Term
| What is the job of a Patient Care Technician (PCT)? |
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Definition
| To monitor patient care and assist patient in recieving safe andeffective dialysis. |
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Term
|
Definition
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Term
| What is the main goal of dialysis treatment? |
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Definition
| To acheive the highest level of wellness possible by removing wastes and excess liquid from the blood. |
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Term
| Who makes up the dialysis care team? |
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Definition
Technicians,Nurses, Dieticians,
Social Workers, Doctors
& Patients. |
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Term
| What are some factors which affect one's overall health? |
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Definition
| Age, Activity Level, Treatment Plan, Other Illness & Support System. |
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Term
| Which are the two most common types of Dialysis? |
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Definition
| Periotoneal (PD) and Hemodialysis (HD). |
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Term
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Definition
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Term
| What 3 functions does dialysis replace? |
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Definition
1. Removes wastes from blood,
2. Removes excess fluid,
3. Balaces electrolyes. |
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Term
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Definition
| Electrolytes are the salts in the body. The most common salts are sodium ions, potassium ions, and chloride ions that carry an electrical charge. |
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Term
| Why are electrolytes important? |
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Definition
| The electrolytes in the blood serum produce an electrical charge, which permit cells to preform their normal functions. |
|
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Term
| what happens if the electrical charges amongst the electrolyes become unbalanced? |
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Definition
| The nerve and muscle cells within the body, including the brain, may fail to conduct nerve impulses, leading to cramps and confusion. Further electrolyte imbalances can lead to heart failure, siezures or water retention. |
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Term
|
Definition
| An electrically charged particle |
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Term
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Definition
| A synthetic or organic devise that serves as the artificial kidney. It has a blood compartment and a dialysate compartment. |
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Term
| What does the dialyzer permit? |
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Definition
| It allows for the counterflow of dialysate and blood, which are seperated by a semipermiable membrane or hollow microfibers. |
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Term
| Describe the flow of fluids through the dialyzer. |
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Definition
| Blood flows through the microfibers (blood compartment) and dialysate flows around the microfibers (dialysate compartment). |
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Term
| What is a semipermiable membrane? |
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Definition
| A barrier with microscopic pores which allow for the passage of some substances but not others, depending on size. |
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Term
| In (HD) Hemodialysis, what is the delivery system? |
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Definition
|
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Term
| What does the delivery system control? |
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Definition
| Blood flow (Extraction and Return), Saftey Parameters, Dialysate Mixing and the Delivery of Dialysate. |
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Term
| Typically, how often is HD preformed? |
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Definition
| Three times per week, 4 hours each treatment. |
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Term
| How much kidney function does (HD) dialysis replace? |
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Definition
| About 15% of kidney function is restored through Hemodialysis. |
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Term
| Can HD be done independantly at home? |
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Definition
| Yes, short treatments 5 to 6 times per week or longer treatments at night 3-7 days a week. |
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Term
| When was the first CELLULOSIC MEMBRANE used for dialysis? |
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Definition
| In 1943, by Willem Kolff in a rotating drum. |
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Term
| The greatest advancements in primitive dialysis were made during which three year period? |
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Definition
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Term
|
Definition
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Term
|
Definition
| A form of vascular acess by which the artery and vein are linked extracorporally by a plastic tube. |
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Term
| Why are shunts rarely used today? |
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Definition
| There is a high risk of infection and clotting. |
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Term
| Six years after the shunt was created, who pioneered the fistulae procedure? |
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Definition
|
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Term
| What is a AV fistula or native fistula? |
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Definition
| An arteriouvenus connection underneath the skin between a vein and an artery. |
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Term
| When was the first hollow fiber dialyzer mass marketed? |
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Definition
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Term
| What was the dialysis dilemma between 1960-1973? |
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Definition
| There were not enough dialysis machines to treat pts with kidney failure. |
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Term
| Regarding renal failure, prior to 1973, what was the "Death Committe"? |
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Definition
| It was a group of people and clergy who chose which ESRD patients would not recieve care based on age, maturity, education, dependants, economic status and their relative contribution to society. |
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Term
| Prior to 1973, why did some people choose death over dialysis? |
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Definition
| Primarily because the cost of dialysis care was extremely expensive, and financially burdensome. |
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Term
| How did government interceed on behalf of families affected by ESRD? |
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Definition
| In 1972 Congress passed a law "92-603" and created the ESRD Program to provide Medicare benifits to pts entitled to Social Security benefits. |
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Term
| What does the ESRD 92-603 law ensure? |
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Definition
| That SS eligible pts are entitled to Medicare benefits which pay up to 80% of allowable costs. |
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Term
| Of all the life threatening diseases, such as hepatitis, and HIV, which disease has it's own Medicare Program? |
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Definition
| Renal Disease, through the ESRD Medicare Program. |
