Application of Journal Club for Nurses in the Hemodialysis Unit

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Application of Journal Club for Nurses in the Hemodialysis Unit

Dinara Sadykova

Master’s thesis January 2021

Social services, Health and Sports

Degree Programme in Advanced Nursing Practice

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Author(s)

Sadykova, Dinara Type of publication

Master’s thesis ^DateJanuary 2021

Language of publication:

English Number of pages

39 Permission for web

publication: x Title of publication

Application of Journal Club for Nurses in the Hemodialysis unit Degree programme

Degree Programme in Advanced Nursing Practice Supervisor(s)

Hopia, Hanna Ospanova, Dinara Assigned by

Background: The development of evidence-based nursing practice improves the quality of patient care. Therefore, it is important for nurses to study scientific articles and apply the results of nursing research in their practice. A journal club as a teaching method

contributes to the development of new skills and the acquisition of new knowledge among nurses. The journal club leads to the development of critical thinking. Starting a journal club contributes to the following: meeting the need to receive and apply new information.

This in turn contributes to the acquisition of new skills as well as their application.

Objective: To promote the evidence-based practice of nursing in one large clinic through the pilot activities of the Nursing Journal club and make a plan on how to turn a Journal club into a daily nursing practice.

Methods: The ‘Flipped classroom’ approach was chosen to organize a journal club for nurses in the hemodialysis unit. The club was established with six steps. Twenty nurses from the hemodialysis unit took part in three meetings of the journal club. After the meeting, the participants filled out the proposed questionnaire and gave oral feedback about the journal club.

Results: The nurses noted the importance of the journal club meetings as it was important for them to study and develop evidence-based nursing practice. It was decided that when choosing the day and time for the meeting, they will be guided by the workload of the department and the work of the nursing staff. It was also agreed that the nurses will study the selected articles in advance, which will help to fully focus on the discussion of the scientific article during the meetings. A plan was also proposed for the introduction of a journal club into daily nursing practice.

Conclusion: The Journal Club is a convenient and helpful method for exploring new trends in nursing practice. The informal format of the meetings of the journal club promotes a deeper immersion in a new topic and motivates to apply new knowledge in practice.

Keywords/tags (subjects)

Nursing Journal Club, nurses, research, hemodialysis unit Miscellaneous (Confidential information)

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1 Introduction

Currently, humanity has an increased need for professional medical care as well as qualified nursing care. In this regard, it becomes evident that nurses need to be more aware of new research in nursing. Thus, the nurse will meet a high professional level.

(Purnell & Majid 2017.) Nurses should regularly improve and enhance their own nursing awareness, which should be applicable in clinical practice to ensure optimal patient care. The study and analysis of evidence-based research results helps nurses apply them in their practice. This, in turn, leads to the best patient outcomes. Thus, the use of evidence-based nursing practice contributes to the provision of quality nursing care. (Luby, Riley, & Towne 2006.) Nurses who use evidence are able to show better patient care. This in turn helps to reduce the risk of complications. (Dyckoff, Manela, & Valente 2004.)

The Journal Club is a way to get to know the latest published literature that has the potential to impact clinical practice and nursing education (Sortedahl 2012). The Journal Club helps nurses learn about new evidence in nursing. This contributes to the development of the nurse. It is important to note that the meetings are held in an informal setting. The non-traditional form of training contributes to the

development of the professionalism of the nurse and the improvement of the quality of care. (Pasek & Zack 2004.)

The journal club promotes professional development as well as the development of cooperation between various areas in health care (Laaksonen, Paltta, von Schantz, Ylönen, & Soini 2013). For each meeting of the Journal Club, a specific study is

selected, which is subject to detailed study by all members of the club. Discussions in the Journal Club involve participants in an in-depth study of the selected study, which makes it possible to analyze and apply the results in their practice. (Xiong, Giese, Pasi, Charidimou, van Veluw, & Viswanathan 2018.)

Through participation in the Journal Club, nurses conduct discussions, learn to critically evaluate scientific publications, and share their experiences with other club members and colleagues. Active discussions and debates by nurses about new research in nursing lead to a better understanding of the chosen topic that can help them apply the knowledge gained in their practice. That is why the topic should be

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chosen very carefully. Usually, topics are chosen according to interests of all participants of the Journal Club. (Xiong et al. 2018.)

Membership in the journal club encourages nurses to participate in nursing research and the development of nursing science. This makes it possible to develop critical thinking, which is necessary for evidence-based nursing practice. Thus, the journal club turned out to be an effective teaching method, which is widely used in clinical nursing practice. A large number of nursing research studies have now been published that contribute to the development of evidence-based nursing practice.

(Turner & Mjolne 2001.)

2 Evidence-based Practice and Journal Club

2.1 Evidence-based Knowledge

Description of the importance of the evidence base was noted by Archibald Cochrane in 1972, who put forward the opinion that medical personnel should constantly improve their skills and knowledge, for which it is necessary to conduct research and share the results with colleagues (Yonkaitis 2018). So, the researcher conducts a literature review on the topic of interest in which all sources must have a sufficiently high level of reliability. After that, recommendations are given, the accuracy of which should be evaluated. Then the research results, conclusions, and recommendations are allowed to be published. (Adams & McCarthy 2007.)

Over time, the results obtained in the course of scientific research began to be applied in clinical practice. In turn, evidence-based clinical practice has led to an increase in the quality of medical care and a favorable outcome of diseases.

(Bondmass 2014, 9.) In the early 1990s, articles appeared describing evidence-based medicine. Thus, the evidence base has become a reliable source of the best modern articles, the application of which leads to the best results in patient care. (Spek, Wieringa, Lucas, & Dijk 2013.)

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2.2 History of the Development of the Journal Club

The earliest mention of the Journal Club is found in the memoirs of Sir James Paget, a surgeon at St Bartholomew's Hospital in London in 1835–1854, who described a kind of club in a room above the bakery at the hospital gates where doctors could sit and read magazines. In 1875, Sir William Osler founded North America's first journal club at McGill University in Montreal to acquire and distribute publications to which researchers and readers could not afford to subscribe. (Rowlands & Winslow 2011.) Over the next 150 years, journal clubs took various forms to meet the needs of participants and facilitate a critical discussion of scientific articles in contemporary literature. Over the years, the three goals of journal clubs have been preserved: to keep abreast of modern literature, influence clinical practice, and teach critical reading and thinking skills. (Rowlands & Winslow 2011.) The description of the fact that the Journal Club is an effective forum for discussing current clinical problems found in the literature comes from one of the first journal clubs founded by Dr. Osler in 1875. Journal Club has an unwritten heritage and familiarity with the latest

literature, influencing clinical practice and teaching criticism. (Sortedahl 2012.) The development of clinical trials and the training of nurses with the necessary competencies are key factors in evidence-based healthcare practice. Nurses reflect on participating in the Nursing Journal Club in order to develop their competencies to support the research culture of nursing in their departments. (Kjerholt & Hølge 2008.) Journal clubs are needed for critical evaluation to determine the value of science and to develop critical thinking to determine if published results are applicable in practice (Davis, Hendry, Barlow, Leonard, White, & Coetzee 2014).

