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Ohio Laws and Rules
Chapter 4723-23 Dialysis Technicians
4723-23-01
Definitions.
For purposes of this chapter the following definitions apply:
(A) "Certificate to practice" means the certificate issued by the board which authorizes an individual to provide dialysis care and to use the title Ohio certified dialysis technician.
(B) "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.
(C) "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.
(D) "Dialysis training program" means a program approved by the board in accordance with 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 that a temporary certificate issued in accordance with section 4723.76 of the Revised Code, a certificate to practice as an Ohio certified dialysis technician issued in accordance with section 4723.75 of the Revised Code, or a certificate renewed in accordance with section 4723.77 of the Revised Code no longer authorizes the holder to provide dialysis care or represent that the holder is authorized to provide dialysis care because the individual provided written notification to the board of the intent not to practice as a dialysis technician in Ohio.
(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 in accordance with section 4723.75 of the Revised Code or a certificate renewed by the board in accordance with section 4723.77 of the Revised Code.
(J) "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.
(K) "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.
(L) "Temporary certificate one" means the certificate issued by the board to:
(1) An applicant who has successfully completed a dialysis training program approved by the board. The certificate shall be current for not more than eighteen months; or
(2) An applicant who has experience as a dialysis technician in a jurisdiction that does not license or certify dialysis technicians and who has successfully completed a program that is substantially similar to a training program approved by the board. The certificate shall be current as follows:
(a) For an individual who worked as a dialysis technician for twelve full months or longer, the certificate shall be current for not more than six months; or
(b) For an individual who worked as a dialysis technician for less than twelve months, the certificate shall be current for not more than the number of months equal to eighteen months minus less the number of full months the individual worked as a dialysis technician; or.
(M) "Temporary certificate two" means the renewed certificate issued by the board to an applicant who did not pass the examination of a testing organization approved by the board while holding a temporary certificate one, and who shall be actively enrolled or re-enrolled at the time of expiration of certificate one or the effective date of temporary certificate two, in a dialysis training program approved by the board that has been modified to meet the learner's needs. This certificate is not renewable and shall be current for not more than six months after the applicant re-enters a training program. The temporary certificate authorizes an individual to provide dialysis care in order to provide an opportunity for the certificate holder to gain the experience necessary to be able to pass the certification examination offered by a testing organization approved by the board.
(N) "Temporary certificate three" means a certificate issued by the board to an applicant who did not pass the examination of a testing organization approved by the board while holding a temporary certificate one followed by a temporary certificate two, and who has waited at least one year before entering or re-entering a dialysis training program approved by the board. This certificate shall be current for not more than six months after the applicant re-enters a training program. The temporary certificate authorizes an individual to provide dialysis care in order to provide an opportunity for the certificate holder to gain the experience necessary to be able to pass the certification examination offered by a testing organization approved by the board.
(O) "Lapsed certificate" means a certificate to practice as a dialysis technician to which the following apply:
(1) If the certificate was issued in accordance with section 4723.76 of the Revised Code, the holder has failed to renew the certificate as provided in division (C) of that section;
(2) If the certificate was issued in accordance with section 4723.75 of the Revised Code, the holder has failed to satisfy the renewal requirements set forth in section 4723.77 of the Revised Code and this chapter;
(3) The holder has not requested that the board place the certificate on inactive status in accordance with the provisions of this chapter.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
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
(A) To obtain a temporary certificate one to practice as a dialysis technician, an applicant who meets the qualifications set forth in division (A) of section 4723.75 of the Revised Code shall:
(1) Submit a completed application on a form specified by the board that includes the requirements set forth in division (A) of section 4723.75 of the Revised Code. When the applicant is enrolled in a dialysis technician training program approved by the board, the applicant shall submit, the application no later than four weeks prior to completing the program; and
(2) Submit an application fee of thirty-five dollars.
(B) The board shall issue a temporary certificate one to practice as a dialysis technician as follows:
(1) Upon notice from a training program approved by the board that the applicant has successfully completed the program and has demonstrated competency to practice as a dialysis technician in accordance with division (B) of section 4723.75 of the Revised Code, the board shall issue the applicant a temporary certificate one that is current for not more than eighteen months after the applicant entered a dialysis training program approved by the board;
(2) For an applicant who is not required to complete a dialysis technician training program pursuant to division (A)(3)(b) or (A)(3)(c) of section 4723.76 of the Revised Code, the board shall issue the applicant a temporary certificate one that is current as follows:
(a) For an applicant who has experience as a dialysis technician, in a jurisdiction that does not license or certify dialysis technicians, for twelve full months or longer after successfully completing a training program that is substantially similar to a program approved by the board, the certificate shall be current for not more than six months; or
(b) For an applicant who has experience as a dialysis technician, in a jurisdiction that does not license or certify dialysis technicians, for less than twelve months after successfully completing a training program that is substantially similar to a program approved by the board, the certificate shall be current for not more than the number of months equal to eighteen months less the number of full months the individual worked as a dialysis technician.
