“The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care

IF 3.2 Q1 UROLOGY & NEPHROLOGY
Megan Urbanski , Emma Blythe , Alicia Hamblin , Alexis A. Bender , Courtney Hoge , Clarica Douglas-Ajayi , Fran Rickenbach , Jessica Joseph , Kelli Collins Damron , Jennifer Craft Morgan , Bernard Jaar , Laura Plantinga
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引用次数: 0

Abstract

Rationale & Objective

Dialysis patient care technicians (PCTs) provide essential, frontline care for patients receiving in-center hemodialysis. We qualitatively explored perceptions of the PCT job role, responsibilities, and training among current PCTs, non-PCT dialysis staff, and patients receiving hemodialysis.

Study Design

Focus group study.

Setting & Participants

Discussions were conducted in March–May 2023 among US PCTs, non-PCT staff, and patients.

Analytical Approach

Thematic analysis was conducted using inductive and deductive strategies.

Results

Seven focus groups (N = 36 participants) were conducted (3 with PCTs [n = 19], 2 with non-PCT staff [n = 6], and 2 with patients [n = 11]). Eight themes emerged: (1) value of PCT role is not reflected in job or organizational policies and structures; (2) PCTs play a flexible and often ill-defined role in dialysis clinics; (3) despite being in a position with high risk of burnout, PCTs find ways to persevere and provide high-quality care; (4) PCTs are often perceived as “helpers” or ancillary rather than an integral part of the dialysis care team; (5) PCT job training and qualifications are not standardized and often not commensurate with job expectations and responsibilities; (6) PCT-patient relationships are deeply valued, but boundaries can be fluid and become blurred because of the frequency and nature of dialysis care; (7) dialysis patients and staff are vulnerable to multilevel workplace safety issues; and (8) PCT-staff dynamics have a strong impact on employee morale, clinic efficiency, and patient satisfaction.

Limitations

Non-English-speaking participants and physicians were excluded, limiting diversity in perspectives.

Conclusions

PCTs play a multifaceted role in dialysis care that is highly valued among patients and staff but not always reflected in actual tasks performed by PCTs, training received by PCTs, or the respect afforded to PCTs. Our findings are actionable and can inform future intervention-based work aimed at improving the PCT role in US hemodialysis care.

Plain-Language Summary

In the United States, patient care technicians (PCTs) spend the most chair-side time with patients receiving hemodialysis, but little is known about the role of patient care technicians (PCTs) in dialysis care. We conducted 7 focus groups with US PCTs, other dialysis staff, and patients receiving hemodialysis. Discussions showed that the PCT role is highly valued among dialysis staff and patients, but this is often poorly reflected in organizational structures. PCTs also often work outside of their scope and training. Additionally, PCTs and patients form strong bonds, but these relationships are sometimes viewed as problematic. Results highlight the complex, valuable role PCTs play in US dialysis care, as well as areas to improve to ultimately improve patient care.
"中心的心脏":探索病人护理技术员在美国透析护理中的作用。
理由与目的:透析患者护理技术人员(pct)为接受中心血液透析的患者提供必要的一线护理。我们定性地探讨了当前的PCT、非PCT透析人员和接受血液透析的患者对PCT工作角色、职责和培训的看法。研究设计:焦点小组研究。背景和参与者:于2023年3 - 5月在美国pct、非pct工作人员和患者中进行了讨论。分析方法:运用归纳和演绎策略进行主题分析。结果:共进行了7个焦点组(N = 36),其中pct组3个[N = 19],非pct组2个[N = 6],患者组2个[N = 11]。出现了八个主题:(1)PCT作用的价值没有反映在工作或组织政策和结构中;(2) pct在透析诊所中发挥着灵活且往往不明确的作用;(3)尽管职业倦怠的风险很高,但pct仍能找到坚持并提供高质量护理的方法;(4) pct通常被视为“助手”或辅助,而不是透析护理团队的组成部分;(5) PCT岗位培训和资格不规范,往往与岗位期望和职责不相称;(6) pct患者关系受到高度重视,但由于透析护理的频率和性质,界限可能是不稳定的,变得模糊;(7)透析患者和工作人员易发生多层次的安全生产问题;(8) PCT-staff动态对员工士气、诊所效率和患者满意度有显著影响。局限性:不讲英语的参与者和医生被排除在外,限制了观点的多样性。结论:pct在透析护理中发挥着多方面的作用,在患者和工作人员中受到高度重视,但并不总是反映在pct执行的实际任务、pct接受的培训或给予pct的尊重上。我们的研究结果是可行的,可以为未来以干预为基础的工作提供信息,旨在提高PCT在美国血液透析护理中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Kidney Medicine
Kidney Medicine Medicine-Internal Medicine
CiteScore
4.80
自引率
5.10%
发文量
176
审稿时长
12 weeks
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