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  • Canadian Association of Nephrology Nurses and Technologists

    Standards of Nephrology Technical Practice

    Spring 2013

  • Standards of Nephrology Technical Practice 2

    Table of Contents Standards Committee Members (2013) ................................................................. 3 Introduction ............................................................................................................ 4 Nephrology Technology - Description .................................................................... 4 Goals for a Nephrology Technologist ..................................................................... 5 Objectives of a Nephrology Technologist ............................................................... 5 Scope of Practice ................................................................................................... 6 Standards of Practice .............................................................................................. 7 Standard 1 Qualification Requirement ................................................................. 7 Standard 2 Regulations ....................................................................................... 7 Standard 3 Law and Ethics ................................................................................. 8 Standard 4 Professional Development ................................................................ 8 Standard 5 Contribution to the Multi-disciplinary Team ....................................... 9 Standard 6 Quality Assurance ............................................................................. 9 Appendix I: Quality Assurance Testing ................................................................... 10 Appendix II: CSA-ISO. Standards .......................................................................... 11 Appendix III: CANNT Standards of Technical Practice for Home Dialysis12

  • Standards of Nephrology Technical Practice 3

    AD HOC REVEW COMMITTEE MEMBERS (2013) Doug Franklin Manager, Renal Technology WRHA Manitoba Renal Program, Winnipeg, MB Mukesh Gajaria Chief Technologist, Dialysis/Nephrology Hospital for Sick Children, Toronto, ON Gil Grenier Manager, Biomed Nephrology Technical Services The Ottawa Hospital, Ottawa, ON

    Lorin Hompoth CET Dialysis Tech II South Calgary Dialysis Centre, Calgary, AB Marilyn Muir CANNT President (2011-2012) Health Sciences Centre, Winnipeg, MB

    Jeffery Huska Technologist Sudbury Regional Hospital, Sudbury, ON Shripal Parikh Technologist Calgary Health Region's, Calgary, AB

    Rejean Quesnelle CANNT Vice-President of Technologists Renal Technologist Halton Healthcare Services, Oakville, ON Patty Quinan Clinical Nurse Specialist-Dialysis Access CANNT President (2010-2011) Humber River Regional Hospital, Toronto, ON Dave Riggs Chief Technologist Capital District Health Authority, Halifax, NS

  • Standards of Nephrology Technical Practice 4

    Introduction

    Nephrology technologists play an integral role in the care of patients with End Stage Renal Disease (ESRD) who undergo renal replacement therapies. They ensure that the equipment and methods used in dialysis treatment delivery are safe, effective and in accordance with accepted protocol. The technologist shares a common goal with other nephrology professionals - that is to provide quality care by working as part of a multi-disciplinary team. In an effort to provide quality care, the nephrology technologist has a responsibility to maintain competencies in conjunction and accordance with the CANNT Standards for Nephrology Technical Practice through recognized training and continued education. The Canadian Association of Nephrology Nurses and Technologists, (CANNT), as a professional association, has a mandate to establish, maintain, evaluate and revise standards of practice. The nephrology technologist requires a broad knowledge base including understanding of dialysis principles, membrane technology, electronics, hydraulics, mechanics, plumbing, water purification systems, computer applications, chemistry, and knowledge of renal anatomy and disease processes. The CANNT Standards for Nephrology Technical Practice provide guidelines for evaluating this knowledge by identifying the minimum professional and practice expectations. The goals and objectives of the nephrology technologist are also identified and serve as the foundation for quality technological practice. The CANNT Technical Standards Committee, in consultation with the Board of Directors and the CANNT technical membership, develops standards that address the needs of the nephrology technical community as a whole, while recognizing that diversity exists in the field. The Standards for Nephrology Technical Practice that follows are intended to:

    Identify goals for nephrology technical practice in Canada.

    Promote and define quality in nephrology technical practice by outlining qualification requirements and by providing a scope of practice statement

    Nephrology Technology - Description

    Nephrology technology is a specialized area of technical practice with personnel trained to provide expert support to nephrology programs in the following areas:

  • Standards of Nephrology Technical Practice 5

    Haemodialysis: Support for adult and pediatric haemodialysis programs is the largest component of the role, as haemodialysis utilizes the most sophisticated technology. The technologist requires knowledge in the preparation and operation of the entire clinical setup with expertise in the following areas:

    Principles of dialysis

    Water treatment (Theory and application of water purification equipment)

    Plumbing/Electrical installations

    Dialysis procedures and complications of dialysis

    Membrane technology and Dialyser reprocessing

    Haemodialysis systems components: including extra corporeal, hydraulic and electrical/electronic systems

    Computer applications and networking technologies

    Safety standards and directives

    Applied Sciences: chemistry, human biology, microbiology

    Access flow assessment and measures of dialysis adequacy

    Anticoagulation and coagulometric technologies

    Documentation The role of the technologist within the haemodialysis program encompasses: preventive maintenance; troubleshooting and repair of haemodialysis equipment; product evaluation, clinical support; education of staff and individuals with CKD; and research in the above areas. Peritoneal Dialysis: Support for peritoneal programs is less intensive as the role is generally restricted to equipment support in addition to that provided to the haemodialysis program. Goals for a Nephrology Technologist

    1. To support the daily operation of the dialysis facility by providing the most efficient and timely services to the patient and the multidisciplinary team.

    2. To provide quality service by establishing reasonable and measurable standards of practice for all components of technical services support.

    Objectives of a Nephrology Technologist

    1. To provide expertise related to the management of dialysis equipment and related technology and to assist clinical staff in making informed decisions on the acquisition, use and replacement of dialysis equipment.To work with medical and nursing staff to ensure coordination of technical service for the entire Renal Program in keeping with the hospitals long term objectives.

  • Standards of Nephrology Technical Practice 6

    2. To provide on-going performance testing of dialysis equipment in an effective and consistent manner, thereby assuring compliance with manufacturers specifications and pertinent standards.

    3. To perform the activities of machine and accessory preparation, operation and disassembly to assist clinical staff with unit patient care activities.

    4. To perform preventive maintenance on dialysis equipment where it can be demonstrated that such activities minimize the cost, improve the quality of operation and/or reduce the down time and disruption associated with equipment failure.

    5. To periodically measure and evaluate the quality of technical services provided to nephrology programs and adjust these services as necessary to maintain established standards.

    6. To assist in evaluation of new technology pertaining to dialysis and make suggestions and/or recommendation after evaluation

    7. To provide training for the patient, family and nurses in the technical aspects of dialysis in preparation for self-care at home or in a community or hospital based self-care unit.

    8. To ensure that each technologist has the opportunity for professional development and to provide means for periodically appraising this development.

    9. To participate in nephrology program administrative activities and ensure cost effective utilization of human and material resources within budgetary control of Technical Services.

    10. To initiate or participate in research activities within the scope of nephrology technology and in cooperation with the multi-disciplinary team.

    Scope of Practice

    The nephrology technologist provides several levels of support depending on the size, location and complexity of the nephrology program.

    1. The Nephrology Technologist assumes primary technical responsibility for all medical devices used in the delivery of renal replacement therapies, including but not limited to: dialysis machines, reprocessing equipment, water treatment equipment, artificial kidneys, blood lines and related equipment.

    2. The Nephrology Technologist may

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