Transcript Launching and Sustaining Unit Based Jounal

Marti Buffum, DNSc, RN, PMHCNS-BC
Associate Chief Nurse for Research
Deborah Burgoon, MS, RN, AOCN
Clinical Nurse Specialist, Oncology
VA San Francisco
Kaiser Permanente Nursing Research Council
March 8, 2011
Objectives
 Explore purposes and types of nursing journal clubs
 Identify methods for beginning and sustaining journal
clubs
 Describe evaluation methods
Types of Journal Clubs
 Topic-based
 Updating
 Informative
 Team building
 Evidence-based problem solving
 Finding solutions
 Journal-based
 Specific specialty journal (AACN, JPN, GN)
Reasons for Journal Clubs
 Intellectual stimulation
 Appreciating others’ expertise
 Learning resources among each other
 Developing professionalism
 Remote: e-journal club, phone
 New projects can emerge
 Demystification of research
 Developing skills
How to Start: 6 steps!
 Post and distribute article
 Include discussion questions
 Plan time and location and ANNOUNCE!
 Identify facilitator
 Conduct the journal club
 Evaluate
 Schedule next meeting
Kleinpell, R. (2002). Rediscovering the value of the journal club. American
Journal of Critical Care. 11(5), 412-13.
Customize to Your Area
 Nurse manager guidance and support
 Utilize experts as needed
 Engage staff, find enthusiastic champions
 Take turns presenting
 Encourage discussion
 Openness and flexibility required
 Use incentives (food?); provide CEUs
 Create “take home message” and post
 Keep continuous schedule
 Include staff from other units when ready!
Remote Locations
 Virtual journal club
 Email distribution of everything

Time delay
 Live meeting
 Conference 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
Club
How 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 knowledge
 Being involved in discussion
 Change opinion/view
 Widen understanding
 New information
 Informative and educational
 Leaning something in depth
 Increase interest about what we’re doing
 Keep up with current changes/education/new knowledge
Why volunteer to do an article review?
 Increase self-confidence in public talking and discussion
 Increase knowledge of the unit as a whole
 Advance career activities, help unit, want to contribute
 Share info with staff
 Do it for research
 Way overdue, we should have done this before
 Nurse Manager’s encouragement
 I can learn something
 I’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 problem
 Tight work load might stress staff
 Try at lunch time
 Maybe administrative time should be given
How to evaluate
 Everyone is at a different pace/level
 Consider journal club as an innovation
 Rogers’ model of diffusion
 Appreciation to Keri Nelson (2006) for assisting with evaluation
Who is Rogers and what is Diffusion of
Innovation?
 Stages of Adoption:
 Knowledge
 Persuasion
 Decision
 Implementation
 Confirmation/Adoption
Keys to Success
 Understanding the stages of development can improve
patience with adopting changes
Knowledge
 What 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?
Persuasion
 How 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?
Decision
 How 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?
Implementation
 After 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/Confirmation
 Journal 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 Club
 What 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)