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Term
| What changed the dynamics of dialysis care? |
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Definition
| Government intervention and Government funding. |
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Term
| What was a major benifit of the ESRD Medicare Program? |
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Definition
| More independant centers began to open as free standing, non hospital based clinics devoted to dialysis care. |
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Term
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Definition
| Large Dialysis Organization |
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Term
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Definition
| Purchase, or own smaller dialysis centers across the country. |
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Term
| How does medicare pay for treatment? |
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Definition
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Term
| What is a Composite Rate? |
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Definition
| A payment based on an individul's age, weight, height and is based on that individuals need of overhead, staff, drugs, training and equipment. |
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Term
| Who calculates the composite rate? |
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Definition
| Congress calculates the rate, and adjusts the rate by legal decree. |
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Term
| When was the composite rate last adjusted? |
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Definition
In 2002.
The average rate was $130.50 per treatment.(63K annually) |
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Term
| At the current composite rate, are centers making a profit by serving pts whose only form of payment is made by composite rate? |
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Definition
No.
ESRD medicaid composite rate payments cause centers to suffer a loss of about $10 per "Medicare only" patient. |
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Term
| How much does private insurance generally pay per patient? |
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Definition
| $126K per patient annually. |
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Term
| In 1978, Medicare contracted HOW MANY AGENCIES to provide oversight(Quality Control) throughout the United States? |
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Definition
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Term
| What type of oversight is provided by these networks? |
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Definition
Quality Improvement
Rehabilitation
Collect and Report Data
Provide Resources
Collect Grievances |
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Term
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Definition
| The degree to which services rendered actually increase the likelyhood of a desired outcome, all of which are consistent with current professional knowledge. |
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Term
|
Definition
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Term
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Definition
| It assesses the US healthcare system. |
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Term
| What is a strategy promoted by the IOM to improve care? |
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Definition
| The "Six Aims" of Improvement. |
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Term
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Definition
| Safe, Effective, Patient Centered, Timely, Efficient & Equitable Care. |
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Term
| What was the original purpose of the Medicare ESRD Program? |
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Definition
| To keep patients alive, and help them to stay active, employable and able to pay taxes. |
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Term
| How do the reports generated by ESRD Networks help law makers? |
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Definition
| It help congress to decide if dialysis treatments paid for by the ESRD Program actually help to meet the goal set by the ESRD Program of 1972. |
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Term
| What is the greatest pressure of any clinic? |
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Definition
| To assess and treat the overal condition of it's patients, and show that it has been providing cost effective quality care. |
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Term
| How is QUALITY CARE checked? |
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Definition
| It is checked by comparing centers to PRESET STANDARDS (Quality Assurance). |
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Term
| What happens if a center does not meet the Quality Assurance Standards already set by Medicare? |
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Definition
| The center risks loosing it's Medicare Certification to provide ESRD services. |
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Term
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Definition
| he Centers for Medicare and Medicare Services" |
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Term
| What main service does CMS provide? |
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Definition
| Oversight and the inspection of Medicare funded facilities. |
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Term
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Definition
| It is a state agency, the Department of Health Services |
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Term
| What is the CMS's relationship to the DHS? |
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Definition
| The federal agency contracts(CMS) the state agency (DHS) to facilitate the actual inspections and to report back to the CMS. |
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Term
| What do these contracted DHS surveyors do? |
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Definition
| They visit Medicare funded clinics with PRESET GUIDELINES (Quality Assurance Checklists) and report if the clinic has met these standards. |
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Term
| Why is important to work each day as if it were to be inspected? |
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Definition
| Because mishaps and oversights can cause a center to loose it's main source of funding or medicare certification. |
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Term
| Aside from the CMS standards, who else has set Quality Assurance Guidelines? |
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Definition
| The Regional ESRD Networks, Joint Commissions on Healthcare Organizations (JCAHO) and the Association for the Advancement of Medical Instrumentation (AAMI). |
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Term
| JCAHO has focused its QA standards in which area? |
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Definition
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Term
| ESRd Network has focused its QA standards on what two areas? |
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Definition
| Patient care and Patient Outcomes. |
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Term
| AAMI has focused its QA standards in which area? |
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Definition
| Water Treatment Standards, Dialysate Preparation Guidelines, Dialyzer Reprocessing Standards. |
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Term
| The FDA has focused its QA standards in which area? |
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Definition
| The safety and effectiveness of all medical equipment and devices. (Dialyzers, tubing, monitoring devices, alarms, machines, reprocessing, water treatment systems). |
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Term
| If there is a problem with a device, equipment or there are adverse events what federal entity requires that a report to be made? |
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Definition
The FDA.
