1. A. Required subject areas After 12/31/2023, all hemodialysis technician curriculum must include subject areas for CHT, CHT I and CHT II.

   1. (1) Objectives of the hemodialysis technician programs to include:

      1. (a) federal, state and local regulations;
      2. (b) nurse’s role and hemodialysis technician role including the meaning of delegation;
      3. (c) standards of function for hemodialysis technician;
      4. (d) certification expectations and requirements; and
      5. (e) hemodialysis technician students must have a current basic life support credential prior to and while the student has contact with patients.

   2. (2) Orientation to the hemodialysis technician position including:

      1. (a) review of job specifications;
      2. (b) expectation and responsibilities;

      3. (c) role of the health care team and the hemodialysis technician:

         1. (i) roles and contributions of other health team members;
         2. (ii) observation and reporting;
         3. (iii) occupational safety and health administration (OSHA).

2. B. Legal roles and responsibilities of hemodialysis technicians including:

   1. (1) patient’s rights;
   2. (2) negligence and malpractice;
   3. (3) ethical issues relating to patients including but not limited to confidentiality;
   4. (4) documentation;
   5. (5) identification of errors and required reporting of errors to the nurse.

3. C. Orientation to the patient population:

   1. (1) Identifies major anatomical components of the renal system and the role of the normal kidney in maintaining homeostasis;
   2. (2) Recognizes the physiological changes that occur in the body as a result of end stage renal disease;
   3. (3) Verbalizes the principles of hemodialysis;
   4. (4) Recognizes the psychosocial considerations that affect the hemodialysis patient/family and lifestyle;
   5. (5) Identifies changes in the patient’s diet.

4. D. Introduction to dialysis therapy:

   1. (1) Demonstrates efficient, accurate and safe preparation of the dialysis machine including but not limited to the discontinuation of dialysis;
   2. (2) Demonstrates accurate and safe technique when performing arteriovenous punctures for dialysis access;
   3. (3) Identifies patient complications and communicates with a registered nurse;

   4. (4) Identifies and responds appropriately to machine alarms and other potential emergency situations to include but are not limited to:

      1. (a) air leaks;
      2. (b) power failures;
      3. (c) temperature changes;
      4. (d) unconscious patient;
      5. (e) needle dislodgement; or
      6. (f) air embolism;
   5. (5) Identifies infection control principles and practices. Including but not limited to the use of personal protective equipment;
   6. (6) Demonstrates the method of medication administration and identifies potential adverse reactions for medications used in hemodialysis therapy.

5. E. Hemodialysis technician procedures/skills check list for certification in New Mexico.

   1. (1) identification of machine parts and functions;
   2. (2) preparation of machine and extracorporeal circuit equipment monitoring and testing prior to initiation of treatment and disinfection of machine post dialysis;
   3. (3) data collection for registered nurse assessment;
   4. (4) vascular access and specimen collection;
   5. (5) initiation, monitoring and termination of treatment;
   6. (6) appropriate response to real and potential emergency care situations that can impact the patient, staff and the physical building;
   7. (7) administration of medications required for dialysis therapy within the scope of practice as stated in Subsection B and C of 16.12.4.10 NMAC;
   8. (8) correct practice of infection control principles;
   9. (9) identification and comprehension of principles of water treatment system.

6. F. Certification for hemodialysis technician (CHT and CHT II) including their role and responsibilities.

   1. (1) Philosophy and objectives of the advanced hemodialysis technician programs to include:

      1. (a) federal, state and local regulations;
      2. (b) nurse’s role and advanced hemodialysis technician role;
      3. (c) standards of function for advanced hemodialysis technician;
      4. (d) certification expectations and requirements.

   2. (2) Orientation to the (CHT and CHT II) position including:

      1. (a) review of job specifications;
      2. (b) expectation and responsibilities;

      3. (c) role of the health care team and the hemodialysis technician;

         1. (i) roles and contributions of other health team members;
         2. (ii) observation and reporting;

   3. (3) Expanded roles and responsibilities of the advanced hemodialysis technicians (CHT and CHT II) including:

      1. (a) patient’s rights;
      2. (b) negligence and malpractice;
      3. (c) ethical issues relating to patient including but not limited to confidentially and OSHA;
      4. (d) documentation;
      5. (e) identification of errors and required reporting or errors to the nurse.
   4. (4) Review the concepts and practices of infection control.

