While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that nurses' perceptions of the dialysis work environment are important for nurse and patient outcomes in dialysis settings. Further research is needed to explore the predictive ability of the work environment for nurse and patient outcomes in hemodialysis units.

译文

:尽管尽管患有5期慢性肾脏病的人数不断增长,但肾脏科护士短缺仍然存在,但是关于肾脏科护士对其工作环境的看法的经验数据很少。此外,尚无研究检查透析环境中工作环境属性与患者和护士结局之间的关系。这项研究的目的是检验护士对透析工作环境的看法,护士离开当前工作的意图,护士离职率,患者满意度和患者住院率之间的关系。使用了描述性的相关设计。获得了护士级别和设施级别的数据。护士级别数据的样本包括在一家国家透析公司的56个透析设施中担任工作护士角色的199名注册护士。用于设施级分析的样本包括46个透析设施,并且汇总了护士级数据以进行设施级分析。实践环境量表-护理工作指数(PES-NWI)用于衡量护士对透析工作环境的看法。护士离开工作的意图和机构级别的离职率是本研究中检查的护士结局。设施水平的患者满意度和住院率是检查的患者结局。计算相关系数以衡量研究变量之间的关系,并进行独立的t检验以检验工作环境感知中的亚组差异。总体而言,护士对工作环境的评价较高。与打算留下来的护士相比,打算离开工作的护士对工作环境的评价更为负面。在护士对透析工作环境的看法,护士离开工作的意愿,护士离职率和患者住院之间,发现了显着的相关性。研究结果表明,护士对透析工作环境的理解对于透析环境中的护士和患者结局非常重要。需要进一步的研究来探索工作环境对血液透析部门护士和患者结果的预测能力。

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