Access to up-to-date research literature is fundamental to making clinical decisions that underpin patient care using the best and most modern data, advances in clinical research and development (Benner, Hughes, & Sutphen 2008).

The UK Department of Health places particular emphasis on evidence-based practice and the dissemination of research findings in various fields of medicine (Turner &

Mjolne 2001). The Journal club brings positive changes for nurses. Positive manifestations include changing attitudes towards their profession, increasing knowledge, improving skills, changing clinical behavior and improving the patient's

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condition as well as changing the outcome of the disease. (Harris, Kearley, Heneghan, Meats, Roberts, Perera, & Shayers 2011.)

2.3 Journal Club Activity

Evidence-based nursing enhances patient care through the application of proven research findings in recent years (Black, Balneaves, Garossino, Puyat, Qian 2015). The use of evidence is integral to the learning process in the research practice of a nurse (Alam & Jawaid 2009). With the use of the Internet, it became possible to get

acquainted with various studies that are in the public domain. Access to various databases made it possible to develop research activities in the field of nursing and to introduce and apply the most modern methods and achievements in clinical nursing practice. (Turner & MjolneI 2001.)

The introduction of evidence-based nursing practice in practical health care is important. This requires not only getting approval from the administration, but also conveying to nurses the importance of evidence-based nursing practice. Evidence- based nursing practice promotes the use of proven data to solve clinical problems.

Evidence-based nursing practice reflects the exact needs of the patient, provides relevant literature, and obtains existing evidence. (Sadoughi, Azadi, & Azadi 2017.) A large number of clinical studies conducted by high-level nurses based on evidence- based practice are an important link in practical health care. Participation in the Journal Club will lead to nurses gaining new knowledge and changing their outlook and attitude to work. This will lead to the application of the acquired knowledge and research results in clinical nursing practice. (Kjerholt & Hølge 2018; Laaksonen et al.

2013.)

The Journal Club is one of the important teaching tools in postgraduate education (Alam & Jawaid 2009). However, there is no gold standard or clear rules for

maintaining a Journal Club, which allows you to be creative in organizing a Journal Club (Asif, Wiederman, & Kapur 2017). Journal clubs for nursing are needed for critical evaluation to understand the value of science and to develop critical thinking to determine if published results are applicable in practice (Davis et al. 2014). It should be noted, however, that not all nurses have the opportunity to discuss

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nursing research. For example, nurses working in schools are often the only

specialists, i.e., they have no colleagues in the workplace. In this regard, there is no possibility of a lively discussion of practical issues and exchange of experience on the implementation of innovations in practice. In addition, few school nurses have access to information that can be easily accessed in traditional health care settings. In such a situation, meetings with colleagues in a journal club can help nurses for their development and further growth. (Sortedahl 2012.)

3 Purpose and Objectives

The purpose of this development work is to promote the evidence-based practice of nursing in one large clinic through the pilot activities of the Nursing Journal club.

Another goal is to make a plan on how to turn a Journal club into a daily nursing practice.

The objectives of the development work are:

- familiarize nurses to international hemodialysis studies;

- introduce nursing terms to the evidence-based practice concept; and

- discuss and develop, together with the nurses, a plan for further meetings within the framework of the Journal Club.

4 Methodology

4.1 Methodological Approach

Every nurse must be able to put knowledge into practice. The knowledge gained should have an evidence base that will help improve the quality of healthcare services for patients. (Breimaier, Halfens, & Lohrmann 2015.) Journal Club provides an opportunity to teach presentation preparation techniques. Visual elements such as charts, tables, graphs are also widely used. This makes it possible to present new information in an accessible and understandable form as well as the ability to more easily perceive the information. (Ten Tips for Scientific Journal Clubs 2020.)

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The Journal Club promotes the development of critical thinking among its members (McGlacken-Byrne, O'Rahelly, Cantillon, & Allen 2020). The beginning of the journal club will contribute to the following: meeting the need for obtaining and applying new information and contributing to the teaching of new skills as well as their application in practice. Thus, Khan and Gee (1999) visualized the circle of acquiring knowledge in a journal club (see Figure 1). (Khan & Gee 1999.)

Figure 1. The circle of acquisition of knowledge in a Journal Club(according to Khan

& Gee 1999).

It should be noted that the journal club as a teaching method has developed and will continue to develop in accordance with the times. So, at present, there are several formats of the journal club. The most common are the traditional, or as it is also called, the classic format and evidence-based format. Flipped format and virtual

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online format options are also possible. Naturally, each of these approaches has its own advantages and disadvantages, presented in Table 1. (Xiong et al. 2018.)

Table 1. Advantages and disadvantages of different formats of a journal club (Xiong et al. 2018)

Formats of a journal club

Specific

aim(s) Advantage(s) Disadvantage(s)

Traditional

format Keep up-to- data recent literature

No need to prepare in

advance for the attendees Quality of selected articles is inconsistent;

audiences might be ill prepared and

disengaged Grasp clinical updates in an

efficient way Evidence-

based format

Improve critique skills

Promote critical appraisal

skills and research skills Basic biostatistical and methodological

knowledge is needed Flipped

format Engage all

learners Provide in-depth

discussions Spend more time on

organizing and preparing All learners are involved

Virtual online format

Make the journal club more accessible

Easy to access without

location restriction Interaction among attendees is limited Encourage communication

among multiple centers

The online format of the Journal Club is currently of great interest. This is how the journal club National Network of Institutes of Health for Stroke was organized in the USA. More than 200 clinics participate in this club. Online meetings are held

simultaneously with several groups of participants on different topics, which saves time. (Xiong et al. 2018.)

