-23-08 of the Administrative Code are met and maintained throughout the two-year approval period. Site visits may be conducted during each two-year approval period;

(C) At least ninety days prior to expiration of program approval, a dialysis technician training program seeking reapproval shall submit to the board the following:

(1) A reapproval application on a form specified by the board which includes, but is not limited to, verification that the program meets and has maintained the standards set forth in rule 4723-23-08 of the Administrative Code;

(2) Payment of a program reapproval fee of three hundred dollars; and

(3) Any other information requested by the board.

The board may conduct site visits before granting reapproval of a program;

(D) The board shall provide written notification to the dialysis technician training program seeking approval or reapproval if additional information is needed. The notice shall specify a time frame for submission of the required information;

(E) At a regularly scheduled board meeting the board shall review the completed application for approval or reapproval and other necessary documentation to determine compliance with the rules of this chapter. The board shall approve or reapprove a program when the program meets the requirements for approval or reapproval;

(F) The board shall provide the program with written notification of its approval status;

(G) When a complete application for reapproval is submitted to the board in accordance with paragraph (C) of this rule and the board fails to make a determination before the program's approval expires, the board shall issue a notice to the nurse responsible for administering the program extending approval of the program until board action is taken on the reapproval application;

(H) If at any time a dialysis training program approved by the board or a program seeking approval or reapproval appears not to meet or maintain the minimum standards set forth in this chapter:

(1) The board shall submit to the nurse responsible for administering the program a written deficiency report which identifies the standard or standards not being met or maintained and shall include the date on which the board is to consider the deficiency report;

(2) Within thirty days after receipt of the deficiency report, the nurse responsible for administering the program may submit to the board either:

(a) A written plan of correction which sets forth the steps taken by the program to meet or maintain each minimum standard identified in the report as not being met or maintained; or

(b) A written response to the report disputing its findings and setting forth evidence that the program is meeting and maintaining each minimum standard identified in the report as not being met or maintained;

(3) The board may grant approval, reapproval, or propose to deny or withdraw approval of the program based on the deficiency report, the program's response to the report, and any other relevant evidence. The board shall deny or withdraw approval of a program only pursuant to an adjudication in accordance with Chapter 119. of the Revised Code.

R.C. 119.032 review dates: 10/08/2010 and 10/01/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.74
Prior Effective Dates: 10/01/2000, 02/01/2006

4723-23-08 Requirements for a dialysis technician training program approved by the board.

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

(A) In accordance with paragraph (D) of rule 4723-23-01 of the Administrative Code, an approved training program shall consist of not less than three hundred twenty clock hours of instruction and shall include a minimum of one hundred clock hours of theoretical instruction in a classroom setting, and a minimum of two hundred twenty clock hours of supervised clinical experience. The curriculum shall include content that ensures sufficient preparation for safe and effective practice as a dialysis technician. The curriculum shall include, but is not limited to, the following content:

(1) Classroom instruction that includes:

(a) Completion of the application for a dialysis technician intern certificate, located at http://www.nursing.ohio.gov/forms.htm (revised October 2013), to be submitted to the board no later than four weeks prior to completion of the approved training program;

(b) A review of the relevant laws and rules regulating the practice of a dialysis technician and appropriate program policies;

(c) Renal anatomy and physiology;

(d) Infection control and universal precautions;

(e) Basic chemistry of body fluids and electrolytes;

(f) Manifestations of renal failure;

(g) Blood work and laboratory values related to dialysis; (h) Principles of dialysis;

(i) Pharmacology of the drugs commonly used during dialysis;

(j) Medication administration techniques specific to the drugs used in dialysis;

(k) Management of the complications of dialysis and renal failure;

(l) The role of the dialysis technician in a dialysis setting including, but not limited to, legal and ethical considerations and concepts of delegation;

(m) Water treatment relevant to dialysis;

(n) Principles of patient education related to renal failure;

(o) Principles of and requirements for documentation;

(p) Communication and team work skills;

(q) Operation of dialysis delivery systems that includes the machines, dialysate, and dialyzer;

(r) Principles of safe effective dialysis care;

(s) Principles related to the nutritional considerations for patients receiving dialysis;

(t) Psychosocial aspects of renal disease;

(u) Principles of dialyzer reprocessing;

(v) Principles for initiating, monitoring, and discontinuing dialysis;

(w) Principles related to the adequacy of dialysis; and

(x) Establishing and maintaining professional boundaries with a patient.