It requires all healthcare providers to fill out special reports for manufactures and the federal goverment, disclosing adverse events relating to problems with medical equipment. |
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Term
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Definition
| The United States Renal Data System. |
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Term
| What does the USRDS provide? |
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Definition
| USRDS provides reports comparing data from every dialysis center in the United states annually. |
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Term
| What do the ESRDS annual reports disclose? |
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Definition
National averages which include:
MORALITY RATE
Number of Patients
&
Cost of Treatment. |
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Term
| What publically disclosed report can be used to evaluate patient outcomes in a particular clinic or in a particular region? |
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Definition
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Term
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Definition
The Clinical Preformance Mesures Project is a joint effort between the CMS, and ESrD Networks and Dialysis Centers that compare the quality of "MEDICARE ONLY" Dialysis to preset guidelines set by the National Kidney Foundations's Quality Initiative Goals. |
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Term
| The CPM Project Annual Report provides data based on which criteria? |
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Definition
| Adequacy of treatment, Vascular Access, Anemia, and Albumin Test Results. |
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Term
| What are two major pt outcomes measured against the Q.A. standards for Dialysis Care? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
What do the clinical practice guidlines outlined in Core Curriculum actually provide? |
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Definition
Improved outcomes for all patients.
It provides the best approach to care and treatment based on current scientific and professional knoweledge. |
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Term
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Definition
| A medical condition, by which there is a shortage of oxygen carrying red blood cells in the blood. |
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Term
| What are symptoms of anemia? |
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Definition
| Fatigue, low blood pressure and chills. |
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Term
| After (HD) treatment, how can a tech help reduce anemia? |
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Definition
1. By preventing the dialyzer from clotting.
2. Making sure that the maximum amount of blood is returned to the patient.
3. By preventing excess blood loss when removing needles. |
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Term
| How can techs ensure that pts get adequate dialysis? |
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Definition
1. Correclty preform blood draws.
2. Ensure that pt gets at least the minimum tx.
3. If needed, explain why pts should stay on the entire prescribed time. |
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Term
| How can techs ensure that pts access sites are preserved and protected? |
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Definition
1. Techs can protect and preserve pt accesses when proper technique is used to access the site.
2. When the proper pressure is used after removing needles after treatment.
3. When access problems are reported to nurses or doctors as soon as possible. |
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Term
| Generally, what is the ongoing goal of all patient care centers? |
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Definition
| Continuous improvement & improving pt outcomes by delivering high quality, efficient care in the dialysis industry. |
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Term
What is the difference between CQI and QA? |
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Definition
| Continuous Quality Improvement focuses on how things presently work, and the steps required to make them better, which would prevent future problems while Quality Assurance focuses on the survey of data in order to screen for potential deficiencies or problem areas. |
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Term
| What is the difference between Top Down and Bottom Up QCI? |
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Definition
| Quality care iniciatives can begin with management (Top to bottom) or it can begin with the service workers (bottom up) |
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Term
| What are examples of Clinical QCI? |
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Definition
| Improvements in anemia, tx adequacy and access issues. |
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Term
| What are examples of Technical Quality Care Iniciatives? |
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Definition
| Improvements in water treatment, dializer reuse or personal protective equipment. |
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Term
| What are examples of Organizational Quality Care Iniciatives? |
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Definition
| Improvements in accountability, Work Friendly Hours of Operation, Patient Saftey, Pt Scheduling and Staff Scheduling. |
