Exploration of factors influencing nurses’ performance in the care of hemodialysis patients at selected nephrology units in Rwanda.

Abstract

Introduction: Hemodialysis is the commonest and successful treatment method of renal diseases that requires high technology, needles, skills and knowledge of providers. The procedure runs the risk of associated errors and issues of harm to patients. Nurses play major role in the delivery of this treatment by providing all pre, inter and post hemodialysis nursing care. Therefore, nurses need to understand all aspects of such technology, have the hands-on skills, be highly knowledgeable and have enough expertise to be able to meet patients‟ needs. Aim: The aim of the study was to explore factors influencing nurse‟s performance in the care of hemodialysis patients in selected nephrology units in Rwanda. Method: A qualitative survey design was used involving twelve registered nurses from UTHK, UTHB, KFH and KDC Hemodialysis centers. A purposive sampling strategy was used. Data were collected through face to face interview and were audio recorded. Six steps of thematic analysis approach namely familiarization with data, generating initial codes, searching for themes, reviewing themes, defining and naming themes and producing the report were followed to analyze collected data. Results: Two main themes emerged from the study. The first entitled “Facilitating factors of nurse‟s performance‟‟ had six subthemes namely the continuous professional developments that nurses received, good interpersonal relationship among staff, personal factors, good working environment, receiving feedbacks on nurse performance and effective leadership and management. The second theme was “barriers to the performance of nurses” made of six subthemes namely the personal related barriers, poor working conditions, organizational barriers, poor resources, poor collaboration within staff and patient-related barriers. Conclusion: The findings obtained from this study revealed a sufficient number of facilitating factors and barriers to the performance of nurses in hemodialysis settings in Rwanda. Strategies should be put in place to address to identify barriers to enhance nurse performance and patients care and sustainability of facilitating factors in nursing practice, especially in HD units.