(2) Supervised clinical instruction which:

(a) Provides the dialysis technician trainee with the opportunity to practice the cognitive, psychomotor, and affective skills required for the safe performance of dialysis care by the dialysis technician;

(b) Meets the learning needs of each trainee;

(c) Meets the established program objectives or outcomes; and

(d) Is provided concurrently with the related classroom theory instruction;

(B) The program shall be administered by a registered nurse who meets the following qualifications:

(1) Current, valid licensure in Ohio to practice nursing as a registered nurse;

(2) At least thirty-six months experience in the practice of nursing as a registered nurse, of which at least twenty-four months has been in the care of renal patients, with at least six of those months in dialysis care; and

(3) Education or experience in adult education;

(C) The registered nurse who is responsible for administering the program may utilize other health care professionals to assist in conducting classroom and clinical portions of the program in accordance with the professional's educational background and applicable scope of practice as set forth in the appropriate sections of the Revised Code;

(D) The registered nurse who is responsible for administering the program shall:

(1) Assure that the governing body of the training program establishes in writing the policies required by paragraph (E) of this rule; and

(2) Implement the policies as written;

(E) The program shall adopt and implement policies that establish:

(1) Criteria for trainee admission and continuation in the program that require, at a minimum, that the individual be able to safely perform the essential functions of a dialysis technician;

(2) Criteria for trainee re-enrollment in the program;

(3) Criteria for successful completion of the program;

(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 that the trainee has been taught the required skills, signed by both a registered nurse and the trainee;

(5) A process for maintaining trainee records including but not limited to: ;

(a) The date the trainee began the program;

(b) The date the trainee completed the program; and

(c) Competency check lists for each trainee;

(6) An accurate, timely process for providing written notice to the board regarding enrollment and program completion that includes, but is not limited to, the following:

(a) Notice that a trainee has enrolled or re-enrolled in a program provided no later than the first day the trainee begins the program;

(b) Notice that a trainee has successfully completed the program, provided to the board by the nurse who is responsible for administering the program; and

(c) Notice that a trainee has failed to complete the program, provided to the board within one week after the trainee leaves the program;

(7) A process for monitoring the status of the temporary certificate a trainee may hold;

(8) A process for evaluation of the program which includes, but is not limited to:

(a) Feedback from trainees enrolled in the program regarding the program and the instructional personnel assisting with the program;

(b) Feedback from the employers of the trainees who have successfully completed the program; and

(c) A review of the trainees' level of achievement on the national certification examination;

(9) The criteria for making modifications in the training program or in the testing components of the program to meet the learning needs of individual trainees who are re-enrolling or who have previous training or experience in dialysis care;

(10) Those individuals who have authority to notify the board regarding trainee enrollment, re-enrollment, withdrawal from, and completion of the program; and

(11) A procedure in accordance with paragraph (F) of this rule for dealing with the unexpected vacancy of the nurse responsible for administering the program;

(12) For individuals with experience in the armed forces of the United States, or in the national guard or in a reserve component, the program shall have a process in place to:

(a) Review the individual's military education and skills training;

(b) Determine whether any of the military education or skills training is substantially equivalent to the curriculum established in Chapter 4723-23 of the Administrative Code; and

(c) Award credit to the individual for any substantially equivalent military education or skills training.

(F) When the nurse responsible for administering the program vacates the position or is replaced, the board shall be immediately informed in writing of the vacancy and provided the name and qualifications of the new administrator. A training program shall not initiate a new dialysis technician training course unless an administrator who meets the requirements of paragraph (B) of this rule is in place; and

(G) When a decision is made to close a training program, the board shall be notified in writing of the decision and shall be provided with the following information:

(1) The tentative date of the closing;

(2) The location of the program's records, including but not limited to trainees' records; and

(3) The name and address of the custodian of the records.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013 and 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.74
Prior Effective Dates: 10/01/2000, 02/01/2004, 02/01/2006

4723-23-09 Information required when attesting to the competence of an applicant for a dialysis technician intern certificate or a certificate to practice as an Ohio certified dialysis technician.

