RN, MSN, ACNP, AOCN
RN, BSN, MPH, OCN,
RN, MSN, OCN
Marianne Davies is an Oncology Nurse Practitioner in Medical Oncology at the Smilow Cancer Hospital and Lecturer at Yale School of Nursing; Monica Fradkin is Oncology Nursing Education Coordinator, and Elizabeth Blasiak is Service Line Educator-Medical Oncology, at the Smilow Cancer Hospital.
Ongoing professional development and the use of evidence-based practice (EBP) are priorities of Yale-New Haven Hospital, a Magnet-designated institution. However, research dissemination, utilization, and promotion can be challenging in a busy tertiary care environment. Among the barriers identified by staff nurses responding to a survey of EBP beliefs and utilization were lack of experience in critiquing and synthesizing the research literature and translating these findings into practice.
To develop a way to overcome these barriers, the Oncology Nursing Council Research Committee (representing all areas of oncology nursing practice within the institution) and the Oncology Nursing Education Department of Smilow Cancer Hospital at Yale-New Haven created a 10-member steering committee representing nursing education, staff nurses from the inpatient and outpatient units, clinical trials nursing, a clinical nurse specialist, and an advanced practice nurse. The goals of the project were to disseminate results of research relevant to patient care, improve knowledge of the research process, enhance staff ability to critique research, and to motivate nurses to participate and collaborate on research initiatives.
The committee chose a journal club format and selected the Oncology Nursing Society (ONS) Virtual Journal Club as a framework to facilitate a prompt start of the project. To pique nursing staff interest and promote a sense of community, the committee decided to name the journal club the Smilow Society and employed a shared governance model to encourage involvement of nursing staff in the planning process. One of the committee members designed the society’s poster, which is displayed on all of the oncology units to promote the journal articles each month.
Access to articles and the meeting schedule are posted on the nursing intranet. The initial articles were chosen by the steering committee from the ONS Virtual Journal Club library to appeal to a broad audience, with topics based on areas of interest expressed by the nursing staff, including cognitive dysfunction, osteoporosis, dermatologic toxicities, peripheral neuropathy, diabetes, and infection management.
We scheduled the initial journal club sessions in the early morning to accommodate outpatient clinic schedules and inpatient shift changes. Attendance at the sessions averaged 8-10 participants, representing inpatient and outpatient units, and the feedback was quite positive.
The time of the meeting proved to be challenging for some of the inpatient units, so a second “traveling journal club” session was scheduled during lunchtime on a different inpatient unit each month. These sessions have been well attended by 12-15 nurses from each unit. The sessions also attract other staff members, such as nursing students, pharmacists, and medical assistants. Nurses practicing offsite in our community care centers are able to teleconference in to the session.
Participants are provided a Smilow Society notebook for journaling during each session. An advanced practice nurse from the steering committee serves as facilitator of the sessions to promote discussion of research critiquing strategies, and a summary of each session is posted on the nursing intranet. Nurses who attend are given a “frequent reader card,” which is validated at the end of each session; at the end of the year, frequent attendees will be recognized.
We recommend that nurses discuss meeting topics with their colleagues and suggest that those who are members of ONS sign on to the ONS Virtual Journal Club site and take a post-test for continuing education credit. The discussions have generated several potential research projects, and nurses have been encouraged to develop a work group to explore topics further, with an eye toward matching them with research mentors from the Yale-New Haven Hospital Nursing Research and Evidence-Based Practice Committee for project development.
The Smilow Society journal club promotes professional growth, encourages collaboration among staff, and promotes evidence-based improvements to patient care. The success of the project is due to the commitment and collaboration of staff nurses and advanced practice nurses. Following the ONS Virtual Journal Club framework offers another potential benefit by promoting participation in one’s professional organization.
Future directions within the cancer center include the promotion of staff nurses as facilitators, collaboration with advanced practice nurse content experts, and using webcasts for staff at community-based cancer treatment centers. In addition, the journal club—a best practice model for research dissemination— is being adopted throughout the hospital by other patient care services. The goal is to expand to the entire Yale-New Haven Healthcare Network.