The ‘Flipped classroom’ approach was chosen to organize a journal club for

hemodialysis nurses. This method allows all meeting participants to be involved in a discussion on a selected topic. The advantage of this approach is that this format allows for deeper discussions. This advantage is achieved due to the fact that the selected material is distributed in advance to all members of the journal club. This allows you not to waste time reading the article and its main results, but instead, devote time to the discussion and the possibility of applying the results obtained in clinical practice. Among the disadvantages, it is worth noting more time to prepare

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for the meeting and organize a meeting of the journal club. (McGlacken-Byrne et al.

2020.)

4.2 Steps of the Journal Club Organization

There is no common format of organizing a Journal Club (Xiong et al. 2018). The following steps were taken to establish a journal club for dialysis nurses.

Step 1. For each meeting, it was necessary to select a leader for holding the Journal Club meeting. The leader of the journal club should be the person who is responsible for choosing the place and time of the meeting as well as in what format the meeting is held. (Xiong et al. 2018.) For the first meeting, it was proposed to choose the one who put forward the idea of holding meetings, the subsequent organizers and speakers would choose the draw method.

Step 2. In order for each meeting of the Club Journal to be interesting, it was necessary to choose the right scientific material, the selected article should be relevant, for example, for the hemodialysis department. Many articles had been published on innovations in dialysis and dialysis patient care. At the same time, it was important to choose exactly those articles that had evidence and could later be used in clinical practice.

It was necessary to identify several clinical problems associated with nurses’ clinical activity, as articles directly related to the field of hemodialysis would be actively discussed and criticized by the nurses of the hemodialysis department. Identified innovations would be put into practice.

At the first meeting of the journal club, nurses were asked to identify the most important clinical issues for further joint study. The following topics were thus defined:

- Arteriovenous fistula: constant vascular access for hemodialysis sessions - Dialysis at home

- Viral Hepatitis C in patients on program hemodialysis

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Step 3. It was necessary to choose a convenient time for meetings. The time and frequency of meetings were actively discussed with the participants, and it was decided to meet every second Thursday of every month, at four hours after the end of the second shift. This time was chosen due to the fact that almost all participants found it most convenient due to their work schedule.

Step 4. Articles for meetings of Journal Club: “Arteriovenous Buttonhole Access Cannulation in Pediatric Patients on Hemodialysis”, “Profile of the Patient Using a Central Venous Catheter during Hemodialysis”, and “A Hospital-Based Program to Reduce Central Line-Associated Bloodstream Infections among Hospitalized Patients Receiving Hemodialysis Using a Central Venous Catheter for Vascular Access”. Having selected the articles, it was necessary to translate them into Kazakh or Russian, then give out copies to all participants so that each participant familiarized themselves with the article and prepared questions of interest, and the speaker himself could prepare a critical summary of the selected article.

Step 5. Each Journal Club would be accompanied by a snack (pizza, sushi) as an incentive for participating in the Journal Club. Everything was bought at the expense of the department head. This helped to create an informal atmosphere, to switch from work and devote this time to studying and discussing a scientific article.

Step 6. It was necessary to get feedback from the Journal Club meeting, using a pre- prepared questionnaire (Malloch & Porter-O-Grady 2006, 70). Getting feedback would help to understand how important and interesting the prepared material was as well as to identify the expectations of the Journal Club members and their need for the information received. The feedback was collected orally. Some notes were done according to given feedback for improving the Journal Club.

Also, at the end of the first meeting, all members of the journal club were asked to fill out a questionnaire (see Appendix 1). This questionnaire had several questions that could help to reveal the nurses’ needs in Journal Club and opportunity to take part in Journal Club.

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4.3 Recommendations for Journal Club’s Speakers

Speaking at a meeting of the Journal Club can be very stressful, especially if this is the first speech before the public. So, Lucy Bauer (2015), according to her own

experience of holding a Journal Club, offers the following five tips for Journal Club first-timers: knowing the material, keeping presentation concise, simplifying unfamiliar concepts, before speaking it is good to ask yourself questions about the topic, and asking specific questions to the journal club’s members (Bauer 2015).

It is worth noting that the speaker is a member of the journal club like all other members, so they do not have to be an expert. The main thing is that the speaker shows genuine interest in the topic and tries to report the information as accurately as possible.

Any criticism is aimed at development. This is the attitude that should be towards all comments at the meeting of the journal club. In no case should you treat critical statements as personal insults. These statements concern only the article, and not the speaker themselves.

Active discussion, as well as feedback from members of the journal club, is considered a good sign (Laaksonen et al. 2013). This means that the audience listened carefully to the information presented—the speaker was effective in their speech.

Sometimes the speaker may disagree with the author of the article. Therefore, during the report and discussion, the speaker can, along with all members of the journal club, express their opinion as well as consent or disagreement with the article.

If the speaker is very nervous before speaking in public, they should apologize to the audience and ask for a few minutes to calm down and tune in to the report. This will help the speaker calm down and collect their thoughts to start the presentation.

(Schwantes 2017.)

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5 Organization of the Journal club

5.1 Participants of Journal Club

To organize a journal club for nurses in the hemodialysis department, it was

necessary to obtain consent from the administration of Zhasandy Buirek LLP. For this purpose, a cover letter was prepared (see Appendix 2), which indicated all the necessary information for running a journal club for nurses. An invitation was also prepared for all nurses of the hemodialysis department to take part in the first meeting of the Journal Club (see Appendix 3).

There are 40 nurses working in the LLP Zhasandy buirek. Only 20 participants agreed to take a part in the Journal Club. Half of the nursing staff refused to participate, explaining that they were busy and could not spend their free time at work.

Currently, nurses must constantly engage in self-education to improve their

knowledge and skills. The field of hemodialysis is constantly evolving—the clinics are constantly updating hemodialysis machines, which include new functions. Therefore, nurses are required to meet the new requirements. (Shahdadi & Rahnama 2018.) Continuous self-education in modern life helps nurses to understand that previous professional skills are quickly outdated, and that new forms and methods of work, theoretical knowledge and skills are required. Self-education in nurses promotes determination, perseverance in achieving goals, and hard work. (Being a Nurse Means Pursuing Lifelong Learning 2019.) Considering all this, it was decided, after the first meeting of the journal club, to conduct a survey of the nurses-members of the club in order to identify satisfaction with their work as well as the need for new knowledge.

All participants were asked to fill the questionnaire (see Appendix 1). Twenty nurses answered the questionnaire, including seven men under the age of 35 and 13 women under the age of 35. All of them had experience of 5–10 years in the hemodialysis department (see Table 2). The survey was anonymous, and all data obtained was used only in a generalized form.