(A) The employer of an applicant, for a dialysis technician intern certificate under rule 4723-23-02 of the Administrative Code or a dialysis technician certificate under rule 4723-23-03 of the Administrative Code, or the employer's designee, shall provide written information directly to the board when attesting to the competence to perform dialysis care of the applicant .

(B) The information required by this rule shall include the following:

(1) When the applicant is applying for a dialysis technician intern certificate , verification by the employer or the employer's designee, that a registered nurse or licensed physician observed the applicant perform dialysis care and attests that the applicant consistently performs dialysis care in accordance with acceptable and prevailing standards of safe dialysis care as set forth in section 4723.72 of the Revised Code and this chapter; or

(2) When an applicant is applying for a certificate to practice as an Ohio certified dialysis technician, a statement that the employer, prior employer, or the employer or prior employer's designee, in good faith affirms that the applicant has the knowledge, skills, and ability to provide dialysis care in accordance with acceptable and prevailing standards of safe dialysis care as set forth in section 4723.72 of the Revised Code and this chapter.

(C) The employer or the employer's designee shall provide assurance that the verification or statement required by paragraph (B) of this rule has been sent directly to the board by the employer.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.75 , 4723.76
Prior Effective Dates: 10/01/2000, 02/01/2006

4723-23-10 Requirements for approval and reapproval of a testing organization that conducts an examination of a dialysis technician.

(A) To be approved by the board a testing organization that conducts an examination of a dialysis technician shall meet all of the following requirements:

(1) Be national in the scope of its testing and credentialing;

(2) Maintain files for each candidate who passes the organization's examination for dialysis technicians;

(3) Issue a certificate to each individual who passes the organization's examination for dialysis technicians;

(4) Periodically conduct an analysis of the tasks, role delineation, skills, and knowledge required of a dialysis technician with a minimum of one year's experience in providing dialysis care and revise the examination as needed to reflect the findings of the analysis;

(5) Require a minimum of twelve months experience in dialysis care before the candidate is allowed to take the examination;

(6) Provide a formal process by which an affected individual may appeal the organization's decision to revoke certification when the organization has such revocation authority;

(7) Provide a mechanism for assuring the security of the examination;

(8) Not be affiliated in any way with a provider of dialysis care or with a dialysis technician training program; and

(9) Include on the examination material which comprehensively tests the following:

(a) Patient care activities which include but are not limited to:

(i) Collection of objective and subjective data about the patient's condition;

(ii) The patient's response to dialysis; and

(iii) Appropriate interventions when complications arise in conjunction with dialysis;

(b) Principles of dialysis delivery systems and machine technology which include but are not limited to:

(i) Operation of the machines used in dialysis;

(ii) Machine set-up; and

(iii) Machine evaluation;

(c) Principles of water treatment systems which include but are not limited to:

(i) System components and design;

(ii) Maintenance of the water treatment system;

(iii) Monitoring of the water treatment system; and

(iv) Evaluation of the system;

(d) Principles of dialyzer reprocessing including but not limited to reprocessing procedures, testing, and evaluation; and

(e) Responsibilities of the dialysis technician with respect to documentation, patient education, and professional development.

The board may also require a testing organization to demonstrate that the test administered by the organization is psychometrically sound.

(B) A testing organization seeking approval by the board shall submit to the board a completed application which includes the information required by the board to determine whether the organization meets the requirements set forth in paragraph (A) of this rule. The board shall verify compliance of each testing organization with the criteria contained in paragraph (A) of this rule.

(C) Annually, at a time specified by the board, the board shall provide to each testing organization approved by the board for the prior year a form specified by the board on which the organization shall indicate whether it complies with the criteria contained in paragraph (A) of this rule. The board shall verify continued compliance of each testing organization with the criteria contained in paragraph (A) of this rule.

(D) The board shall issue a written notification to each testing organization that is approved by the board.

(E) No later than January thirty-first of each year, the board shall make available a list of approved testing organizations that meet the requirements of paragraph (A) of this rule.

