Professional Ethics, Communication and Patient Safety
The Professional Ethics, Communication and Patient Safety domain tests informed consent, confidentiality, boundaries, error disclosure and safety culture in dialysis care.
Core rules
- Respect autonomy: explain risks, benefits and alternatives; document informed refusal when a capable patient declines.
- Protect privacy in shared units; discuss only need-to-know information.
- Disclose errors honestly, report them and focus on system improvement rather than blame.
- Use teach-back and clear language; involve interpreters and family per patient preference. Use a trained interpreter, not a family member, for consent discussions when possible.
Worked example
A capable patient refuses a prescribed dialysis session. Assess understanding and capacity, explain consequences, explore barriers, document the refusal and notify the team. Do not sedate, coerce or treat without consent unless emergency criteria apply.
Traps
Do not discuss one patient’s labs at another chair; do not assume refusal equals incompetence; do not hide a medication error; do not promise outcomes you cannot guarantee.