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.

Five Year Review (FYR) Dates: 10/15/2020 and 10/15/2025
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.72, 4723.73
Prior Effective Dates: 10/01/2000, 02/01/2004, 02/01/2006, 02/01/2014, 02/01/2016

Prior History: (Effective: 2/1/2016
Five Year Review (FYR) Dates: 10/15/2015 and 10/15/2020
Promulgated Under: 119.03
Statutory Authority: 4723.79
Rule Amplifies: 4723.72, 4723.73
Prior Effective Dates: 10/01/2000, 02/01/2014, 02/01/2006, 2/1/14)