Hemodialysis Nurse

I. Duties and Responsibilities:

Oversees the preparation of the delivery system, dialysate bath, and dialyzer and confirms that all mandatory alarm tests on the dialyzer and equipment are performed.

Reviews physician orders for dialysis patients, collects pre-treatment dialysis data, and reviews patient records prior to dialysis.

Conducts pre-dialysis patient assessment including obtaining patient vital signs and assessing the patient' s vascular access, laboratory findings, and the patient' s general health.

Verifies that patients are taking all prescribed medications and performs medication reconciliation.

Documents findings of patient assessments and interventions and advises providers of any significant change in the patient's condition and other pertinent information.

Discusses patient concerns and answers questions relevant to care.

Oversees dialysis technicians in the performance of dialysis from start to finish, monitors patient reaction to treatment and performance of the dialysis machines, and demonstrates an in-depth understanding of the mechanics of dialysis.

Assesses, prepares, and cannulates a patient' s vascular access (including needle insertion in arterioveinous fistula or grafts for aseptic connection with dialysis equipment).

Utilizes sterile techniques to assess the dialysis catheter exit site and to apply dressing on the patient' s vascular access (dialysis catheter , arterioveinous access) per protocols.

Maintains skills necessary to perform surveillance on dialysis access (catheter, fistula, graft) for early signs of failure or infection; this includes (if needed and after receiving the appropriate training) the ability to perform arterioveinous access monitoring using ultrasound machine per protocol.

Reviews patient' s electronic/paper records for orders as appropriate and administers dialysisrelated intra-venous and/or oral medications as prescribed and/or per protocol.

Conducts post dialysis assessment and patient discharge by evaluating treatment, documenting medication administration utilizing the appropriate protocols, assessing condition of vascular access, discharging the patient when vital signs are stable, and documenting and recording patient treatment data.

Provides patient education/teaching applicable to the patient' s medical condition.

Refers patient to other disciplines or services as needed (nutrition, social work, etc).

Performs other treatments and diagnostic tests such as blood sugar testing and other tests required as part of patient treatment.

Oversees disassembly and disinfection of dialysis equipment.

Maintains skills necessary to do regional heparinization, separate and store blood samples, set up oxygen, administer saline, and maintain dialysis equipment.

Performs surveillance and testing of dialysis water treatment equipment and dialysis water (such as chlorine, hardness, conductivity, water cultures) to ensure that these machines are operating within the parameters set in the facility's written protocols.

Demonstrates a working knowledge of dialysis laboratory tests and dialysis medications.

Demonstrates an in-depth understanding of infection control and prevention of transmission of blood borne pathogens.

Participates in quality improvement activities to include collection of data for the dialysis unit Quality Assurance Performance Improvement (QAPI) plan.

Responds appropriately and provides assistance in emergency situations.

Provides leadership in improving patient care, maintaining standards of care, directing and teaching personnel in a variety of settings, and providing charge nurse responsibilities as needed.

Works closely with others on the dialysis team and participates in interdisciplinary team meetings.

Maintains responsibility for providing coverage to the dialysis department.