Key result area: Elimination of safety lapses within the dialysis unit by enforcing strict adherence to healthcare safety measures and infection control practices among the dialysis team members

Key performance area - Smooth operations of patient care activities within the unit

Knowledge

Practical and theoretical knowledge of dialysis procedures (hemodialysis, peritoneal dialysis, continuous therapies, plasma exchange) and its complications AND dialysis machines and their components; safety practices inside dialysis room (including infection control practices); basic nursing under the supervision of dialysis nurse; cardiac life support [Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS)]

Skills

Dialysis related procedures (hemodialysis through arteriovenous fistula and central vein catheter, management of complications, performance of peritoneal dialysis exchanges and peritoneal dialysis catheter and transfer set related procedures), communication skills (interaction on patient care with staff members of dialysis team and other departments, doctors and mainly patients), training (preparing other staff members in getting on to the next level of privileging by adequate training)

Job Responsibilities

Overall

ü Adherence to and compliance with protocols and policies of the department for smooth functioning of the department

ü Compliance with duty time and work ethics

ü Hand over and take over during shift change with documentation – on patient care and machine function

ü Data collection on outcome measures within dialysis unit (patient statistics, infection control practices, infection rates, vaccination, machine performance, safety practices, mortality); quality parameters

ü Cleanliness and maintenance of orderly arrangement of records and equipments in the department

Patient care (as per privileging)

ü Care of all patients coming to Dialysis Unit before, during and after the session as per their requirements

ü Identification and appropriate management of clinical problems in patients coming for dialysis before, during and after the session

ü Documentation of patient care details [in dialysis record and patient hand book (and in patient record if admitted)]

ü Adherence to patient related safety practices and quality care – hand hygiene, handling central vein catheter, cannulation and decannulation of arteriovenous access, medication preparation and administration (IV medications can be administered only under supervision of Dialysis Nurse if the Dialysis Technician has diploma or certificate qualification), station disinfection and machine disinfection, cleanliness and dry flooring, waste segregation, sterilization of items for reuse

ü Proper performance of peritoneal dialysis exchanges during training and retraining sessions and transfer set change as per requirement

ü Efficient and prompt management of emergencies inside the unit including emergency sessions

ü Appointments for dialysis as per schedule and appropriate entry in patient hand book

ü Maintenance of log book for the activities for all staffs until they are in privileging level 5 for at least 3 months

Machine

ü Maintenance of good functional status of equipments within the unit and reverse osmosis plant (dialysis machines, cycler, defibrillator, weighing scale, pneumatic chute, non invasive monitoring devices)

ü Regular follow up of warranty and periodic maintenance including calibration (where applicable)

ü Immediate escalation of machine related problems

ü Disinfection of dialysis machines and other equipments as per protocol

ü Maintenance of equipment registers

ü Careful shifting of dialysis machines to different locations within the Hospital if needed

ü Assistance to biomedical engineer during machine repair and service

Interdepartmental

Pharmacy and stores - Pharmacy and store items indent and maintenance of an adequate stock as per requirement (including Erythropoietin and Iron); immediate replacement of stock of crash cart items if used
Accounts - Billing of all activities in the unit including dialysis sessions; Follow up with billing for patients undergoing dialysis through credit or insurance or company
Laundry – Maintenance of linen movement and adequate stock for patient use
Follow up communications to other departments as and when needed
Maintenance of registers with regard to the above
Coordination with medical team in patient care and academic activities

Staff education

ü Learning policies and protocols related to dialysis and patient management (both inpatient and outpatient services) and safety related issues inside dialysis room (including waste segregation, hazardous materials handling and vaccination)

ü Training new recruits and students

ü Supervision on IV cannulation practice for new recruits especially trainees

ü Training housekeeping staff on linen handling, cleanliness, station disinfection, waste segregation and self care

ü Health education program in dialysis unit

Safety practices

ü Disinfection of equipments inside dialysis room

ü Sterilization of stethoscope, suction jars, oxygen jars, laryngoscopes, procedure trays and dialysis catheters

ü Cleanliness of the department including management of spills

ü CCTV monitoring of safety and infection control practices

ü Biomedical waste segregation

ü Incident report to the HOD (patient/staff/equipment related)

ü Hepatitis B vaccination of all susceptible patients

ü Hepatitis B vaccination for self and follow up of immunization status

ü Needle Stick Injury report to the hospital infection control nurse

ü Hospital Infection Control Committee (HICC) activities (surveillance rounds and meetings) if a member of HICC

ü Hazardous material handling

ü Unit meeting

ü Bedside rounds by doctors

ü Continuing Nursing Education and other workshops

ü Housekeeping staff education

ü Classes on protocols and policies of the department

ü Departmental orientation programs

ü Hospital orientation programs where applicable

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