(C) An applicant who does not pass the examination of a testing organization approved by the board while holding a temporary certificate one may apply for a temporary certificate two. To obtain a temporary certificate two the applicant shall:
(1) At the time of expiration of a temporary certificate one or the effective date of a temporary certificate two, be Be actively enrolled or re-enrolled, in a board-approved dialysis training program that has been modified to meet the learner's needs;
(2) Submit a completed application on a form specified by the board that includes the requirements of division (C) of section 4723.76 of the Revised Code: and
(3) Submit a temporary certificate renewal fee of twenty-five dollars. A temporary certificate two to practice as a dialysis technician shall be considered current for not more than six months after the applicant enters or re-enters a dialysis training program approved by the board and shall not be renewed.
(D) An applicant who does not pass the examination of a testing organization approved by the board while holding a temporary certificate one followed by a temporary certificate two may apply for a temporary certificate three. To obtain a temporary certificate three the applicant shall:
(1) Enroll or re-enroll in a dialysis training program approved by the board only after waiting at least one year after expiration of a temporary certificate two;
(2) Submit a completed application on a form specified by the board; and
(3) Submit a temporary certificate renewal fee of twenty-five dollars.
(E) An individual who holds any temporary certificate issued by the board shall not act as a trainer or preceptor in any dialysis training program.
(F) The holder of a temporary certificate issued in accordance with this rule may place the certificate on inactive status by notifying the board in writing of the intent to place the certificate on inactive status and returning the temporary certificate to the board. Upon receipt by the board of the returned temporary certificate, 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 temporary certificate and a reactivation fee equal to the amount of the current fee for that certificate, the board shall reactivate a temporary certificate. Once reactivated, the temporary certificate shall remain active for the length of time for which it was originally issued, less the amount of time for which it previously was on active status.
(G) If through no fault of the board an applicant for a temporary certificate to practice as a dialysis technician is not determined eligible for a temporary 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.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
Promulgated
Under: 119.03
Statutory
Authority:
4723.79
Rule
Amplifies:
4723.75,
4723.751,
4723.76
Prior
Effective Dates: 10/01/2000, 02/01/2002, 02/01/2003, 02/01/2004, 02/01/2006
(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;
(2) If the applicant does not hold a valid temporary certificate to practice as a dialysis technician issued by the board, submit a certificate fee of thirty-five dollars; and
(3) In accordance with division (C) of section 4723.75 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation, on the form specified by the board. The results of the criminal records check shall:
(a) Be received by the board prior to the issuance of a certificate to practice as an Ohio certified dialysis technician; and
(b) 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 division (A)(4) of section 4723.75 of the Revised Code.
(B) If through no fault of the board, an applicant for a certificate to practice as an Ohio certified dialysis technician is not determined eligible for a certificate within two years 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.
(C) An initial 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 the first of January of an odd numbered year, that certificate shall be considered current through the thirty-first of March of the next odd numbered year. The fee imposed shall be in accordance with this rule.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
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
(A) To obtain a certificate to practice as an Ohio certified dialysis technician by endorsement an applicant shall:
(1) Hold a current valid certificate, license, or other authorization to practice as a dialysis technician issued by another jurisdiction that has standards for issuing a certificate, license, or authorization that are substantially similar to the board's standards;
(2) Submit a completed application on a form specified by the board;
(3) Submit an application fee of thirty-five dollars; and
(4) In accordance with section 4723.75 of the Revised Code, submit to a criminal records check completed by the bureau of criminal identification and investigation, on the form specified by the board. The results of the criminal records check shall:
(a) Be received by the board before a certificate may be issued; and
(b) 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 division (A)(4)section 4723.75 of the Revised Code.
(B) Prior to issuing a certificate to practice as an Ohio certified dialysis technician by endorsement the board shall have received directly from each jurisdiction in which the applicant holds a certificate, license, or authorization to practice as a dialysis technician, verification of certification, licensure, or authorization which shows that the certification, licensure, or authorization to practice is in good standing.
(C) Upon receipt of evidence that the applicant holds a certificate, license, or authorization to practice as a dialysis technician in good standing from another jurisdiction, the board shall determine if the requirements of the other jurisdiction are substantially similar to the board's requirements. The board may condition issuance of the certificate on proof of the applicant's successful completion of board-approved course content covering Chapter 4723. of the Revised Code and the rules of the board with respect to the role, accountability, and responsibility of an Ohio certified dialysis technician.
(D) If through no fault of the board, an applicant for a certificate to practice as an Ohio certified dialysis technician by endorsement 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.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
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) 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 a form specified by the board;
(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.
