Hemodialysis care by nurses: exploration of performance factors at four nephrology units in Rwanda

Background: Hemodialysis is the most standard method of Renal Replacement Therapy (RRT) used in Rwanda. Nephrology nursing is a new speciality, and little is known about the nurses’ work performance while caring for patients under going hemodialysis. Objective: To explore factors influencing nurse’s work performance in the care of hemodialysis patients in four nephrology units in Rwanda. Methods: A qualitative descriptive design used a purposive sampling strategy to recruit 12 registered nurses working on the hemodialysis unit. Data were collected through interviews using a semistructured guide. Data analysis used a thematic approach with six phases. Results: Two themes and eight subthemes were revealed. Facilitating factors to increase work performance included the nurses’ education and speciality training, good working environment, good interpersonal relationships among staff, and effective management and leadership. Barriers included, self-perceived knowledge and skills insufficiencies, moral distress, logistical concerns, and poor working conditions. Conclusion: The findings revealed specific facilitating factors and barriers to nurses’ work performance. Nurses at these study sites, in conjunction with faculty in the Master’s Nephrology Track at the University of Rwanda, could become change agents and begin to increase facilitating factors and decrease barriers. Continual improvement in facilitating factors is needed to keep nurses performing well. Keywords: Nephrology, hemodialysis, nurses, work performance