Progress in health care and nursing delivery is a given. Keeping up with progress is another matter. The information era has created unprecedented opportunity for communication but also potential for information indigestion.
Nursing is task oriented, by nature busy. Although necessary, there is little time in a nurse’s day for reflection that enables progress on best practices. Yes keeping up with current research and development is critical for progress and professional development but the what is superseded by the how. How to keep current and incorporate new knowledge and advancements?
Sometimes a tried and true idea can be reinvented to enable a goal to be reached. This is true of nursing.
Nursing journal clubs have been around for decades. There is increasing awareness that journal clubs are an effective forum for translating research into evidence based patient care at the bedside. Don’t let the name fool you into thinking that it is anything like a book club. The nursing journal club has enhanced patient care delivery in many locations through thought provoking discussion and sharing of peer experiences. Thus nurses are empowered to make a positive difference in their organization.
Journal clubs enable nurses to take control of their learning and continuing education. By studying new research in journal clubs nursing care can be changed in measurable ways. For instance an urban hospital’s progressive care unit end of life care challenges were a topic of interest. Ethical quandaries arose when the staff were asked by patients’ families to discontinue life support. The journal club in this unit discussed articles on this topic and also the hospital’s own policy. They also involved the Palliative Care team to present at one session. As a result nurses were able to express their feelings and a bereavement committee was formed that supported both patients and staff. This resulted in improved inter-professional and patient staff communication. In another example the journal club’s discussion of stroke victims treatment in the emergency department led to a decrease in wait times between admittance and testing..
Journal clubs are meetings in different formats. The basis of each meeting can be a research question or topic, a clinical challenge or innovation. Topics such as workflow analysis, feeding tube placement, increasing efficiency in critical care, streamlining care delivery, and the effect of noise on patient stress levels have been discussed in JC. They can be unit based or participants can be in the same area of nursing or from the same institution. Participants are informed of the topic in advance of the meeting. The facilitator can be a nurse manager or guest speaker. It helps to have one overall organizer but the responsibility for facilitating each meeting can be rotated among members. Rotation also enables more commitment and participation.
Setting up a Journal Club
There are several points to consider in setting up a journal club.
The meeting time and place and frequency should encourage maximum participation by making it easy to get to. Members must decide how to encourage participation and awareness of the club’s existence. The HCO ‘s internal network and social media are good ways to advertise. Some clubs have sponsors who cover expenses for room rentals or provisions. But sponsorship could create a perception of conflict of interest if they are companies involved in the medical field such as pharmaceutical or medical equipment companies.
The continuing success of a journal club will depend on the motivation for the club’s existence and access to resources on the newest research, such as hospital libraries, nursing schools, or organizations at the national level. Providing time for the nurses to attend is also another challenge. The most successful clubs have a consistent time and date.
The journal club must decide on a focus. Is the goal to develop research evaluation skills? Or is it to analyze current research to compare it to actual organizational practice, policy, or protocol? Most journal clubs would probably agree that research study should support and enhance nursing care delivery. The guidelines for article and research review must be in step with the journal club’s stated purpose.
Here are some potential questions and discussion points that could be used to create a journal club agenda:
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Discuss the study’s purpose, setting, population, and major findings. Does other research support those findings? What are the implications of this study for nursing care delivery? Is this study relevant to our organization? Will our organization adopt changes and if so how?
What is the clinical practice or research question the article is addressing? Are the purpose, major concepts clearly identified and defined? Are the clinical recommendations supported by scientific evidence? Compare the clinical recommendations to your organization’s practice, policies, and procedures. Discuss the sampling characteristics, and methods. Do the results support the articles findings?
Central Arkansas Veteran’s Healthcare System began their journal club experience by hosting a workshop for potential journal club leaders. They advertised and held a meeting where they outlined the criteria for an effective leader. Those criteria included the skill to locate research relevant to the facility, and adopting creative strategies to foster effective discussion. Through an open house, the nurses on their night shift were also motivated to start their own journal club.
Technology and social media means that there are various methods to achieve a journal club meeting if participants are unable to be physically present all at once in one location. For example teleconferencing was used to connect a remote academic location in the Arctic with a Maritime school of nursing in Canada to help undergrad nursing students become more proficient in understanding and evaluating research. Technology can also enhance meetings, such as interactive polling where participants’ responses are immediately visible on a screen. This can encourage audience feedback.
The journal club must conduct ongoing evaluation of its perceived effectiveness and incorporate feedback from members to maintain its relevance.
Successful journal clubs can change attitudes from “oh brother not another commitment” to “this time spent will meaningfully connect me with my peers to give me the tools, knowledge and encouragement I need to advance in my nursing practice.” As one nurse put it: Studying research reminds us that we are not just nurses doing tasks, we are scientists practicing the science of nursing.”
- Sources:
Canadian Nurse February 2011 Vol. 107 No 2 pp 19-23
MEDSURG Nursing Sept/Oct 2010 Vol. 19 No 5 pp 305-306
Clinical Journal of Oncology Nursing Feb 2009 Vol. 13 No 1 pp 109-112
MEDSURG Nursing Dec 2005 Vol. 14 No 6 pp 390-392
MEDSURG Nursing April 2006 Vol. 15 No 2 pp 100-103
© Young Lion Inc. 2011 - Photo Courtesy of Lower columbia College.
