N.J. Admin. Code § 8:43A-24.6

Current through Register Vol. 56, No. 8, April 15, 2024

Section 8:43A-24.6 - Renal dialysis staff qualifications and policies and procedures

(a) Renal dialysis services shall be under the administrative supervision of an individual with at least one of the following qualifications:

1. A baccalaureate degree from an accredited college or university and the equivalent of at least one year experience in supervising renal dialysis services; or

2. Five years full-time experience in the provision of renal dialysis services and documentation of supervisory experience for at least one year.

(b) The medical staff shall possess the following qualifications:

1. Each physician on the medical staff shall have a current license to practice medicine in the State of New Jersey, and current Drug Enforcement Administration (DEA) and Controlled Dangerous Substances (CDS) certificates.

2. The members of the medical staff may include nephrologists and other physicians with training or demonstrated experience in the care of end stage renal disease patients.

3. Advanced practice nurses or physician assistants shall meet the requirements established by the Board of Nursing in New Jersey (for an advanced practice nurse-N.J.A.C. 13:37-7 ) or the Board of Medical Examiners in New Jersey (for a physician assistant-N.J.A.C. 13:35-2B ).

(c) The director of nursing services is the registered professional nurse who has overall responsibility for the provision of nursing care in the facility. The director of nursing shall have a current New Jersey license to practice nursing and shall meet the qualifications set forth in 8:43A-1.10, except that the minimum 12 months of full-time experience in nursing supervision and/or nursing administration shall have been obtained in a hemodialysis setting within the last 24 months.

(d) Each nurse assigned charge responsibilities shall be a New Jersey-registered nurse currently licensed to practice and have 12 months of full-time experience in hemodialysis obtained within the last 24 months. The responsibilities of a registered professional nurse functioning as a charge nurse shall include:

1. Making daily patient care assignments based on patient needs;

2. Providing immediate supervision of direct patient care;

3. Making patient assessments when indicated; and

4. Communicating with the other members of the health care team.

(e) Dialysis facilities shall assign licensed practical nurses to perform nursing functions within their defined scope of practice, as set forth in the New Jersey Nurse Practice Act at 45:11-23.

(f) Patient care technicians shall be subject to the following policies and procedures:

1. Technicians shall be trained and deemed competent by the facility in accordance with facility policies and procedures in the following areas:

i. Principles of hemodialysis;

ii. Understanding the individual with kidney failure;

iii. Application of dialysis procedures;

iv. Application of dialysate, dialysers and reuse; and

v. Water treatment.

2. A competency evaluation covering the areas identified in (f)1 above shall be performed for each patient care technician and shall be included as a component of the policies and procedures.

i. Until the successful completion of each component of the competency evaluation, the trainee may provide patient care only as part of the training program and under the direct supervision of an assigned preceptor. A preceptor shall be a licensed registered nurse who has 12 months of experience in hemodialysis obtained within the last 24 months and a recommendation by the supervising nurse to be a preceptor.

ii. An individual may not work as a patient care technician unless and until that individual has satisfied the competency requirements in each of the five training areas established in (f)1 above.

3. Trainees shall be identified as such to patients in the treatment area. Trainees shall not be included in the determination of compliance with minimum staffing ratios as set forth at 8:43A-24.7(a).

4. Patient care technicians are prohibited from performing any of the following activities:

i. Comprehensive clinical assessment of the patient;

ii. Primary responsibility for patient education;

iii. Alteration of ordered treatment, including shortening of the treatment time;

iv. Administration of medications;

v. Administration of blood or blood products;

vi. Performance of non-access site arterial puncture; or

vii. Acceptance of physician orders.

(g) Registered dietitians shall possess at least one year of clinical experience as a registered dietitian.

(h) Social workers shall possess a master's degree in social work from a program accredited by the Council on Social Work Education. The facility shall designate one social worker in charge of social services.

N.J. Admin. Code § 8:43A-24.6