The work environment of haemodialysis nurses and its impact on patients' outcomes

The aims of this study were to assess haemodialysis nurses' work environment and investigate the correlation between work environment and patients' outcomes. A cross-sectional study was conducted at the 11 public hospital-based haemodialysis units of the 5th Regional Health Authority of Greece. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess work environment. Nurses were asked to report the frequency of a series adverse events and errors. Study population consisted of 133 nurses (response rate 89.3%). The overall PES-NWI scored just <2.5 (Mean=2.48, standard deviation=0.34) indicating a non-favourable haemodialysis workplace. Nurse-physician Relations, nurse manager ability and nursing foundations for quality of care were the most favourable aspects of work environment. Multivariate logistic regression analysis identified that hypotension (odds ratio (OR)=0.3, 95% confidence interval (CI)=0.1-0.9, P=0.03), venous needle disconnection (OR=0.14, 95% CI=0.03-0.65, P=0.012) and patient fall (OR=0.02, 95% CI=0.001-0.51, P=0.018) were associated with a non-favourable work environment. Findings have important implications for improvement of haemodialysis work environment and enhancement of patients' safety.