BONENT: A Historical Perspective of Growth & Services to the Dialysis Community

The Early Years: Why We Started

BONENT 40th Anniversary

In the early 1970’s, two professional organizations were competing for the membership of nurses and technicians working in the nephrology field, principally in the areas of dialysis and transplantation. These organizations were: The American Association of Nephrology Nurses and Technicians (AANNT) and the American Society of Extracorporeal Technologists (AMSECT).

Each group was concerned with the professional credentials of personnel providing direct patient care. AANNT had about 1,500 members, of which 85% were nurses and 15% were technicians. AANNT was an educational organization, its major activities being an annual meeting, five regional meetings, publishing the AANNT Journal and other related activities.

Previously, a committee had been established to explore the feasibility of an AANNT certification examination. The committee actively investigated the models of other professional groups, the availability of funding, and sought the advice of the American Medical Association, the American Nurses Association, the American Hospital Association, the National Kidney Foundation, and the American Society of Artificial Internal Organs.

AMSECT had approximately 1,000 members. The cardiac perfusionists dominated the membership; dialysis technicians accounted for about 15% and a very small percentage was comprised of nephrology nurses. Credentialing was of critical importance to the AMSECT membership since most of the technicians, either in perfusion or dialysis, had been trained on the job and had no other formal credentials.

Recognizing this urgent need, AMSECT prepared its own certification examination written by a core of clinicians and educators pooled from the AMSECT dialysis members. During the summer of 1973, AMSECT began to administer its certification examination. For some dialysis nurses and technicians, this examination presented a new dimension for them, as no other form of credentialing previously existed.

For others, the test was simply expensive and the direct benefit to the members was not immediately realized. However, AMSECT continued to test between 1973 and 1976, indicating that the candidates felt they would derive some benefit.

AANNT reviewed the AMSECT situation and did not have an alternative to offer its membership. This was becoming an increasingly important matter in that AANNT had many more dialysis technicians in its membership than AMSECT. AANNT and AMSECT began to meet jointly to discuss what could be done to solve this credentialing problem.

BONENT: Born in April 1974

After weighing the many aspects of each organization, an independent testing body was established. This was the beginning of the Board of Nephrology Examiners (Nursing and Technology) BONENT in April, 1974.

From that period to the present, BONENT has been in an evolutionary state. The initial process was concerned with all normal procedures of formulating an organization as well as accomplishing the principle reason for which the organization was established: viable credentialing.

Testing is a complex and on-going process. Large sums of money are necessary to support this type of an endeavor. Seed money was provided in the form of grants from AANNT and industry representatives. Funds are now generated through exam candidates and membership annual support.

BONENT contracted with a professional examination service to help develop and administer the technologist examination - Certified Hemodialysis Technician (CHT). The core curriculum was defined and candidate requirements developed so that by April, 1976, a pre-test was administered at the AANNT national meeting. In the early years, the examination was offered at AANNT national and regional meetings.

Recertification would also be required every four years.

The CHT Exam Expands Beyond Theory

The hosting method of administration was later introduced so that candidates could take the Paper & Pencil Examination (PPE) throughout the year in their local areas. A major revision of the exam occurred in 1983, which allowed BONENT to focus its testing on the practice of hemodialysis therapy rather than on theory alone.

CHN Starts in 1979

Future plans always included expansion of existing exams to reflect the increasing specialization of both dialysis nurses and technicians. Once the organization felt comfortable with its technologist exam process, it expanded its offerings in 1979 to include a nursing exam and credential - the CHN - Certified Hemodialysis Nurse.

Constant Revisions to Exams

Examination performance is under continuous review and revisions in all examinations are undertaken on a regular basis.

Peritoneal Started in 1989

In 1989, BONENT introduced a certification examination for the peritoneal dialysis specialty by developing the Certified Peritoneal Dialysis Nurse (CPDN) exam.

Office Moves

The BONENT Executive Office has provided exam coordination and member services from Madison WI, then later from Lenexa KS and most recently from the Washington DC area since 2006.

CBT Available in 2008

In an effort to reach as many nephrology professionals as possible, the Board of Directors decided to implement Computer Based Testing (CBT) across the United States and many other countries. All three exams, at that time were made available at all locations. This exam method has now overtaken the PPE as the leader in exam method of choice.

Federal Government 2010 Certification Mandate

The new ESRD Rules & Regulations approved by the U.S. Federal Government’s Centers for Medicare & Medicaid Services (CMS) were published with comments in the Federal Register (4-15-08). The 116-page CMS ESRD Final Rules stipulated that newly-employed patient care technicians must be certified within 18 months of being hired as a dialysis patient care technician.

And for those PCTs employed on or before October 14, 2008, they would need to be certified within 18 months after that date.

This decision would have quite an effect on the improvement to the quality of patient care. It also was a boon to the numbers of PCTs to become certified in the years following this major decision.

Providing CE via Regional Seminars

With the federal mandate above, BONENT established the Continuing Education Programs Committee to oversee the establishment of providing continuing education hours to its certified members. Its first foray in this area was to provide CE via Regional Seminars. Its first, the Mid-West Regional Seminar, was held in Chicago in July 2012, with over 125 attendees.

Due to the positive feedback from its members, this seminar was followed in 2013 by the Southeast (Orlando FL), the Great Lakes (Cleveland OH) and the Northeast (Newark NJ) regional seminars.

2014 - The BONENT 40th Anniversary: BioMed and CHT Spanish

A new exam catering to the BioMed professional has been under development for some time and will be made available to BioMed professionals in September 2014.

Again to expand its market, the CHT exam has been translated into Spanish and will also be made available, at first, via PPE in the United States only. Once it is evaluated, it will go global.

As you can see BONENT not only continues to evolve, seeking to meet the changing needs of viable credentialing in the nephrology field, but it boasts over 7,000 certified members in 10 countries.