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Table 2. Journal club participants PARTICIPANTS MALE

FEMALE

35%

65%

EDUCATION ACADEMIC DEGREE

BACHELOR’S DEGREE

SECONDARY SPECIAL EDUCATION

0 5%

95%

For nurses who agreed to take part in the journal club, a group was created in messenger. In this chat, a description of the group was presented. Participants had the opportunity to share their thoughts and discuss their ideas, which were aimed at improving the quality of nursing care. An invitation (see Appendix 3) was added to participate in the journal club, with examples of rules for each meeting. Participants were asked to make their own changes to the rules or propose their own rules. It was also indicated that there was no hierarchy between the participants and all nurses were on an equal footing in order for the participants to be comfortable in the discussion and not afraid to express their opinion.

5.2 Meetings of the Journal Club

5.2.1 Beginning of the Journal Club

For analysis during the first meeting of the Journal Club, an article on infectious complications during puncture of an arteriovenous fistula was selected (see Table 3).

Table 3. First meeting of the journal club

Article: Moore, T., Brightman, S., Dodson, D.L., & Warady, B.A. 2019.

Arteriovenous Buttonhole Access Cannulation in Pediatric Patients on Hemodialysis. Nephrology Nursing Journal, 46, 407–411. PMID: 31490050 Place: Hemodialysis Unit Day of the week: Thursday

Time: 13.00 Leader: hemodialysis unit nurse

Participants: 20 nurses Note: first meeting

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The leader spoke in great detail about a study conducted in the hemodialysis department of patients from 0–22 years old. The selection of candidates for the study was carried out according to the following criteria: the initial disease that led to terminal renal failure, patient weight more than 20 kilograms, dialysis experience, and stable psycho-emotional state of the patient since it was necessary to obtain consent to the study. The patients were explained the essence of the study, which was aimed at preventing the development of infectious complications during puncture of arteriovenous fistula. Patients took a smear from the nasal mucosa where they found Staphylococcus aureus. Patients were asked to wash their hands up to the elbows after entering the hemodialysis department and to wear a mask.

The staff also put on protective equipment, treated their hands with a disinfectant solution before putting on sterile gloves, and used disinfectant on the surface of the skin before the puncture of the fistula. Staphylococcus aureus was also found to avoid infectious complications, and the nurses treated the surface of the skin before the puncture with a solution of 2% chlorhexidine + 70% isopropyl alcohol. (Moore, Brightman, Dodson, & Warady 2019.)

The study participants were 14 patients: three women and 11 men. This study, conducted in the hemodialysis department, showed that puncture of the arteriovenous fistula can be performed without an increased risk of infection.

(Moore et al. 2019.)

The meeting took place at the workplace, as agreed in advance. This place and time of the meeting was approved by all members of the journal club. In turn, the

workplace journal club facilitated the establishment of good, trusting contacts with all members. Of course, at first there was some tension. Perhaps this was due to the fact that it was the nurses’ first time taking part in a journal club. The format of such meetings was not entirely clear to them. After a while, the tension began to decrease after which the meeting took place in a friendly atmosphere. The members of the journal club were invited not only to get acquainted with the results of the selected study, but also to discuss the article in a relaxed atmosphere over a cup of hot tea with snacks. The informal meeting allowed the participants to open up, engage in discussions, ask questions, and express their personal opinions. The participants were not afraid to enter into a dialogue with the speaker, because the atmosphere

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was very supportive and friendly. At the end of the meeting, a summary was made that, in fact, arteriovenous fistula puncture could be done without much risk of infection. This requires compliance with the rules of asepsis and antisepsis. Thus, the nurses decided that they would gradually begin to implement the experience

described in the article to reduce fistula infection. It was decided to treat not only their hands, but also the hands of their patients to avoid the risk of infection of the fistula.

Thus, the friendly and warm atmosphere made it possible to discuss not only the results of the selected study, but also to discuss the possibilities of implementation in clinical practice. At the same time, the nurses showed their desire and readiness to introduce this innovation into their daily practice.

5.2.2 Continuing of the Journal Club

For analysis during a second meeting of the Journal Club, an article about the profile of the patient using a central venous catheter during hemodialysis was selected (see Table 4).

Table 4. Second meeting of the journal club

de Lima Guimarães, G., Goveia, V.R., Quispe Mendonza, I.Y., dos Reis Corrêa, A., Silqueira de Matos, S., & Oliveira Guimarães, J. 2016. Profile of the Patient Usinge a Central Venous Catheter during Hemodialysis. Journal of Nursing UFPE / Revista de Enfermagem UFPE, 10, 4434–4442. https://doi-

org.ezproxy.jamk.fi:2443/10.5205/reuol.9978-88449-6-ED1012201601 Place: Hemodialysis Unit Day of the week: Thursday

Participants: 20 nurses Note: second meeting

The content of the article was the use of a venous catheter of the central vein. This study was conducted in Brazil, and the participants were 57 patients in the

hemodialysis department, aged 18 to 60 years, who were on program hemodialysis in the first 90 days after the detection of terminal renal failure. The aim of the study was to reduce the risks of complications after catheterization and to improve the

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quality of life of the patient by non-programmed hemodialysis. (de Lima Guimarães, Goveia, Quispe Mendonza, dos Reis Corrêa, Silqueira de Matos, & Oliveira Guimarães 2016.)

Hemodialysis is a given method of renal replacement therapy that is widely used for patients with end-stage renal failure, both Brazil and worldwide. For a session, vascular access is required. There are two ways: the formation of an arteriovenous fistula or the installation of a venous catheter in the central vein, mainly in the jugular vein, since when installed in the jugular vein, there are fewer risks of complications. The venous catheter has two lumens divided into two types, tunnel and non-tunnel. The implantation of the first catheter requires the work of a

resuscitator and a vascular surgeon, as a special subcutaneous tunnel is created. This catheter has a special “sleeve” whose purpose is to create a barrier for infection. The second type of catheter does not have this protective "sleeve" and is not installed for a long time. The principle of installation is percutaneous puncture; the puncture site is the entrance gate for infection. According to the results, 75% were males, 57%

were Catholic, 20% were uneducated, 50% of the etiology was hypertensive nephropathy, 35% of the consequences of diabetes mellitus, 10% of glomerular damage, of which 70% of the catheter was inserted into the right arterial vein, the reason for removal catheters were 70% fistula formation and 20% infection. (de Lima Guimarães et al. 2016.)

