“The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care
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...
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Elsevier
2025-01-01
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| Series: | Kidney Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590059524001456 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Megan Urbanski |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-da9bd07cd39f4a0a9786ae029d73f285 |
| institution | OA Journals |
| issn | 2590-0595 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj-art-da9bd07cd39f4a0a9786ae029d73f2852025-08-20T01:54:53ZengElsevierKidney Medicine2590-05952025-01-017110093410.1016/j.xkme.2024.100934“The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis CareMegan Urbanski0Emma Blythe1Alicia Hamblin2Alexis A. Bender3Courtney Hoge4Clarica Douglas-Ajayi5Fran Rickenbach6Jessica Joseph7Kelli Collins Damron8Jennifer Craft Morgan9Bernard Jaar10Laura Plantinga11Division of Transplant, Department of Surgery, Emory University School of Medicine, Atlanta, GA; Health Services Research Center, Emory University, Atlanta, GA; Address for Correspondence: Megan Urbanski, PhD, MSW, 101 Woodruff Cir, Suite 1023, Atlanta, GA 30322.Health Services Research Center, Emory University, Atlanta, GADivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CADivision of Geriatrics and Gerontology, Department of Medicine, Emory University School of Medicine, Atlanta, GADepartment of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GANational Association of Nephrology Technicians/Technologists, Dayton, OHNational Association of Nephrology Technicians/Technologists, Dayton, OHNational Kidney Foundation, New York, NYNational Kidney Foundation, New York, NYGerontology Institute, Georgia State University, Atlanta, GADivision of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MDDivision of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA; Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CARationale & 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.http://www.sciencedirect.com/science/article/pii/S2590059524001456Focus groupshemodialysishealth care workerskidney failurepatient care technicianqualitative research |
| spellingShingle | 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 “The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care Kidney Medicine Focus groups hemodialysis health care workers kidney failure patient care technician qualitative research |
| title | “The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care |
| title_full | “The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care |
| title_fullStr | “The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care |
| title_full_unstemmed | “The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care |
| title_short | “The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care |
| title_sort | the heart of the center exploring the role of the patient care technician in us dialysis care |
| topic | Focus groups hemodialysis health care workers kidney failure patient care technician qualitative research |
| url | http://www.sciencedirect.com/science/article/pii/S2590059524001456 |
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