**PURPOSE AND SCOPE**:
Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance with regulations set forth by the corporation state and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI Activities including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FMC Quality Enhancement Goals (QEP).
**PRINCIPAL DUTIES AND RESPONSIBILITIES**:
Patient Education:
- Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC) Adequacy Monitoring Program (AMP) Urea Kinetic Modeling (UKM) and regarding disease process/access.
Patient Treatment:
- Welcome assigned patients and inquire as to their well-being since their last treatment.
- Evaluate vascular access for patency.
- Obtain necessary pre and post treatment vital signs and weight.
- Perform vascular access evaluation pre-treatment.
- Perform vascular access cannulation.
- Perform administration of Heparin as delegated or as allowed by state law.
- Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD).
- Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed.
- Monitor patients' response to dialysis therapy.
- Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document.
- Discontinue dialysis treatment according to established procedures.
- Evaluate patient prior to termination of venous access - standing & sitting blood pressure.
- Evaluate the patient prior to discharge.
- Perform and record Pre and Post dialysis evaluation weight and vital signs with initial identification.
- Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; Sodium (Na) modeling; and UF modeling as prescribed.
- Responsible for ensuring appropriate safety alarms are enabled including Narrow Venous Limits (NVL) 160.
- Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification.
- Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and if applicable progress notes.
- Report any significant information and/or change in patient condition directly to the PCT III (if applicable) or nurse supervisor.
- Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the PCT III (if applicable) or nurse supervisor.
- Perform and document any intervention for unusual patient status and document patients' response to intervention.
- Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures provide appropriate intervention as needed document and report any unusual findings to the PCT III (if applicable) or nurse supervisor.
- Obtain all prescribed laboratory testing and prepare specimens for collection.
Maintenance/Technical:
- Maintain environmental integrity and aesthetics - ensure all areas are safe and clean.
- Clean and disinfect dialysis machine surface chair equipment and surrounding area between treatments according to facility policy.
- Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate.
- Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT).
- Initiate Solution Delivery System (SDS) system.
- Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy.
- Prepare organize and efficiently utilize supplies and equipment to prevent wastage.
Record Keeping:
- Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities.
- Review treatment sheets for completeness ensure nursing signatures are documented and ensure omitted entries are completed or corrected where appropriate.
- Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart.
- Prepare lab requisitions for prescribed or stat Lab specimens according to laboratory destination.
- Collect label appropriately prepare and store lab samples according required laboratory specifications.
- Ensure collection of lab specimens by appropriate lab courier.
**PHYSICAL DEMANDS AND WORKING CONDITIONS**:
- The physical demands and work envir