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Dialysis Technician Training in Oregon

The Oregon Department of Public Health has jurisdiction over the regulations affecting dialysis technician training and certification requirements. Oregon state law says that it is unlawful for someone to act as a dialysis technician without first being certified by the Health Authority. Individuals wishing to practice as a dialysis technician will need to receive a certified hemodialysis technician (CHDT) certificate before starting work in a dialysis facility.

Applicants must complete the following in order to be certified:

1. Provide evidence of a high school diploma or equivalent
2. Complete an approved training program
3. Complete the certificate application
4. Complete the examination application
5. Complete the consent for criminal records check

Dialysis technician trainees are allowed to perform technician duties if they are an integral part of the training program and the trainee is working under the direct supervision of a nurse educator, clinical preceptor, or technician educator. Trainees are restricted to performing duties as defined by the scope of practice regulations and the job description at the facility. The job description may not exceed the scope of practice as determined by the state.

State authorized functions of a dialysis technician include:

• Venipuncture for dialysis access
• Data collection used for the nursing assessment
• Lidocaine injection in preparation for dialysis access
• Heparin bolus administration
• Normal saline bolus administration
• Connection of dialysis access to normal saline or heparinized normal saline
• Initiate or discontinue dialysis via central lines
• Administer oxygen on the basis of standing orders or facility protocol

Dialysis technicians are not authorized to perform the following:

• Oral, intramuscular, intravenous, or subcutaneous medication administration
• Arterial punctures outside of dialysis access
• Determine the frequency or duration of dialysis treatments
• Administer blood or blood products
• Accept verbal or telephone orders
• Perform dialysis on a hospitalized intensive care unit patient

In addition to the requirements established by the state of Oregon, the Centers for Medicare and Medicaid Services (CMS) has recently established its own technician regulations. Individuals working as a dialysis technician in any state will be required to comply with federal regulations. The CMS is currently responsible for reimbursing dialysis facilities for approximately 80% of the costs associated with delivery of care. Since most clinics are dependent on these funds, they are compelled to comply with all government requirements.

CMS regulations 494.140 (e)(1-4) mandate that the patient care technician training and certification requirements must incorporate the following expectations…

1. Meet all state requirements for:
   • Education
   • Training
   • Credentialing
   • Competency
   • Standards of practice
   • Certification
   • Licensure
2. Have a High School Diploma or GED
3. Complete an approved program that includes the following:
   • Principles of dialysis
   • Care of patients with kidney failure
   • Possible complications of dialysis
   • Water treatment and dialysate preparation
   • Infection control
   • Safety
   • Dialyzer reprocessing
4. Certification by a State or National Program within 18 months of employment

It is now mandatory for all dialysis technicians to complete the certification process regardless of state regulations. Most dialysis facilities have designed a training program that prepares technicians to perform their duties and pass a national certification examination. In general, technicians are allowed to work for a period of 6 to 18 months prior to becoming certified. The exact length of time will depend on whether or not the state has more stringent requirements than the federal government. Aspiring technicians should inquire with potential employers about the specifics of their training program as well as local certification requirements.

National Certification Organizations include:

1. The Nephrology Nursing Certification Commission (NNCC)
   • Certified Clinical Hemodialysis Technician (CCHT) Exam
2. The Board of Nephrology Examiners Nursing and Technology (BONENT)
   • Certified Hemodialysis Technician (CHT) Exam
3. The National Nephrology Certification Organization, Inc. (NNCO)
   • Certified in Clinical Nephrology Technology (CCNT) Exam
   • Certified in Biomedical Nephrology Technology (CBNT) Exam

In 1978, Congress created 18 non-profit renal networks in the United States that were given the responsibility of keeping track of the quality of dialysis therapy being offered by clinics across the country. Each network monitors facilities in one to six states where they actively collect data, create reports, encourage rehabilitation, and act as a resource for patients and personnel. Oregon is part of Network 16 along with Alaska, Idaho, Montana, and Washington.

Oregon Dialysis Technician Training and Career Links

1. Davita
2. DSI Renal
3. Fresenius Medical Care
4. Gambro Healthcare
5. Innovative Dialysis Systems
6. Providence Health and Services

State Contact Information

Phone:          (971) 673-1222
Fax:               (971) 673-1299
Email:           health.webmaster@state.or.us

800 NE Oregon St     Portland, OR 97232

Web Site:     Oregon Health Authority

National Network:   Network 16