Nursing Journal Club Connecting Research, Evidence-Based Practice & Education with Daily Nursing Care By: Trisha Ryan, RN, MSN, MHA Acting Nurse Educator, PeriAnesthesia Nursing Services, Johns Hopkins Hospital September, 2013

Objectives Background Data on Nursing Journal Clubs. Evidence Based Practice & Journal Clubs. Research & Journal Clubs. Journal Clubs & Magnet. Journal Clubs influence on Nursing Education. How to start a Journal Club. Journal Club Criteria. How to maintain interest & keep process growing.

Journal Club Background Data First Journal club – 1875 – Sir William Osler ( medical only). Two main functions of Journal Clubs: Keep nurses & students up to date on clinical research. Improve clinical nurses ability to evaluate published research critically. Journal Clubs play key roles in EBP, Research, Nursing Education & Patient Care. First nursing late 20th century. (Patel, & et all, 2011) (Pierre, 2005)

Influence of Journal Clubs on Evidence Based Practice (EBP) Encourages clinicians to apply their updated data to relevant cases. Encourages RNs to use current, up to date knowledge to facilitate EBP practices. Help RNs to understand & incorporate new knowledge into daily practice. Enhances RN appraisal skills & the learning process. (Patel, & et all, 2011)

Journal Clubs & Magnet Status Magnet facilities are top 6% for nursing care. Skills in quality care & quality improvement. Nursing Journal Clubs: great first step in demonstrating Magnet level status. Improves stakeholder buy-in to improving care. Meets many facilities designs for strategic goal planning regarding Magnet. (Patel, & et all, 2011)

Journal Clubs Influences on Nursing Research Barriers to Nursing Research RNs’ inability to understand, critique,& interpret data found in research journals RNs’ perceived inability to affect change RN leadership not supportive of nursing research Ways Nursing Journal Clubs can help Improves RN’s ability to interpret & critique data Improves RN’s confidence in research role Encourages RN leadership to support research efforts. (O’Nan, 2011)

Journal Clubs & Nursing Education Positives & Negatives Assists students to develop critical thinking skills while still in a classroom setting. Fostered collaborative learning activities for RNs & nursing students. Pertinent topics, sufficient time, comfortable setting, & interactive/ motivated facilitators promote learning. Journal clubs thought to be great “teaching & learning methods that promote understanding, attitudes, motivation & competencies essential for producing evidence based care.” Increased dishonesty with nursing students that participated in journal clubs (plagiarism). (Laaksonen, & et al, 2013) (Laaksonen, & et al, 2013, p 286) (Woith, Jenkins, & Kerber, 2012)

How to start a Journal Club Determine whether unit based or hospital based. Work with Department Lead person to back process. Determine locations to search for Journal Club level articles. Determine meeting locations. Determine proper times & dates that RNs can attend. Be prepared to devote time each month to the process. Become credentialed in applying for CEUs through ANCC. (AJCC, 2002)

Journal Club Criteria for CEUs Peer Reviewed article at least 7 pages = 1 hr CEU. Article no more than 5 years old. Needs assessment performed relating to topic. CEUs File forms 1 month prior. Pay for any ANCC CEU dues. Must have evaluations from RNs. Must keep attendance record 5 yrs.

How to check the validity of the Journal or Research article Peer Reviewed - # 1 test. Current research (< 5 yrs old). Demographic group. Noted Bias’. Missing groups. Type of research – Quantitative/ Qualitative: Quantitative – Looking for # of common factors. Qualitative - Looking for factors that affect outcomes. (AJCC, 2002)

Formulate Journal club objectives Look at 3 major categories in the article: Demographics, population, mix of pts or criteria. Treatment or action specifics. Strength of research – look for possible bias. Formulate key items for each category to focus on. Formulate questions relating to points that get staff looking for material within the article. Formulate two ways to look at each category (ask what if and what if not?).

Formulate Journal club questions Review article for thought provoking questions. “Relate to practice” questions – Who has had this experience? Ask for group experiences with issues. Look for specific topic questions. Objective covering questions. Open ended questions to spark discussion.

How to Market the Journal Club to the Organization Gather & include key stakeholders: RN staff Directors & Assistant Directors Nursing Coordinators Nurse Managers Create communication network. Send out article & club questions at least one week in advance. Provide copies the day to stakeholder units.

Journal Club Meeting Environment Comfortable circle style. All participants in seated positions. Facilitator acts as a guide, not a lecturer. Quiet, away from distraction. Not on unit, away from patient care if possible.

Article Scenario Read provided article. Be ready to talk about following questions. What barriers are there to implementing EBP? What are some ways to overcome these barriers? What types of experiences have you had with EBP projects? What benefits have been associated with journal clubs? What are the steps to starting a journal club? (Lippincott’s Evidence Based Practice Network, 2013)

Evaluation Always need to evaluate the quality of the process. Should include questions on:(via Likert scale) Environment suitability. Instructor preparedness. Appropriateness of material . Interest of topic. Suggestions for improvement or future topics. Should be obtained before giving out certificates. Should be reviewed & feedback reported per ANCC CEU requirements to improve future meetings.

Keeping Journal Club growing Keep material relevant to stakeholders. Keep material up-to-date with unit issues. Keep creative in ways of presenting material (insert brief puzzles, games or quizzes to change things up). Explore multi user online systems or webcasts to increase long distance audiences. (Billingsley, Rice, Bennett, & Thibeau, 2013)

Questions

References American Journal of Critical Care Journal Club. (2002). What is a journal club? From the AJCC website located at http://ajcc.aacnjournals.org/site/misc/journalclubw ebpage.pdf Billingsley, L., Rice, K., Bennett, M., Thibeau, S., ( 2013). Using a Multiuser Virtual Environment to Facilitate Nursing Journal Clubs. From Clinical Nurse Specialists, V 27, I 3 (pp 146 -154) Laaksonen, & et al. ( 2013). Journal club as a method for nurses and nursing students’ collaborative learning: A descriptive study. From Health Science Journal, V 7, I 3 (pp 285 – 292)

References Cont Lippincott’s Evidence-Based Practice Network (2013). Evidence-Based Practice Network. From Lippincott’s Nursing Center. Com located at http://www.nursingcenter.com/evidencebasedpracticenetw ork/EBP-Blog-Landing- page/ShowMeTheEvidence/November-2012/Using-a- journal-club-to-increase-EBP-knowledge-and O’Nan, C. L. ( 2011). The effect of a journal club on perceived barriers to the utilization of nursing research in a practice setting. From Journal of Nursing in Staff Development, V27, N 4 (PP 160- 164) Patel, & et al. ( 2011). Evidence-based practice and a nursing journal club; An equation for positive patient outcomes and nursing empowerment. From Journal for Staff Development, V 27, N 5 (pp 227 – 230)

References Continued Pierre, J. S. (2005) Changing nursing practice through a nursing journal club. From The Journal of Med-Surg Nursing, V 14, N6 (PP 390 – 392) Woith, W. M., Jenkins, S. H., Kerber, C. H. ( 2012). The impact of a journal club intervention on student perceptions and behaviours regarding academic dishonesty. From Journal of Nursing Education and Practice, V3, N3 (pp 27 – 34)