​Determining Scope of Practice

Credentialed Dialysis Technicians (DTs) are required to practice with reasonable skill and safety and within their scope of practice as outlined in 201 KAR 20:478 below.

Section 1. Scope of Practice.

1. The scope of practice of a dialysis technician shall include the following and shall be performed under the direct, on-site supervision of a registered nurse, an advanced practice registered nurse, a physician, or a physician's assistant:
   • Preparation and cannulation of peripheral access sites (arterial-venous fistulas and arterial-venous grafts);
   • Preparation of catheter ports, access, including connection and disconnection, and site care of percutaneously or surgically inserted central venous catheters, if the dialysis technician has six (6) months experience that includes training and skills validation regarding central venous catheters;
   • Initiating, delivering, or discontinuing dialysis care;
   • Administration of the following medications only:
2. Heparin 1:1000 units or less concentration either to prime the pump, initiate treatment, or for administration throughout the treatment, in an amount prescribed by a physician, physician's assistant, or advanced practice registered nurse. The dialysis technician shall not administer heparin in concentrations greater than 1:1000 units;
3. Normal saline via the dialysis machine to correct dialysis-induced hypotension based on the facility's medical protocol. Amounts beyond that established in the facility's medical protocol shall not be administered without direction from a registered nurse or a physician; and
4. Intradermal lidocaine, in an amount prescribed by a physician, physician's assistant, or advanced practice registered nurse;
   • Assistance to the registered nurse in data collection;
   • Obtaining a blood specimen via a dialysis line or a peripheral access site;
   • Responding to complications that arise in conjunction with dialysis care; and
   • Performance of other acts as delegated by the registered nurse pursuant to 201 KAR 20:400.
5. The scope of practice of a dialysis technician shall not include:
   • Dialysis care for a patient whose condition is found by the registered nurse to be critical, fluctuating, unstable, or unpredictable;
   • The preparation of catheter ports, access, including connection and disconnection, and site care of percutaneously or surgically inserted central venous catheters, except as authorized in Section 1(1)(b) of this administrative regulation; and
   • The administration of blood and blood products.
     




​Advisory Opinion Statement

AOS # 21 Roles of Nurses and Technicians in Dialysis provides guidance for DTs and nurses who provide dialysis care as to what constitutes safe practice and to facilitate the delivery of safe, effective care to the public. An advisory opinion is not a regulation of the Board and does not have the force and effect of law.

​Interventions identified in this Advisory Opinion Statement include:

• The Role of Nurses and Technicians in the performance of
  • Dialysis
  • Central Venous Catheters (CVC)