The Medical Instrument Technician (Hemodialysis) is assigned to the Dialysis Unit, which is organizationally under Hospital Specialty Medicine. The Dialysis Unit HCT is an integral member of the Dialysis Team and helps with various duties in the Dialysis Unit that are necessary to maintain a well functioning unit. The Medical Instrument Technician (Hemodialysis) The duties and responsibilities include but are not limited to the following: Explains the basics of the dialysis procedure to the patient as necessary; Cleans area of established access (AV fistulas, graft, or catheter), using antiseptic solution; Takes and records patient's pre-dialysis weight, temperature, blood pressure, pulse rate, and respiration rate; Initiates and terminates dialysis by establishing and maintaining a circulatory access for therapy by inserting needles into AV fistulas and vein grafts; Verifies good blood flow prior to dialysis treatment and makes adjustments to the needle placement to allow for optimal blood flow rates; Connects hemodialysis machine to patient's access to start blood circulating through dialyzer; Performs dressing change and accesses permanent/temporary catheters according to Dialysis unit policy and procedure for initiation of the hemodialysis treatment; Uses sterile/clean techniques when initiating and terminating dialysis; Performs ultra filtration dialysis under the supervision of the RN; Assembles supplies and prepares equipment for each dialysis treatment; Inspects equipment settings, including pressures, conductivity (proportion of chemicals to water), and temperature to ensure conformance to safety standards. Starts blood flow pump at prescribed rate. Inspects venous and arterial pressures as registered on equipment to ensure pressures are within established limits. Calculates fluid removal or replacement to be achieved during dialysis procedure. Monitors patient for adverse reaction and hemodialysis machine for malfunction. Takes and records patient's post-dialysis weight, temperature, blood pressure, pulse rate, and respiration rate; Receives requests or instructions from the RN on the stable chronic renal failure patients, and carry out assignment under the supervision of an RN to perform hemodialysis using the appropriate dialyzer, treatment time, prescribed dialysate concentrate and machine settings; Recognizes and reacts to signs and symptoms that signal the onset of disequilibrium, such as hypotension, low blood sugar, seizures and arrhythmias. Report to the RN immediately of any abnormal or unexpected values or patient complaints. Performs a variety of personal care or nursing care activities as directed and supervised by the RN. This may include procedures to obtain diagnostic tests, such as, blood specimens, glucose testing, EKGs; Set up machine by attaching dialyzer and tubing and primes with saline or heparinized solution to prepare machine for use; Assists nurses and physicians during medical emergencies or at times when more intensive care is required; Gathers patient information necessary to update the data system. Documents equipment tasks performed and data collected on the patient paper flow sheet; Completes identified tasks to support patient care outcomes; Identifies patient and ensures that patient identification on armband matches patient under consideration according to policy and procedure; Services, inspects, tests, evaluates, modifies, maintains and documents dialysis equipment and systems using manufacturer's recommendations and VA policy and Procedures. Cares for a variety of equipment; dialysis machines, reverse osmosis (RO), water treatment instruments; Instructs staff in the safe use and care of dialysis equipment; Ensures maximum performance and safety through the specialized application of electronics and mechanics; Understands the American Association of Medical Instrumentations (AMMI) Standards and monitors the RO for variation, adjusts and documents accordingly; Performs preventive maintenance, and calibration of all dialysis equipment/systems to ensure device safety, proper operation and diagnostic and/or therapeutic efficacy, using standard test equipment and industry standards (JCAHO, NFPA, UL, VA CSA, AAMI); Maintain maintenance records and machine repair. Responds to inspections for JCAHO etc.; Works closely with Biomed to ensure that correct policy and procedure are being following for dialysis equipment; Documents all repair and inspection incidents as required by accrediting bodies (JCAHO, CAP). Is a mentor or preceptor to lower grade technicians; Analyzes deviations from the expected in dialysis patients, determine if they are machine or patient related and responds according to the findings; Provides instruction to home dialysis/self-care in the maintenance of the equipment; Provides instruction for physicians, nurses and other personnel in dialysis procedures, equipment operation and maintenance; Monitors and instructs other dialysis technicians in the correct procedure and follow thru for water, dialysate, portable machines and dialysis machine culturing as well as endotoxin testing. Work Schedule: Tour of duty may be 0500 - 1330, 0600 - 1430, 0830 - 1700 or 1100 -1930. Subject to approval by supervisor and operational need. Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.