Core Curriculum for the Dialysis Technician
A Comprehensive Review of Hemodialysis
Module 1 – Today’s Dialysis Environment: An Overview
As a patient care technician, your job is to help patients with chronic kidney disease (CKD) receive safe and effective dialysis. To do this well, it will help you to learn what dialysis is, how it was developed, how to ensure high-quality care for patients, and how to perform and carry out your duties in a professional manner. We cover all of these topics in this module. While there are many treatment goals for patients with CKD, the main goal is to help each patient reach the highest level of wellness possible. Helping patients to reach this goal is one of the most rewarding parts of caring for patients with CKD. Dialysis is provided by a team that includes technicians, nurses, dietitians, social workers, doctors—and, most important of all, patients. Some patients choose to take a very active role in their care and know a lot about their treatment and how it affects them. The team should support this nterest and knowledge: research shows that patients who self-manage their care and know more about it stay healthier and live longer. It takes a team to make sure that patients’ needs for treatment, nutrition, medications, and social services are met. Other specialists, such as physical therapists, pharmacists, exercise physiologists, and clergy, may be called on as well. With good dialysis, many people with CKD can lead full and active lives. For others, having a good quality of life is harder. A person’s health depends on a number of factors. These can include age, former activity level, proper treatment, other illnesses (such as diabetes or high blood pressure), and support from loved ones. With training and experience, a dialysis technician can help patients feel their best, and at the same time, have a rewarding career.
Module 2- The Person With Kidney Failure
After completing this module, the learner will be able to Identify the structures and functions of the normal kidney. Describe acute vs. chronic kidney disease. List five symptoms of uremia. Describe at least four conditions that often occur due to kidney failure. Discuss the treatment options for kidney failure. Identify members of the care team. Discuss the communication skills dialysis technicians use while working with patients. Describe the goal of rehabilitation and the technician’s role in it.
Module 3 – Principles of Dialysis
Hemodialysis may seem complex, but it is based on simple scientific principles. This module will help you understand these principles and how they are used in dialysis. Dialysis replaces three main kidney functions:
1. Removing wastes from the blood
2. Removing excess fluid from the blood
3. Keeping electrolytes (electrically charged particles) in balance
Module 4 – Hemodialysis Devices
A dialyzer lets the patient’s blood interact with dialysate through a semipermeable membrane. Dialysate is a blend of treated water and chemicals; it removes wastes and fluid, and balances electrolytes. A delivery system supplies fresh dialysate and removes used dialysate. Modern, high-tech delivery systems include a blood pump, an ultrafiltration pump, a dialysate conductivity monitor, alarms, and pressure gauges. Better membranes, safety monitors, and the use of computers have made dialysis safer. These advances allow today’s staff to turn more of their time to patients. Trained staff who know dialysis principles, equipment, and procedures are the most vital monitors of patient safety. This module covers hemodialysis devices, including dialyzers, dialysate, and delivery systems. If you carefully follow your center’s procedures and apply the principles reviewed in this module, you can master the use and maintenance of each device and help deliver safe dialysis treatments.
Module 5 – Vascular Access
Vascular access makes chronic hemodialysis possible because it allows the care team to “access”
the patient’s blood. An access can be internal (inside the body) or external (outside the body). It must:
Allow repeat access to the blood
Handle blood flow rates that will ensure effective treatments
Be made of materials that are not prone to causing reactions or infections
The three main types of access are fistulae, grafts, and catheters.
Module 6 – Hemodialysis Procedures and Complications
Cleaning a patient’s blood with dialysis is a complex process with many steps—and each step may be crucial to keeping patients safe and maintaining their comfort. Dialysis treatments can only be uncomplicated and routine when staff pay close attention. This module covers the types of patient care tasks, technical tasks, and skills you will need to learn to deliver safe and effective treatment. It goes over the processes of dialysis, from set-up through clean-up. Your actions at each step— from setting up the machine, to washing your hands, to putting in needles, to monitoring the treatment—affect your patients. This module is a general review of procedures and complications you may encounter. The exact tasks that you can do will vary with the Nurse Practice Acts, regulations, and laws in each state; and with your center’s policy. A team of technicians, nurses, nephrologists, social workers, dietitians, pharmacists, and others cares for dialysis patients. The authors assume that patient assessment is the job of registered nurses, but that you can help by gathering data, noting and reporting unexpected findings, and providing input into the care plan.
Module 7 – Dialyzer Reprocessing
The dialyzer is a feat of engineering: complex enough to do some of the work of a human kidney, yet simple enough to be mass produced, and reliable enough to be used many times. For medical and non-medical reasons, many dialyzers are reprocessed: cleaned and disinfected to be used again by the same patient instead of being thrown out after a single use. This is called reuse. Dialyzer reprocessing is regulated by the federal and some state governments. Regulations include the standards and conditions centers must follow so reuse is as safe and effective as possible for both patients and staff. A reprocessing technician has the immense job of maximizing patient benefits of reuse and reducing the risks. This is done by carefully following all of the guidelines, regulations, and center procedures. This module covers the history of the reasons for reprocessing, the role of regulations and guidelines, and the steps used to reprocess dialyzers.
Module 8 – Water Treatment
Dialysate is a fluid used to help remove wastes from patients’ blood. Water is used to make dialysate, mix concentrate, and to flush out and reprocess dialyzers. If dialysis water has contaminants (harmful substances), they may enter the blood through the dialyzer and cause disease, injury, or even death to a patient. Healthy people can handle some contaminants in their drinking water; healthy kidneys remove most of them. People with failed kidneys do not have that protection. To be safe, water to be used for dialysis must pass through a water treatment system—a series of devices, each of which takes out certain contaminants. This module covers why and how water is treated before it is used for dialysis. It describes the components of a water treatment system, how the system is monitored, and the common contaminants found in water.
No Copyright Infringement Intended. The Following attached documents has been authorized for educational use by Caribbean Dialysis Inc.