Again, the atmosphere was very friendly in the meeting. Nurses felt comfortable and could discuss the results of the research. It should be noted that this time almost all the participants began to show themselves as more active participants. The tension that had taken place at the first meeting of the journal club was no longer felt. From the very beginning, the nurses began to actively show themselves, and they listened with interest to the speaker. Further, the discussion was rather stormy. This is because in the nursing experience, many patients have gone through central vein catheterization. Now nurses have identified for themselves the fact that temporary vascular access causes inconvenience to patients and can reduce their quality of life.

Therefore, a multidisciplinary team should reduce the potential risks from using CTDL and promote improved quality of life associated with health.

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5.2.3 Subsequent Meetings of the Journal Club

This article was chosen by nurses, as the topic of working with central venous catheters is very relevant in the hemodialysis department (see Table 5).

Table 5. Third meeting of the journal club

Conwell, P., Aniskiewicz, M., Ghidini, J., & DeVaux, L. 2019. A Hospital-Based Program to Reduce Central Line-Associated Bloodstream Infections among Hospitalized Patients Receiving Hemodialysis Using a Central Venous Catheter for Vascular Access. Nephrology Nursing Journal, 46, 587–590.

Place: Hemodialysis Unit Day of the week: Thursday

Participants: 20 nurses Note: third meeting

A venous catheter located in the central vein is actively used for patients who are primarily faced with the problem of dialysis, but this method of catheterization poses a risk of infection of the bloodstream, which has serious consequences up to death.

The hemodialysis department has created a program that includes the use of special training tools to coordinate nursing care for an installed venous catheter (see Table 6).

Table 6. Nurses’ actions

Actions Implementer

Temperature measurement Dialysis nurse

The application of a sterile dressing 2*2 Dialysis nurse Report first symptoms of infection Dialysis nurse Special marking on a special label about the

time and date of the last dressing Dialysis nurse Prohibition of the use of a venous catheter

for other manipulations, for example for infusion.

Dialysis nurse

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Keep the dressing clean Throughout hospitalization, monitor the cleanliness of the dressing.

This program is a strategy to reduce the incidence of CLABSI among hospitalized patients on hemodialysis with CVC. Dialysis nurses have been trained in central line general care and have mastered new competencies. An active collaboration has also been introduced between different specialties such as interventional radiology, kidney transplant, surgery and anesthesia, and the nephrology team to reduce the risk of CLABSI associated with non-nephrology procedures.

During 2015, 3210 HD procedures were performed on 400 patients using CVC for vascular access, and a total of nine CLABSIs occurred. In 2016, 2,585 HD procedures were performed on 375 patients using CVC. In the first five months of 2016 (before the implementation of the program), five CLASBIs occurred. This was in line with the projected annual rate of 12 events per year (see Figure 2).

Figure 2. Incidence of CLABSI Before and After Program Implementation (Conwell, Aniskiewicz, Ghidini, & DeVaux 2019)

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Before the implementation of the program for the prevention of infectious complications of the arteriovenous catheter, 14 infectious complications were recorded in 17 months, and after the introduction of the program for the prevention of infectious complications, not a single infection of the arteriovenous catheter occurred within 30 months.

Based on the excellent performance of this program, large hemodialysis clinics have developed special programs that allow the clinic to directly benefit from the

management of dialysis patients without infectious complications, thereby reducing the cost of treatment, saving the clinic budget and reducing the percentage of clinical complications.

This program interested the nurses. It is them who have to change the tactics of caring for dialysis patients in connection with the development of any complications.

Therefore, it was important for dialysis nurses to learn about this study, which showed such a good result from the implementation of this program.

On the whole, this article was well received by the participants. However, many had questions about how such approaches can be implemented in clinical practice. After discussion in a team of like-minded people, it was revealed that the implementation of such programs requires the interaction of specialists from different fields. Thus, the implementation of the results obtained from the study was not possible within the framework of this journal club. However, this information helped nurses to realize that they are an important link in a multidisciplinary team helping dialysis patients improve their quality of life.

The article presented was selected by the nurses themselves. Also, the nurses began to be active not only in discussing the proposed study, but also in the very choice of the topic for subsequent meetings of the journal club.

It should be noted that at the very beginning of the work of the journal club during the leader's speech, it was difficult for the nurses to remain silent, and the discussion began after mentioning each new information in the field of hemodialysis described in the article. But in subsequent meetings, the students showed more respect for the leader and gave the leader the opportunity to finish the report, after which they began to emphasize the advantages of the described methods and taking notes,

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writing them down on leaflets or on mobile phones. Of course, not all the

information received could be used in the hemodialysis department because there is no such equipment, but they listened with interest to what exists in the world and how it is successfully applied.

6 Characteristics of Successful Journal Clubs

The Journal Club is a teaching strategy for implementing evidence-based nursing practice (Johnson 2016). The Journal Club taught participants to study articles and get acquainted with new research and skills. The journal club promotes the

dissemination of scientific knowledge and develops critical thinking and the ability to evaluate new information.

Journal clubs can be successful. Deenadayalan and colleagues (2008) identified the main characteristics of a successful journal club: regularity of meetings, compulsory attendance of the club, clearly defined goals, convenient timing of meetings, incentive to participate in the club, a trained journal club leader, correctly selected articles, and the distribution of necessary material in advance (Deenadayalan, Grimmer, Prior, & Kumar 2008).

Nurses at regular meetings of the Journal Club learned to define research methods, formulate a summary of research and learned to express their opinions as well as to have an interest in the development of nursing (Johnson 2016). Therefore, the journal club as a teaching method is of great importance. One of the goals of the journal club is to link scientific research with clinical practice (Bowles, Marenah, Ricketts, & Rogers 2013).

So, the benefits of organizing a journal club can already be appreciated through several regular meetings. At the same time, nurses will be able to show new skills, such as assessing the information received, the ability to perceive scientific

literature, the ability to lead a discussion, the development of evidence-based nursing practice, and satisfaction of the need for continuing medical education (Bowles et al. 2013).

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Some difficulties may arise when introducing a journal club. So, when the first meetings of the journal club are being planned, it is important to notify all future participants in advance. (Arnold 2020.) It is necessary to properly inform the nurses about the organization of this training format (Ten Tips for Scientific Journal Clubs 2020). All members of the magazine club must clearly know what will happen. For a successful start, it is necessary to determine the meeting place, organize snacks, choose a topic, and provide the necessary material for familiarization to all members of the journal club. (Arnold 2020.) The selection and preparation of the leader of the journal club is also important (Xiong et al. 2018). Naturally, it is desirable that the leader be one of the nurses. At the same time, every effort must be made to make participation in the journal club a routine matter for nurses. Then there will be journal club attendance and interest in participating among nurses.

