Joint Position Statement of the
National Association of Nephrology Technicians/Technologists (NANT)
American Nephrology Nurses’ Association (ANNA)
and the
on Dialysis Technicians/Technologists

Background and Rationale

The ultimate goal of the nursing process is to effect positive patient outcomes in the most cost-effective way. 

ANNA and NANT recognize that the achievement of favorable patient outcomes is a collaborative effort between all members of the interdisciplinary team.

ANNA and NANT further acknowledge that dialysis patient care technicians* (PCTs*) deliver the majority of direct care in most chronic dialysis facilities. PCTs* perform specific direct patient care activities and function under the direction and oversight of the registered nurse. Dialysis technicians and technologists work under a defined scope of practice, in the practice setting of a dialysis facility, and any licensure or certification requirements in effect in the state in which they are employed. Additional specific facility/agency policies and procedures in congruence with State Nurse Practice Acts related to delegation may also apply. (Refer to ANNA’s Position Statement “Delegation of Nursing Care Activities.”)

ANNA supports the collaborative role of Registered Nurses (RNs) with members of the interdisciplinary team in the provision of care to individuals undergoing dialysis therapy for chronic kidney failure. ANNA believes the overall accountability and responsibility for nursing care rendered to patients and the coordination of patient care activities is the responsibility of RNs with experience in nephrology nursing who, by basic nursing education and state practice regulations, are designated to provide dialysis assessments and interventions. 

ANNA and NANT support:

• Additional research to determine the appropriate skill mix of personnel and staffing patterns.
• The development of a standard national program of education and training for dialysis patient care technicians, preferably in a formal setting. 
• The Centers for Medicare & Medicaid Services Conditions for Coverage for End Stage Renal Disease Facilities mandate that technicians complete standardized training and competency testing and become certified within 18 months of the first date of training.  
• Annual continuing educational requirements.

ANNA and NANT promote standards for education of all practitioners as a means to achieve quality of care, and both associations will work collaboratively at the state and Federal levels to achieve these goals.

ANNA and NANT agree that the term “certification” should be reserved for private-sector programs that attest to the competency of individual health professionals. Both associations strongly urge registered nurses and dialysis technicians/technologists to pursue certification by a nationally recognized testing organization as soon as eligible.

References

American Nephrology Nurses Association. (2011). Nephrology Nursing Scope and Standards of Practice (7th Ed.). Pitman, NJ: N. Gomez (Ed.)

American Nephrology Nurses Association. (2012). Delegation of Nursing Care Activities Position Statement. Retrieved from http://www.annanurse.org/advocacy/resources-and-tools/position-statements.

Anthony, M.K., Standing, T., & Hertz, J.E. (2000). Factors influencing outcomes after delegation to unlicensed assistive personnel. Journal of Nursing Administration, 30(10), 474-481.

Centers for Medicare & Medicaid Services (CMS). (2008). Medicare and Medicaid Programs; Conditions for Coverage for End-Stage Renal Disease Facilities; Final Rule. Final rule displayed at:  http://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/downloads/ESRDfinalrule0415.pdf.

*NANT has formally requested that CMS change the term Patient Care Technician (PCT) to the term Nephrology Clinical Technician (NCT) in the CMS regulations. Once CMS changes the terminology in their regulations, the term will also change in this joint position statement.

Adopted by the ANNA Board of Directors

January 1997

Adopted by the NANT Board of Directors

January 1997

Revised and/or reaffirmed biennially from 1998-2013

           Revised September 2016

NANT President 2022-24
Kevin M. Burns, Sr.

