Gardner Jane K, Thomas-Hawkins Charlotte, Fogg Louis, Latham Carolyn E
Renal Care Group, Nashville, TN, USA.
Nephrol Nurs J. 2007 May-Jun;34(3):271-81; quiz 282.
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.
尽管5期慢性肾病患者人数持续增长，但肾病护理人员短缺的情况依然存在。目前，关于肾病护士对其工作环境看法的实证数据匮乏。此外，尚无研究探讨透析环境中工作环境属性与患者及护士结局之间的关系。本研究旨在探讨注册护士对透析工作环境的看法、护士离职意向、护士离职率、患者满意度和患者住院率之间的关系。采用了描述性、相关性设计。获取了护士层面和机构层面的数据。护士层面数据的样本包括一家全国性透析公司56家透析机构中担任注册护士的199名护士。机构层面分析的样本包括46家透析机构，并对护士层面的数据进行汇总以进行机构层面的分析。使用护理工作指数实践环境量表（PES-NWI）来衡量护士对透析工作环境的看法。护士离职意向和机构层面的离职率是本研究中考察的护士结局。机构层面的患者满意度和住院率是考察的患者结局。计算相关系数以衡量研究变量之间的关系，并进行独立t检验以检验工作环境看法方面的亚组差异。总体而言，护士对工作环境的评价较为积极。与打算留任的护士相比，表达离职意向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、护士离职意向、护士离职率和患者住院率之间发现了显著相关性。研究结果表明，护士对透析工作环境的看法对透析环境中的护士和患者结局很重要。需要进一步研究来探索工作环境对血液透析单位护士和患者结局的预测能力。