7 Ethical Issues of Thesis Work

The thesis work was approved locally by the ethics committee of KazMUCE /the organizer, and administration of the department presented an idea of beginning Journal Club for nurses in the hemodialysis unit. For goals and objectives to each member of the Journal Club, see Appendix 3. Each participant received an informed consent (see Appendix 4) before meeting regularly. It is also informed that all

participants have the right to stop attending meetings of the Journal Club at any time without any consequences, penalties, or fines. Each participant was also described the rules for meeting behavior. The attendance of the participants and the duration of each meeting was announced. Participants were given the opportunity to reflect on the outcome of each meeting and ask questions of interest to them.

8 Results of Implementation of Journal Club

8.1 Analyzing of Oral Feedback

After the first meeting of the Journal Club, the participants began to give rave reviews that everything went perfectly, and how well they understood everything.

So, all participants were asked to give oral feedback. According to the feedback, it

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was clear that the Journal Club was necessary for them. Nurses wanted to know evidence-based nursing practice. Also, nurses said that it is important to consider the workload of the department when choosing the day and time for a meeting, so that the participants are not so tired, but that in general such meetings were useful.

It was agreed that questions on the article would be prepared in advance, and many in the discussion admitted that they did not familiarize themselves with the article. It was because they did not take the Journal Club seriously, which they sincerely

regretted and promised to be more responsible. After the first meeting of the Journal Club, they understood the importance and necessity of acquainting themselves with innovations in the field of hemodialysis, and even remembered things that they had long forgotten.

The following meetings of the Journal Club were more saturated with comments and discussions. The chosen topic for the third meeting was the article "A Hospital-Based Program to Reduce Central Line-Associated Bloodstream Infections among

Hospitalized Patients Receiving Hemodialysis Using a Central Venous Catheter for Vascular Access". Before the discussion, nurses familiarized themselves with the article, and since there was no need to explain the essence of the meeting, there was more time for discussion. Everyone listened this time, probably because they were familiar with the material.

8.2 Plan on How to Turn a Journal Club into a Daily Nursing Practice

The effectiveness of a journal club depends on various factors. These include defining the goals of the journal club and each meeting, choosing a topic and a specific article, preliminary acquaintance with the article of all members of the journal club,

choosing the leader of the journal club meeting, and maintaining a discussion of the selected topic.

In order to introduce a journal club to daily nursing practice, it is necessary to

prepare a plan for the introduction of a journal club. Based on several sessions of the club for hemodialysis nurses, the following plan for the introduction of a journal club can be proposed (see Table 7).

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Table 7. Plan on how to turn a journal club into a daily nursing practice

# Actions

1 Obtaining approval from the administration of the medical institution for training nurses through a method such as the Journal Club

2 Informing nursing staff and inviting everyone to a journal club meeting 3 Determining the place and time for the meeting of the journal club 4 Preparing the meeting place. Preparing a treat to create a supportive

informal environment

5 At the first meeting, it is mandatory to familiarize all participants with the principles of running a journal club, as well as jointly determine the rules of this journal club.

6 Determining the regularity of the meetings of the journal club 7 Determination of the leader of the journal club

8 Choosing a topic of interest for future meetings

9 Choosing a method of informing the members of the journal club

8.3 Analysis of the Questionnaire

According to the results of the survey of 20 nurses who agreed to answer the

questionnaire (n = 20), when assessing their chosen profession, 30% noted that they only partially liked the profession of a nurse, and 20% of respondents had a negative attitude towards the profession (see Figure 3). Half of the nurses (50%) did not regret their chosen profession at all. However, 40% of nurses were thinking about changing their profession, 10% of them were already in the process of getting a new education and changing jobs.

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Figure 3. Аttitude to the nursing profession (n = 20)

Whether they had problems at work, 30% of nurses said no, 30% infrequently, 20%

said sometimes, and 20% admitted that very often. None (0%) had a workflow without problems with a leak (see Figure 4).

Figure 4. Problems at work (n = 20)

As to motivation for choosing the profession of a nurse, 40% noted the ability to realize their professional skills, and another 40% the ability to help people. Also, 10%

of nurses had confidence that people need them. In addition, 10% of nurses

30%

20%

50%

partly like the nursing profession

negative attitude towards the nursing profession do not regret chosen profession

30%

20%

no problems infrequent problems at work sometimes problems at work often problems at work

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considered communicating with people the main motive when choosing the profession (see Figure 5).

Figure 5. Motives for choosing the nursing profession (n = 20)

When they were asked if they had heard anything about the journal club for nursing, all the nurses answered “no” (100%). When asked whether they found time for self- education, 100% of the nurses said that there is no time at all, since 100% of the nurses in the hemodialysis department work more than 14 hours per day and have 1–2 days off per week, which they spend on rest and communication with family.

When asked if their hemodialysis skills are out of date, 60% answered no, and 20%

added that they had never thought about it. Of the respondents, 40% said that their skills and knowledge were outdated, and 10% added that they received skills from their older and more experienced colleagues (see Figure 6).

40%

10% 10%

ability to realize professional skills the ability to help people confidence that people need communication with people

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Figure 6. Outdating of hemodialysis skills (n = 20)

It should be noted that 100% of nurses agreed that it is necessary to learn new things in the field of hemodialysis. Thirty percent of the nurses thought that it is possible to engage in self-education at the workplace, 70% answered that it was impossible, and 20% added that this is impossible because they are always busy with the work

process and there are no breaks (see Figure 7).

Figure 7. Self-education in the workplace (n = 20)

60%

40%

hemodialysis skills are not outdated hemodialysis skills are outdated

30%

70%

self-education in the workplace is possible self-education in the workplace is impossible

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The survey revealed that the profession of a nurse for the members of the journal club is a favorite thing, and not just a duty. It is important for them to help people, to be needed by patients, and to provide quality care. Unfortunately, in the workplace, nurses face all sorts of challenges. This leads to a decrease in job satisfaction.

Members of the journal club noted the importance of developing and improving their skills and knowledge in the field of hemodialysis. However, only one third of them admitted that it is possible to engage in self-development and training in the workplace. So, none of the nurses had previously assumed the existence of such a teaching method as a journal club. As a result, they showed interest in this format of training and expressed their wishes for holding further meetings of the journal club.