(F) The board may discontinue approval of a testing organization that does not meet the criteria contained in paragraph (A) of this rule or that fails to timely return to the board the form indicating compliance with paragraph (A) of this rule.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.751
Prior Effective Dates: 10/01/2000, 02/01/2006

4723-23-11 [Rescinded]Procedures for providing information to the dialysis technician registry.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013
Promulgated Under: 119.03
Statutory Authority: 723.79
Rule Amplifies: 4723.751
Prior Effective Dates: 10/01/2000, 02/01/2006

4723-23-12 Standards for medication administration by a dialysis technician.

(A) A dialysis technician shall administer only the following medications:

(1) Intradermal lidocaine or another single therapeutically equivalent local anesthetic for the purpose of initiating dialysis treatment;

(2) Intravenous heparin or other single therapeutically equivalent anticoagulant for the purpose of initiating and maintaining dialysis treatment;

(3) Intravenous normal saline;

(4) Patient specific dialysate to which the dialysis technician may add only electrolytes; and

(5) Oxygen, when the administration of the oxygen has been delegated to the dialysis technician by a registered nurse.

(B) When administering the medications set forth in paragraph (A) of this rule, the dialysis technician shall:

(1) Assure that the right dose of the right medication is given to the right individual through the right route of administration at the right time;

(2) Accurately and timely document the administration of the medication and notify a physician or licensed nurse of the patient's response to the medication as appropriate;

(3) Consult with an appropriate licensed practitioner when the dialysis technician believes or has reason to believe that a prescribed medication is inaccurate, not properly authorized, harmful or potentially harmful to a patient, or contraindicated by other documented information; and

(4) Take any other action needed to assure the safety of the patient.

(C) A dialysis technician shall administer the medications authorized by this rule only if the task has been delegated to the dialysis technician by a registered nurse in accordance with Chapter 4723-13 of the Administrative Code or by a licensed physician.

(D) The dialysis technician shall be in the immediate presence of a registered nurse or physician when administering medications.

(E) Notwithstanding paragraph (D) of this rule, when a dialysis technician administers medications while providing dialysis care in the patient's home as the patient's partner a registered nurse shall supervise the technician in accordance with rule 4723-23-13 of the Administrative Code.

R.C. 119.032 review dates: 10/08/2010 and 10/01/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.72
Prior Effective Dates: 10/01/2000, 02/01/2003, 02/01/2006

4723-23-13 Standards and procedures for supervising a dialysis technician who provides dialysis care in the home.

(A) A dialysis technician may provide dialysis care in the home of a patient as the patient's partner only if the technician is an Ohio certified dialysis technician.

(B) When an Ohio certified dialysis technician provides dialysis care in the home of a patient as the patient's partner, a registered nurse shall supervise the care provided by the dialysis technician. The registered nurse who is supervising the dialysis technician shall meet the following requirements:

(1) Hold a current, valid license to practice nursing as a registered nurse in Ohio; and

(2) Be employed by or under contract with a medicare-approved home dialysis program.

(C) When a registered nurse is supervising the care provided by an Ohio certified dialysis technician in accordance with paragraph (B) of this rule the nurse shall:

(1) Visit the patient's home at least one time per month while the dialysis technician is providing dialysis care to the patient to determine whether the care is being provided in accordance with the standards for safe dialysis care as set forth in this chapter; and

(2) Assess the quality of the care provided by the dialysis technician and provide a written report of each visit to the medicare-approved home dialysis program.

(D) When a registered nurse determines that an Ohio certified dialysis technician is not providing care in accordance with the standards for safe dialysis care as set forth in this chapter, the nurse shall immediately notify the medicare-approved home dialysis program and take whatever additional steps are needed to assure the safety of the patient.

R.C. 119.032 review dates: 10/08/2010 and 10/01/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.72
Prior Effective Dates: 10/01/2000, 02/01/2006

4723-23-14 Standards for safe dialysis care.

(A) This rule sets forth the minimal acceptable standards of safe and effective dialysis care and provides criteria for the board to evaluate a dialysis technician's adherence to the acceptable standards of safe dialysis care. For purposes of this rule, "dialysis technician" means an individual holding a dialysis technician certificate or a dialysis technician intern certificate.