   5. (5) Understand the principles and rationale for the clamping and care of central venous line catheters:

      1. (a) positive thoracic pressure;
      2. (b) risk of complications with clamping/unclamping catheters;
      3. (c) antiseptic solutions and catheter material.

   6. (6) Understanding and administering heparin to central venous catheters:

      1. (a) pre-dialysis blood work;
      2. (b) identification of arterial and venous catheter ports;
      3. (c) connection to dialysis blood lines.

   7. (7) Preparation, initiation, monitoring and termination of dialysis with the central venous catheters:

      1. (a) arterial pressure monitoring;
      2. (b) documentation;
      3. (c) verification with registered nurse of correct placement of a new central venous catheter.
   8. (8) Maintaining central venous catheter patency including injection of heparin or saline into catheter ports.

   9. (9) Identification of complications including, but not limited to:

      1. (a) emergency life threatening care;
      2. (b) access recirculation;
      3. (c) inadequate flow;
      4. (d) clotting; or
      5. (e) catheter dislodgement.

7. G. CHT and CHT II candidate procedures/skills check list for certification in New Mexico shall also include the following:

   1. (1) Identify difference between permanent and temporary central venous catheters;
   2. (2) Demonstrate ability to maintain an aseptic field;
   3. (3) Demonstrate correct infection control practices throughout all procedures including the proper selection of approved antiseptic solutions;
   4. (4) Demonstrate aspiration of heparin or saline with the correct sized syringe;
   5. (5) Demonstrate ability to maintain positive pressure in the catheter lumen;
   6. (6) Identify and respond appropriately to complications with the central venous catheter;
   7. (7) Determine correct lumen volume and instill heparin or saline aseptically post treatment;

   8. (8) Correctly demonstrates catheter ports are capped, clamped and secured after termination of hemodialysis treatment.

      HISTORY OF 16.12.4 NMAC:

      Pre-NMAC History: The material in this part was derived from the previously filed with the state records center and archives under:

      BON Manual #90-1, New Mexico Board of Nursing Rules and Regulations for Hemodialysis Technicians, filed 1/29/1990;

      BON Manual 93-2, New Mexico Board of Nursing Rules and Regulations for Hemodialysis Technicians, filed 08/25/1993.

      History of Repealed Material:

      16.12.4 NMAC Certification of Hemodialysis Technicians and Training Programs repealed, 2/17/2006.

      16.12.4 NMAC, Hemodialysis Technicians, filed 12/21/2005 - Repealed effective 10/1/2016.

      16.12.4 NMAC, Hemodialysis Technicians, filed 9/1/2016 - Repealed effective 12/13/2022.

      Other History:

      BON Manual 93-2, New Mexico Board of Nursing Rules and Regulations for Hemodialysis Technicians (filed 8/25/1993) was renumbered, reformatted to 16 NMAC 12.4, Certification of Hemodialysis Technicians and Training Programs, effective 1/1/1998.

      16 NMAC 12.4 amended Certification of Hemodialysis Technicians and Training Programs (filed 12/10/1997), renumbered, reformatted, amended and replaced by 16.12.4 NMAC Certification of Hemodialysis Technicians and Training Programs, effective 7/30/2001.

      16.12.4 NMAC Certification of Hemodialysis Technicians and Training Programs (filed 6/12/2001) replaced by 16.12.4 NMAC Certification of Hemodialysis Technicians and Training Programs, effective, 2/17/2006.

      16.12.4 NMAC Certification of Hemodialysis Technicians, effective, 10/1/2016.

      16.12.4 NMAC, Hemodialysis Technicians, filed 9/1/2016 Replaced by 16.12.4 NMAC, Hemodialysis Technicians, effective 12/13/2022.

[16.12.4.16 NMAC - Rp, 16.12.4.16 NMAC, 12/13/2022]