This questionnaire showed that currently, nurses in dialysis departments are ready to learn, acquire new knowledge and skills, and apply them in practice. The only caveat is that many do not have enough time and energy to learn. Therefore, such a training format as a journal club, which can be held in workplaces, is an excellent alternative for nurses to learn new things without interrupting their work, and also makes it possible to immediately apply certain results in clinical practice.

9 Discussion

The purpose of this development work was to promote the evidence-based practice of nursing in one large clinic through the pilot activities of the Nursing Journal club.

Another goal was to make a plan on how to turn a Journal club into a daily nursing practice. These purposes were achieved by realization of meetings of journal club for nurses in the hemodialysis unit. There were three meetings of the journal club, the participants were 20 nurses from hemodialysis unit, and three topics were discussed.

The main result of this development work was to create a plan to make journal club a part of the routine of nurses' work. According to Xiong and colleagues (2018), there are several key elements for implementing a journal club. Moreover, these

recommendations can be modified and supplemented depending on the goals and objectives of the implementation of a particular journal club. (Xiong et al. 2018.)

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To define this plan for introducing the journal club into the daily work of a nurse, three meetings of the journal club for nurses in the hemodialysis unit were held.

Thus, 20 nurses took an active part in all three meetings. First, they were explained the purpose of the meeting and the rules of the journal club. Each meeting was held at the workplace, which was approved by all participants. This made it possible to devote more time to the analysis of articles and not to be distracted by other things not related to the topic of the meeting of the journal club. In general, the meetings were held in a friendly atmosphere, which gave an additional impetus for further participation in the club.

Based on the results of three meetings of the journal club, feedback was collected, and a questionnaire was conducted. The results showed that in many ways, the journal club can meet the needs of nurses to study scientific articles and develop evidence-based nursing practice. A study by Laaksonen and colleagues (2013)

showed that a journal club allows you to gain new knowledge and apply it in practice in the future.

10 Conclusion

The introduction of a journal club teaching method was well received by the hemodialysis nurses. Feedback from several journal club meetings revealed that nurses are eager to learn and want to advance in their profession. However, at the same time, they often do not have enough time to devote themselves to learning new things. In such a situation, the journal club was successful. Of course, the nurses were somewhat apprehensive at first about the organization of a journal club in the hemodialysis department because they were afraid of the new and unknown. But after the first meeting, they realized that this format is quite convenient and useful for them. This way they can learn new trends in their field and apply skills with support from each other. All meetings took place in a relaxed atmosphere, which contributes to a deeper immersion in a new topic and motivates to apply new knowledge in practice.

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References

Adams, S. & McCarthy, A.M. 2007. Evidence-Based Practice Guidelines and School Nursing. Journal of School Nursing, 23, 128–136.

DOI: 10.1177/10598405070230030201

Alam, S. & Jawaid, M. 2009. Journal Clubs: An Important Teaching Tool for

Postgraduates. Journal of the College of Physicians and Surgeons—Pakistan: JCPSP, 19, 71-72. PMID: 19208306

Arnold, W. 2020. A Guide to Starting Your Own Journal Club. Addgene’s Blog.

Retrieved from https://blog.addgene.org/a-guide-to-starting-your-own-journal-club Asif, I.M., Wiederman, M., & Kapur, R. 2017. Journal Clubs in Sports Medicine Fellowship Programs: Results from a National Survey and Recommendations for Quality Improvement. Clinical Journal of Sport Medicine, 27, 552–556. https://doi- org.ezproxy.jamk.fi:2443/10.1097/JSM.0000000000000402

Bauer, L. 2015. 5 Tips for Journal Club First-Timers. Retrieved from

https://irp.nih.gov/blog/post/2015/03/5-tips-for-journal-club-first-timers Being a Nurse Means Pursuing Lifelong Learning 2019. Eastern Illinois University.

Retrieved from https://learnonline.eiu.edu/articles/rnbsn/nurses-pursue-lifelong- learning.aspx

Benner, P., Hughes, R.G., & Sutphen, M. 2008. Chapter 6. Clinical Reasoning,

Decisionmaking, and Action: Thinking Critically and Clinically. In Hughes, R.G. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US). Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK2643/

Black, A.T., Balneaves, L.G., Garossino, C., Puyat, J.H., & Qian, H. 2015. Promoting Evidence-Based Practice Through a Research Training Program for Point-of-Care Clinicians. The Journal of Nursing Administration, 45, 14-20. doi:

10.1097/NNA.0000000000000151

Bondmass, M.D. 2014. Overview of evidence-based Practice. In Mateo, M.A. &

Foreman, M.D. (Eds.) Research for Advanced Practice Nurses: From Evidence to Practice. 2^nd edition. Springer Publishing Company, 3-14.

Bowles, P., Marenah, K., Ricketts, D., & Rogers, B.A. 2013. How to prepare for and present at a journal club. British journal of hospital medicine, 74, 150-152.

DOI: 10.12968/hmed.2013.74.Sup10.C150

Breimaier, H.E., Halfens, R.J., & Lohrmann, C. 2015. Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach. BMC Nursing, 31, 14-18. doi: 10.1186/s12912-015-0064-z.

Conwell, P., Aniskiewicz, M., Ghidini, J., & DeVaux, L. 2019. A Hospital-Based Program to Reduce Central Line-Associated Bloodstream Infections among Hospitalized

(34)

Patients Receiving Hemodialysis Using a Central Venous Catheter for Vascular Access. Nephrology Nursing Journal, 46, 587–590. PMID: 31872988

Davis, C., Hendry, I., Barlow, H., Leonard, A., White, L.-A., & Coetzee, M. 2014.

Journal club: Integrating research awareness into postgraduate nurse training. Curationis, 37, 1–9. https://doi-

org.ezproxy.jamk.fi:2443/10.4102/curationis.v37i2.1244.

de Lima Guimarães, G., Goveia, V.R., Quispe Mendonza, I.Y., dos Reis Corrêa, A., Silqueira de Matos, S., & Oliveira Guimarães, J. 2016. Profile of the Patient Usinge a Central Venous Catheter during Hemodialysis. Journal of Nursing UFPE / Revista de Enfermagem UFPE, 10, 4434–4442. https://doi-

org.ezproxy.jamk.fi:2443/10.5205/reuol.9978-88449-6-ED1012201601

Deenadayalan, Y., Grimmer, S.K., Prior, M., & Kumar, S. 2008. How to run an effective journal club: a systematic review. Journal of Evaluation in Clinical Practice, 14, 898–

911. https://doi-org.ezproxy.jamk.fi:2443/10.1111/j.1365-2753.2008.01050.x Dyckoff, D., Manela, J., & Valente, S. 2004. Improving practice with a journal club. Nursing, 34, 29. https://doi-org.ezproxy.jamk.fi:2443/10.1097/00152193- 200407000-00030

Harris, J., Kearley, K., Heneghan, C., Meats, E., Roberts, N., Perera, R., & Kearley- Shiers, K. 2011. Are journal clubs effective in supporting evidence-based decision making? A systematic review. BEME Guide No. 16. Medical Teacher, 33, 9–23.

https://doi-org.ezproxy.jamk.fi:2443/10.3109/0142159X.2011.530321

Johnson, J.A. 2016. Reviving the Journal Club as a Nursing Professional Development Strategy. Journal for Nurses in Professional Development, 32, 104-106.

