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The Adoption of Formal Dialysis Technician Competency Requirements

Technicians are an instrumental component of the healthcare system and are highly valued by advanced medical personnel who depend on them for ongoing patient support. Within the dialysis specialty, an individual who is employed as a technician is generally responsible for setting patients up for treatment, supervising the treatment process, and maintaining equipment. Due to an increase in the prevalence of end stage renal failure secondary to diabetes and hypertension, demand for qualified technicians has steadily risen over the past several years. This has created many new career advancement opportunities for those who want to work in a patient care setting, but who prefer not to spend many years of their life completing a college degree and advanced medical training.

As demand for dialysis treatment increased, many regulatory agencies began to realize the need for new competency requirements within the industry. Prior to 2008, there were very few if any guidelines that had to be followed in order to show that technicians were capable of providing the kind of high quality and comprehensive care that patients had come to expect. Because the US Centers for Medicare and Medicaid Services (CMS) are responsible for reimbursing dialysis facilities for around 80% of the services they provide to the public, they were the branch of the government that took the initiative to develop and adopt formal legislation requiring technicians to demonstrate competence. In October 2008, the CMS incorporated language into their conditions for coverage that stated that all technicians would now be expected to complete a training program and successfully pass a national certification examination.

Individuals who are new to the dialysis technician profession are typically required to participate in a training program prior to taking a certification exam or providing direct patient care. Although some of the facilities currently in operation have outsourced the training process to independent educational institutions in their area, most offer new employees an in-house option that provides them with the knowledge and skills they will need in order to perform their day-to-day responsibilities and successfully pass a state and federally approved certification exam. Because there are many community colleges and vocational schools who promote certificate programs for dialysis technicians, it is important to contact employers to make sure that they will recognize the credentials offered by these programs before the decision to enroll is made. In many cases, a college program may not be required for an open position.

After completing the training and orientation process, new technicians are generally allowed to gain a few months of experience working with patients before they take the certification exam. Although a few states have developed standards that are stricter than the federal guidelines, most have adopted the rule that requires a technician to complete the exam within 18 months of hire. The program instructor will likely cover this topic during the training period so that new technicians are familiar with the laws that apply to them. The three most commonly recognized national certifying organizations in the US include the Board of Nephrology Examiners Nursing and Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), and the National Nephrology Certification Organization (NNCO). The basic technician exam offered by each of these organizations is recognized by most state agencies.

Individuals considering a career in this profession should not be deterred by the new dialysis technician certification requirements. In fact, formal credentialing regulations are a positive sign that the technician’s contributions to the comprehensive care of patients is a valuable part of the medical system and should be reimbursed by governmental and private insurance agencies. Also, higher standards for employment make it more difficult for unqualified applicants to compete for open job positions and can result in a higher dialysis technician salary for those who are qualified to provide care. This results in more career advancement opportunities for those who have taken the time and made the effort to comply with local, state, and federal regulations.

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