Table 4.

Strategies to improve nurse engagement in home dialysis programs

Home Dialysis Nurses
AdvantagesDisadvantages
 Schedule of 8 am to 5 pm Less opportunities for growth into leadership, considering smaller market share of patients on home dialysis
 No scheduled work on holidays or weekends Call responsibilities for after-hours issues
 1:1 care of patient, starting with evaluation, training, and then care at home Lack of moonlighting opportunities
 Role in education and training
 Nurse to patient ratio (1:20 at UAB) may appear high, but ability to see patients at your own pace
Measures that helped our program in high retention of staff
 Offer a 4-day work week
 Offer flexibility in work and call schedule
 Dedicated steps toward staff engagement, including team building efforts and quality incentives
 Ongoing discussions, with success, with LDO to adjust nurse/patient ratios (overstaffing) to
  Accommodate for training and growth
  Achieve quality and safety measures
  Train new hires
 Cross-training of nurses in home hemodialysis and peritoneal dialysis
Proposals for a national level policy change
 Consider incentives for nursing staff engaged in home modalities
 Dedicated effort to offer leadership and growth opportunities to home dialysis nurses
  • UAB, University of Alabama at Birmingham; LDO, large dialysis organization.