(B) If a completed renewal application is not submitted to the board on or before the first of March of the odd numbered year, the application shall be considered late and a late fee shall be imposed in accordance with section 4723.08 of the Revised Code.
(C) A certificate holder who does not intend to practice as an Ohio certified dialysis technician in Ohio may request to have the certificate placed on inactive status as follows:
(1) At time of renewal, by checking the appropriate box on the certificate renewal form that indicates the certificate holder wants to place the certificate on inactive status; or
(2) At any other time prior to the expiration of the current certificate, by submitting to the board a written statement requesting inactive status and providing the board with the current certificate.
(D) A certificate holder who fails to renew a certificate to practice as an Ohio certified dialysis technician on or before April first of odd numbered years, and who fails to request inactive status in accordance with paragraph (C) of this rule, shall be considered to have a lapsed certificate.
(E) 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.
(F) 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.
(G) 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 a form specified by the board;
(2) A reactivation fee of thirty-five dollars; and
(3) Documentation of compliance with the continuing education requirements set forth in paragraph (C) of rule 4723-23-06 of the Administrative Code.
(H) 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 a form specified by the board;
(2) A renewal fee of thirty-five dollars plus a reinstatement fee of one hundred dollars as provided in division (A)(20) of section 4723.08 of the Revised Code; and
(3) Documentation of compliance with the continuing education requirements set forth in paragraph (D) of rule 4723-23-06 of the Administrative Code.
(I) The holder of a temporary certificate one, temporary certificate two, or temporary certificate three may reactivate an inactive temporary certificate by submitting to the board both of the following:
(1) A completed reactivation application on a form specified by the board; and
(2) A reactivation fee of thirty-five dollars.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
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) No fewer than 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) A dialysis technician from another jurisdiction who applies for a certificate to practice as an Ohio certified dialysis technician by endorsement shall not be required to meet the continuing education requirement to obtain an initial certificate to practice as an Ohio certified dialysis technician.
(C) 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.
(D) When a certificate to practice as an Ohio certified dialysis technician is allowed to lapse 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.
(E) 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.
(F) 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.
(G) 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.
(H) 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.
(I) Notwithstanding paragraph (H) 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.
(J) The calculation of contact hours based on credit hours earned in an academic institution shall be in accordance with paragraph (B) of rule 4723-14-04 of the Administrative Code.
(K) Educational activities which satisfy the requirements of this rule are the same as those set forth in rule 4723-14-05 of the Administrative Code.
(L) 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 in accordance with 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.
(M) The holder of a certificate issued in accordance with section 4723.75 or section 4723.76 of the Revised Code 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.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
Promulgated
Under: 119.03
Statutory
Authority:
4723.79
Rule
Amplifies:
4723.77
Prior
Effective Dates: 10/01/2000, 02/01/2004, 02/01/2006
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 which ensures sufficient preparation for safe and effective practice as a dialysis technician. The curriculum shall include, but is not be limited to, the following content:
(1) Classroom instruction which includes:
(a) Completion of the application for a temporary certificate one 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 which 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 which establish:
(1) Criteria for trainee admission and continuation in the program which 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 which 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, notification 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;
(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.
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, 02/01/2004, 02/01/2006
(A) The employer of an applicant, or the employer's designee, shall provide written information directly to the board when attesting to the competence to perform dialysis care of an applicant who is applying for either a temporary certificate one to practice as a dialysis technician in accordance with division (A)(2) of section 4723.76 of the Revised Code, or a certificate to practice as an Ohio certified dialysis technician in accordance with division (B)(2)(b) of section 4723.75 of the Revised Code
(B) The information required by this rule shall be submitted on a form specified by the board and shall include the following:
(1) When the applicant is applying for a temporary certificate one, 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 the standards for the safe performance of 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 or the employer's designee, in good faith affirms that the applicant has the knowledge, skills, and ability to safely provide 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.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
Promulgated
Under: 119.03
Statutory
Authority:
4723.79
Rule
Amplifies:
4723.75
Prior
Effective Dates: 10/01/2000, 02/01/2006
(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 the thirtieth of January 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.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
Promulgated
Under: 119.03
Statutory
Authority:
4723.79
Rule
Amplifies:
4723.751
Prior
Effective Dates: 02/01/2006
4723-23-11
Procedures for providing information to the dialysis technician registry.
When information is provided to the board for purposes of the registry set forth in paragraphs (A)(6) and (A)(7) of rule 4723-1-03 of the Administrative Code, the information shall be submitted to the board in the format required by the board.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
Promulgated
Under: 119.03
Statutory
Authority:
4723.79
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
(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.
(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 is 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 is not precluded from communicating appropriate patient information with other members of the health care team for health care purposes only.
(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)(8) and (H)(9) of this rule.
(I) A dialysis technician shall 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.
R.C.
119.032 review dates:
10/08/2010 and
10/01/2015
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