Professional Practice and Quality Improvement
Professional practice, safety, and continuous improvement
Technicians work within a defined scope: performing dialysis treatments and related tasks under registered nurse delegation and state law. You do not assess, diagnose, develop the plan of care, or change prescriptions; when a finding is outside your scope, report it to the nurse. Know your facility policy on medication administration, since technician authority varies by state.
Confidentiality is non-negotiable: discuss patients only with those who need to know, secure records, and avoid conversations in waiting rooms. Respect patient rights, informed consent, advance directives, and cultural and religious needs. Maintain professional boundaries.
Bloodborne pathogen safety follows standard precautions: treat all blood and body fluids as infectious, wear gloves and other PPE as indicated, perform hand hygiene before and after patient contact, never recap needles, and dispose of sharps immediately. If exposed, wash the area with soap and water, report immediately, and follow the post-exposure protocol rather than waiting.
Quality improvement is everyone's job. Understand the PDSA cycle, root cause analysis, and failure mode and effects analysis, plus the measures facilities track: Kt/V and urea reduction ratio, hemoglobin, phosphorus and albumin, catheter use, bloodstream infection rates per 100 patient-months, and hospitalization. Report errors and near misses through the non-punitive reporting system; the goal is system repair, not blame.
Rule of thumb: when a measure is off, ask "what in the process allowed this?" before asking "who did this?"