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Term
| What is the CQI Planning Process? |
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Definition
1. Identify an area of concern.
2. Analyze the problem.
3. Identify or define the root cause of the problem.
4. Plan it, Do it, Check it, Act on the results.
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Term
| In a dialysis treatment center, who has the most direct pt contact amongst the care team? |
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Definition
| The Patient Care Technician |
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Term
| What does it mean to demonstrate professionalism? |
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Definition
| To behave and preform duties in a courteous, conscientious and generally business like manner. |
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Term
| Why is important to address pts by their titles? |
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Definition
| Because using first names or nicknames may errode proffessional boundaries. |
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Term
| Why is it important to remember to say "please" and "thank-you"? |
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Definition
| Appreciation, and kind modes of speech demonstrate respect, and allows pts to retain dignity. |
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Term
| Why is it important to wear a name badge and/or introduce yourself to new pts before attempting to interact with them? |
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Definition
| Proper introductions and titles demonstrate professionalism, common courteousy. It also helps pts to feel more safe and comfortable while being rendered treatment. |
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Term
| What are 3 ways to boost pt confidence? |
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Definition
1.Be on time.
2. Be prepared.
3.Adhere to Clinical and Proffesional Modes of Practice.
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Term
| Why is important to never talk about your personal life to clinical staff or patients? |
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Definition
| It errodes the proffessional boundaries and may make others feel uncomfortable. |
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Term
| Why is important never to talk around patients as though they aren't there? |
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Definition
| It creates an uneasy enviroment, that may make the pt feel diminuative, ignored or aggitated. |
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Term
| Why is it important to protect every patients privacy and confidential information? |
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Definition
Because it is the law!
(HIPPA) |
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Term
| Why is it important to wear appropriate and clean clothing in a healthcare setting? |
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Definition
| It demonstrates good hygine, fosters pride and promotes trust within the clinical setting. |
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Term
| Why must one never shout accross the treatment area? |
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Definition
The level of noise must be kept to a minimum, so that confidentiality of each patient is protected, and so that pts generally feel safe. |
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Term
| Why must one avoid rushing or running through a tx area? |
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Definition
| Pts may become worrisome or generally begin to feel unsafe. |
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Term
| Why must the pt care area be visibly neat, clean and free of blood? |
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Definition
It demonstrates that efforts are being taken to create an enviroment where the highest possible quality of can be rendered. |
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Term
| What is the MOST IMPORTANT aspect of professional behavior? |
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Definition
| Knowing how to maintain boundaries. |
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Term
| What is the second most important aspect of professional behavior? |
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Definition
| Respecting and Maintaining Everyone's Privacy. |
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Term
| Proper Discipline, Professional Knowledge, Personal Commitment & Self Confidence all lead to ? |
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Definition
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Term
| How many national certifications are presently available for (HD) technicians? |
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Definition
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Term
| Which test is offered as an entry-level COMPETENCY exam for individuals with at least 6 months experience? |
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Definition
CCHT Exam
This exam is offered by The Nephrology Nursing Certification Commission. |
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Term
| How long is the NNCC's CCHT certification valid? |
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Definition
|
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Term
| Who wrote the CCHT exam and where can study materials be found for this exam? |
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Definition
Both NANT and the ANNA wrote this exam.
Study materials can be found by visiting their websites. |
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Term
| What does the CCHT exam measure? |
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Definition
| Basic competency in the area of HD. |
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Term
| What are the four types of Questions covered by the CCHT Exam? |
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Definition
50% Clinical Aspects of Care
23% Technical Aspects of Care
12% Role Play
15% Enviromental Aspects of Care
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Term
| To take a practice exam for the CCHT which website should be visited? |
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Definition
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Term
| Once a tech has completed 12 consecutive months of employment or graduated from an accredited dialysis course, one may then become eligible to take which exam? |
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Definition
|
|
Term
| What does the CHT exam measure? |
|
Definition
Technical Proficiency in 5 Areas of Practice:
65% Patient Care
10% Machine Technology
5% Water Treatment
5% Reprocessing
15% Personal Development/Education
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Term
| The CHT Exam has online practice exams at www.goamp.com/bonent, but the actual exam has how many questions? |
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Definition
| 150 multiple choice, to be answered in 180 minutes. |
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Term
Once a tech has completed 12 consecutive months of work experience and has mastered the principles of dialysis, patient care/assesment, machine operation and preparation he/she may take which exam to measure his/her current level of competence as a technician? |
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Definition
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