Marti Buffum, DNSc, RN, PMHCNS-BC Associate Chief Nurse for Research Deborah Burgoon, MS, RN, AOCN Clinical Nurse Specialist, Oncology VA San Francisco.

Marti Buffum, DNSc, RN, PMHCNS-BCAssociate Chief Nurse for Research

Deborah Burgoon, MS, RN, AOCNClinical Nurse Specialist, Oncology

VA San Francisco

Kaiser Permanente Nursing Research CouncilMarch 8, 2011

ObjectivesExplore purposes and types of nursing

journal clubsIdentify methods for beginning and

sustaining journal clubsDescribe evaluation methods

Types of Journal ClubsTopic-based

UpdatingInformativeTeam building

Evidence-based problem solvingFinding solutions

Journal-basedSpecific specialty journal (AACN, JPN, GN)

Reasons for Journal ClubsIntellectual stimulationAppreciating others’ expertiseLearning resources among each otherDeveloping professionalism

Remote: e-journal club, phoneNew projects can emergeDemystification of researchDeveloping skills

How to Start: 6 steps!Post and distribute article

Include discussion questions

Plan time and location and ANNOUNCE! Identify facilitatorConduct the journal clubEvaluateSchedule next meetingKleinpell, R. (2002). Rediscovering the value of the journal club.

American Journal of Critical Care. 11(5), 412-13.

Customize to Your AreaNurse manager guidance and support

Utilize experts as neededEngage staff, find enthusiastic championsTake turns presentingEncourage discussion Openness and flexibility required Use incentives (food?); provide CEUsCreate “take home message” and postKeep continuous schedule Include staff from other units when ready!

Remote LocationsVirtual journal club

Email distribution of everything Time delay

Live meetingConference calls

APN Journal Club: Learnings

Some of the things I have gained from participating in our journal club (not necessarily in order of importance):

An increased sense of collegiality with other facility NPs with different areas of expertise.

 Expanding one’s knowledge base both from the review

article as well as from NPs with different areas of expertise.

 Ensuring that our clinical practice is evidence based and

is up to date. Improving collegiality with physician colleagues by

being able to intelligently discuss recently published studies.

APN Learnings (cont’d)Opportunity for collaboration and future consultation

Reading outside of my specialty that I would not normally do

Reading new materials that relate to all of us and our practice (e.g., effectiveness of different diets, patient education strategies)

Becoming less fearful about research critique imperfections!

Unit Based Journal ClubHow do staff feel about their new Journal Club?All staff feel “good, great” about Journal Club.

 What do staff like about Journal Club? Learning a lot Increased knowledgeBeing involved in discussionChange opinion/viewWiden understandingNew information Informative and educationalLeaning something in depth Increase interest about what we’re doingKeep up with current changes/education/new knowledge

Why volunteer to do an article review?Increase self-confidence in public talking and discussionIncrease knowledge of the unit as a wholeAdvance career activities, help unit, want to contributeShare info with staffDo it for researchWay overdue, we should have done this before Nurse Manager’s encouragementI can learn somethingI’ll wait until I become more comfortable talking in front

of staff 

Should other units have Journal Clubs?All staff said “yes, other units should do it

too.”

What advice would you give? Time might be a problemTight work load might stress staffTry at lunch timeMaybe administrative time should be

given

How to evaluateEveryone is at a different pace/levelConsider journal club as an innovationRogers’ model of diffusion

Appreciation to Keri Nelson (2006) for assisting with evaluation

Who is Rogers and what is Diffusion of Innovation?Stages of Adoption:

KnowledgePersuasionDecisionImplementationConfirmation/Adoption

Keys to Success

Understanding the stages of development can improve patience with adopting changes

KnowledgeWhat is journal club?How do you get a journal club started on

your unit?What is evidence-based practice and how

can journal club be used as a vehicle to adopt changes?

PersuasionHow do you get leaders and managers to

buy-in to the importance of starting journal clubs?

How do you promote journal club participation among staff on each unit?

DecisionHow do you decide if journal club is worth

implementing?Is journal club relevant to the nursing

practice on each unit?How is the staff going to respond to the

implementation of journal club?

ImplementationAfter journal club is initiated, how do you

motivate and encourage participation among staff?

How do you empower (provide resources, support and time) staff to participate?

What aspects of journal club impacts nursing practice?

Adoption/ConfirmationJournal club has been successfully integrated

into the nursing culture on the unit.The staff values participating in journal club

and volunteer to present articles with meaningful discussion.

The articles/journals provide strong evidence for practice application.

Decisions for Journal ClubWhat type of article?

Research? Are findings ready for practice?

What more is needed?What more would you like to know?

Usefulness of discussing in a group?How to evaluate (see handout, poster)