PCT recertification—Pathway for professional growth

How do we define “professionalism” in our workplace? Ask this question and you will receive a number of meanings based on the individual's experiences in the workplace. Professionalism in practice has been described as committing to teamwork, adhering to ethical principles and practices, demonstrating sensitivity to diverse patient populations and end-oflife care, and taking personal responsibility for professional growth and development to enhance patient care.

When Centers for Medicare & Medicaid Services (CMS) released a final rule for Medicare conditions for coverage (CfC) in 2008, certification of hemodialysis patient care technicians (PCTs) was mandated. Certification could be obtained by passing a CMS-approved exam and is required in order for a PCT to provide direct patient care in a hemodialysis clinic.1 Beyond the mandate, certification and recertification contributes to professional growth and development though education and the opportunity to network with peers and other professionals for sharing of information. Therefore this certification requirement, along with regular intervals of recertification, can be seen as moving forward the formal recognition of the PCT as a professional member of the nephrology team.

The requirement by CMS for patient care dialysis technicians to be certified can be found at 42 CFR 494.140(e)(4) in the Conditions for Coverage;1 The patient care dialysis technician is to be certified under a state certification program or a national commercially available certification program.

BONENT certification must be maintained with an annual certification fee of $55 (in 2011), or $200 for four years in advance. There is no extra fee for recertification if the annual certification fee is paid.5

See the NNCC website (www.nncc-exam.org) for review of this and additional information concerning PCT recertification.

Further information for attainment of recertification through NNCO can be found at www.nnco.nbccc.net and www.ptcny.com/clients/NNCO.

Several states have implemented a PCT certification and competency-testing program. To meet the requirements of 42 CFR 494.140(e)(4), a PCT certificertification program must be equivalent to the approved commercial national certification programs. CMS requirements include standardized testing reflecting the content listed in the regulation, administered in a proctored environment unrelated to any dialysis facility, and having a process in place for ongoing certification.3 State certification allows a certified PCT to practice in the State in which he or she is employed as a PCT.

One example of a state with provisions or requirements that meet CMS approval is the alternative pathway for California PCTs. Details and guidelines can be found at the websites http://www.californiadialysis.org/res_pct_info.html and www.californiadialysis. org/CHT_Exam_Info.html.

In a 2010 editorial, Danilo Concepcion reminds us is that “Passing an exam is not the end-all evidence that demonstrates the ability to produce the best outcomes for the dialysis patient.”10 We are encouraged to view certification and recertification as a base to build upon to support the development of knowledge and skills through continuing education opportunities.