• 1983 Stuart Kaufer
• 1983 - 85 C.W. Miller
• 1986 - 91 Martin Hudson
• 1991 - 92 Jeff Hover
• 1992 - 93 Mark Rolston
• 1993 - 94 Tom Suttle
• 1994 - 95 Mark Rolston
• 1995 - 96 Dennis Todaro
• 1996 - 97 Philip Varughese
• 1997 - 98 Jim Curtis
• 1998 - 99 Russell Dimmitt
• 1999 - 00 Belinda Bethea
• 2000 - 01 Zelma Griffin
• 2001 - 02 Clifford Glynn
• 2002 - 03 Efraim Figueroa
• 2003 - 04 Clifford Glynn
• 2004 - 05 Tim Dillon
• 2005 - 07 Danilo Concepcion
• 2007        Loni Cloutier
• 2007 - 08 Forest Rawls
• 2008 - 09 Karen Evans
• 2009 - 10 Andrew Lleras
• 2010 - 11 Heather Paradis
• 2011 - 12 Charles Torres
• 2012 - 13 Heather Paradis
• 2013 - 14 Kevin Burns, Sr.
• 2014 - 15 Nicole Anderson
• 2015 - 16 Kazim Naqvi
• 2016 - 17 Kevin Burns, Sr.
• 2017 - 18 Charles Johnson 
• 2018 - 19 William G. Macias
• 2019 - 20 Dwelyn Williams
• 2020 - 21 Clarica Douglas Ajayi
• 2021 - 22 William G. Macias
• 2022 - 24 Kevin M. Burns, Sr.

Learn more about the Centers for Medicare and Medicaid Services (664 KB PDF) Conditions of Coverage that went into effect on October 14, 2008. These rules include a federal mandate for technician certification. Technicians are required to be certified as of 14 April, 2010.

ERSD Conditions Crosswalk
This chart is designed to crosswalk the former Conditions for Coverage for ESRD services to those made final in the April 15, 2008 Federal Register.

ESRD Interpretive Guidance Update (link)
This is an advance copy of the ESRD Interpretive Guidance. This Interpretive Guidance will also be published in an updated Appendix H of the State Operations Manual (SOM).

The following states have passed technician certification legislation. Click on the links for more information about each state's legislation:

• California Dialysis Technician Legislation
• Ohio Hemodialysis Technician Certification Legislation
• Oregon Administrative Rules
• West Virginia Hemodialysis Technician Certification Legislation

This Legislation Watch on RenalWEB tracks pending dialysis-related legislation at both federal and state levels. Features include links to bill summaries, sample letters to send legislators, related news articles, and position papers from contributors. You can access information by clicking on the links listed on this page.

Legislation Watch on RenalWEB

NANT is a member of the renal community's ongoing efforts to match dialysis professionals willing to serve in times of natural disasters with organizations who need volunteers.

Kidney Community Emergency Response Coalition

The Kidney Community Emergency Response Coalition is compiling a list of individuals who are interested in assisting in the event of a future emergency or disaster. This list will serve as a means to quickly identify volunteers.

Registering as a volunteer does not necessarily mean that you will be called for every disaster that occurs. People will be called as needed. Please note that volunteers will be responsible for their own transportation to the disaster area.

Click here to provide the requested information and take the first step to be a volunteer of this emergency preparedness network. ANNA is coordinating these efforts for nurses and hemodialysis technicians.

An Emergency Hotline is available for dialysis units to contact in the event of a disaster or emergency. The number is 888.335.4363 (888.33KIDNEY).

Bridge of Life (BoL) Medical Mission to Haiti

Recent Jerry Woods Excellence in Dialysis scholar Lisa Marie Walker has been selected to volunteer on a Bridge of Life Medical Mission to Haiti.  

"I am honored to be volunteering on a Bridge of Life (BOL) medical mission to Haiti. As a volunteer, my goal is to raise at least $1,000 by the mission start date on June 4, 2016. By making a contribution in honor of my mission work, you will help me provide primary care and/or chronic kidney disease screenings to families in nearby villages who currently have difficulties accessing treatment due to poor roads and lack of transportation."

To learn more about the Bridge of Life program or to make a contribution to Lisa Marie's mission, please visit the 2016 Haiti Primary Care Mission page.