Patient care hemodialysis technicians (PCTs) perform most of the highly technical clinical treatment and routine tasks in dialysis facilities. Although certification is required within 18 months of hire, no national infection prevention and control training program exists for this workforce. Literature focused on the infection prevention clinical practices of technicians is minimal. Additionally, there is no published literature detailing the on-the-job training of dialysis technicians, nor their capability, opportunity, or motivation to apply infection prevention recommendations into their clinical practice. The purpose of this study was to understand the on-the-job training received by certified PCTs in hemodialysis facilities, investigating the interplay of capability, opportunity, and motivation on their infection prevention behavior. Participants included certified PCTs working in United States hemodialysis facilities. Data was collected using an online survey. The first aim characterized how certified PCTs receive infection prevention education upon hire into the profession, and the content of the education. Survey respondents overwhelmingly reported receiving IPC training from other PCTs during orientation (92.3%). Newer dialysis technicians were more likely to have received online teaching when first hired , whereas more experienced and older PCTs reported receiving on-the-job coaching with registered nurses. The second aim assessed how PCT education, training, and experience were associated with PCT infection prevention capabilities, motivation, and opportunities. Results showed that PCTs with prior healthcare work experience had higher hand hygiene knowledge scores. The third aim assessed how capability, opportunity, and motivation of PCTs are associated with infection prevention behavior. Results showed PCTs were more likely to perform hand hygiene between patients if they had a higher reflective motivation score, and more likely to perform IPC tasks during emergencies with a higher social opportunity score. More research is needed due to the small sample size of this exploratory study. These findings are a first step to acknowledging the important work that PCTs provide in the dialysis setting, their education and training needs, and the ultimate impact their profession has on the safety of a half million hemodialysis patients. Future research should focus on increasing reach into PCT population to achieve more generalizable and actionable data.