(B) In accordance with section 4723.72 of the Revised Code and this chapter, a dialysis technician shall provide dialysis care only when the performance of the care is delegated to the dialysis technician by a physician or registered nurse.

(C) A dialysis technician shall demonstrate competence and accountability in all areas of dialysis care in which the technician is engaged including, but not limited to, the following:

(1) Consistent performance of all aspects of dialysis care according to acceptable standards; and

(2) Appropriate recognition, referral, consultation, or intervention when a complication arises in conjunction with dialysis or when a change in patient status occurs;

(D) A dialysis technician shall timely:

(1) Implement the prescribed dialysis care order for a patient unless the 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; and

(2) Clarify any prescribed dialysis care order for a patient when the technician believes or should have reason to believe that the order is inaccurate, not properly authorized, not current or valid, harmful or potentially harmful to the patient, or contraindicated by other documented information.

(E) When clarifying the prescribed dialysis care order, the dialysis technician shall timely:

(1) Consult with an appropriate licensed practitioner;

(2) Notify the practitioner when the technician decides not to follow the prescribed dialysis care order;

(3) Document that the practitioner was notified of the decision not to follow the direction or the prescribed dialysis care order; and

(4) Take any other action needed to assure the safety of the patient.

(F) A dialysis technician shall timely report to and consult as necessary with other members of the dialysis care team, including, but not limited to, the licensed nurse or physician when a patient refuses to follow the prescribed dialysis care order.

(G) A dialysis technician shall maintain the confidentiality of patient information obtained in the course of practice. The dialysis technician shall communicate patient information with other members of the health care team for health care purposes only, shall access patient information only for purposes of patient care or for otherwise fulfilling the dialysis technician's assigned job responsibilities, and shall not disseminate patient information for purposes other than patient care or for otherwise fulfilling the dialysis technician's assigned job responsibilities through social media, texting, emailing, or any other form of communication.

(H) A dialysis technician shall do the following to promote patient safety:

(1) Display the applicable title or initials set forth in section 4723.73 of the Revised Code at all times when providing dialysis care;

(2) Completely, accurately, and timely document and report all patient data obtained while providing dialysis care and the patient's response to the care;

(3) Completely, accurately and, timely document and report to the appropriate practitioner all errors in or deviations from the prescribed dialysis care regimen;

(4) Not falsify any patient record or any other documents prepared in the course of or in conjunction with the provision of dialysis care. This includes, but is not limited to, case management documents or reports, time records or reports, and other documents related to billing for dialysis services;

(5) Implement measures to provide a safe environment for the patient;

(6) Delineate, establish, and maintain professional boundaries with each patient;

(7) 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;

(8) 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;

(9) Not engage in sexual misconduct or in conduct that may reasonably be interpreted as sexual, or in any verbal behavior that is seductive or sexually demeaning to a patient, or in behavior that may reasonably be interpreted as seductive or sexually demeaning to a patient; and

(10) Treat each patient with courtesy, respect, and with full recognition of the dignity of each individual.

The patient is always presumed incapable of giving free, full, or informed consent to the behaviors by a dialysis technician set forth in paragraphs (H)(7), (H)(8) and (H)(9) of this rule.

(I) A dialysis technician shall not make any false, misleading, or deceptive statements, or submit or cause to be submitted any false, misleading or deceptive information or documentation to:

(1) The board or any representative of the board;

(2) Current employers;

(3) Prospective future employers when applying for positions requiring a certificate to practice dialysis care;

(4) Facilities in which, or organizations for whom, the dialysis technician is working a temporary or agency assignment;

(5) Other members of the patient's health care team; or

(6) Law enforcement personnel.

(J) ) For purposes of paragraphs (H)(6), (H)(7), (H)(8), (H)(9), and (H)(10) of this rule, a dialysis technician shall not use social media, texting, emailing, or other forms of communication with, or about, a patient, for non-health care purposes or for purposes other than fulfilling the dialysis technician's assigned job responsibilities.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/15/2015
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.28 , 4723.72
Prior Effective Dates: 10/01/2000, 02/01/2004, 02/01/2006