DOI: 10.1097/NND.0000000000000241

Khan, K.S. & Gee, H. 1999. A new approach to teaching and learning in journal club. Medical Teacher, 21, 289–293. https://doi-

org.ezproxy.jamk.fi:2443/10.1080/01421599979554

Kjerholt, M. & Hølge, H.B. 2018. Cultivating a culture of research in nursing through a journal club for leaders: A pilot study. Journal of Nursing Management, 26, 42–49.

https://doi-org.ezproxy.jamk.fi:2443/10.1111/jonm.12518

Laaksonen, C., Paltta, H., von Schantz, M., Ylönen, M., & Soini, T. 2013. Journal club as a method for nurses and nursing students' collaborative learning: A descriptive study. Health Science Journal, 7, 285-292.

Luby, M., Riley, J.K., & Towne, G. 2006. Nursing research journal clubs: bridging the gap between practice and research. Medical Surgical Nursing, 15, 100-102.

PMID: 16700249

Malloch, K. & Porter-O-Grady, T. 2006. Introduction to evidence-based practice in nursing and health care. Boston: Jones and Barlett.

McGlacken-Byrne, S.M., O'Rahelly, M., Cantillon, P., & Allen, N.M. 2020. Journal club:

old tricks and fresh approaches. Archives of Disease in Childhood - Education and Practice, 105, 236–241. doi:10.1136/archdischild-2019-317374

(35)

Moore, T., Brightman, S., Dodson, D.L., & Warady, B.A. 2019. Arteriovenous Buttonhole Access Cannulation in Pediatric Patients on Hemodialysis. Nephrology Nursing Journal, 46, 407–412. PMID: 31490050

Pasek, T. & Zack, J. 2004. Cultivating a Research Milieu. Critical Care Nurse, 24, 96–

95. Retrieved from

http://search.ebscohost.com.ezproxy.jamk.fi:2048/login.aspx?direct=true&db=afh&

AN=15351608&site=ehost-live

Purnell, M. & Majid, G. 2017. A pediatric nurses’ journal club: developing the critical appraisal skills to turn research into practice. Australian Journal of Advanced

Nursing, 34, 34–41. Retrieved from

http://search.ebscohost.com.ezproxy.jamk.fi:2048/login.aspx?direct=true&db=afh&

Rowlands, A. & Winslow, S. 2011. The executive nursing leadership journal club. Journal, 94, 190–193. https://doi-

org.ezproxy.jamk.fi:2443/10.1016/j.aorn.2011.04.023

Sadoughi, F., Azadi, T., & Azadi, T. 2017. Barriers to using electronic evidence based literature in nursing practice: a systematised review. Health Information & Libraries Journal, 34, 187–199. https://doi-org.ezproxy.jamk.fi:2443/10.1111/hir.12186 Shahdadi, H. & Rahnama, M. 2018. Experience of Nurses in Hemodialysis Care: A Phenomenological Study. Journal of Clinical Medicine, 7, 30.

doi: 10.3390/jcm7020030

Schwantes, M. 2017. 9 Helpful Tips to Calm Your Nerves Before Speaking. Public Speakikng.

Inc. Retrieved from https://www.inc.com/marcel-schwantes/9-simple-tricks-to-overcome- your-fear-of-speaking.html

Sortedahl, C. 2012. Effect of Online Journal Club on Evidence-Based Practice

Knowledge, Intent, and Utilization in School Nurses. Worldviews on Evidence-Based Nursing, 9, 117–125. https://doi-org.ezproxy.jamk.fi:2443/10.1111/j.1741-

6787.2012.00249.x

Spek, B., Wieringa, de W.M., Lucas, C., & Dijk, N. 2013. Teaching evidence-based practice (EBP) to speech-language therapy students: are students competent and confident EBP users? International Journal of Language & Communication

Disorders, 48, 444–452. https://doi-org.ezproxy.jamk.fi:2443/10.1111/1460- 6984.12020

Ten Tips for Scientific Journal Clubs: How to Organize, Lead, and Participate Well 2020. STEMCELL TECHNOLOGIES. Retrieved from

https://www.stemcell.com/efficient-research/journal-club

Turner, P. & Mjolne, I. 2001. Journal provision and the prevalence of journal clubs: a survey of physiotherapy departments in England and Australia. Physiotherapy Research International, 6, 157–169. Retrieved from

http://search.ebscohost.com.ezproxy.jamk.fi:2048/login.aspx?direct=true&db=rzh&

(36)

Xiong, L., Giese, A.K., Pasi, M., Charidimou, A., van Veluw, S., & Viswanathan, A. 2018.

How to Organize a Journal Club for Fellows and Residents. Stroke, 49, e283- e285. doi: 10.1161/STROKEAHA.118.021728.

Yonkaitis, C.F. 2018. Evidence-Based Practice and School Nurse Practice: A Review of Literature. Journal of School Nursing, 34, 60–67. DOI: 10.1177/1059840517728108

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Appendices

Appendix 1. Questionnaire

PARTICIPANT 1. Male

2. Female

PLEASE YOUR AGE _________ years

WHAT IS YOUR WORK EXPERIENCE? 1. Total work experience _____ years 2. General experience in the field of health _____ years

WHEN YOU PLAN TO IMPROVE YOUR SKILLS 1. In the next 1-2 years 2. In 3-5 years

3. After 5-10 years

4. More than 10 years later WHAT DO YOU PERSONALLY GIVE

QUALIFICATIONS UPGRADE? (NO MORE THAN 3 ANSWERS)

1. Increase income

2. Improving professional status 3. Respect for colleagues 4. Respect for patients 5. Improving self-esteem 6. Other (specify)

______________________

7. Will not give anything significant WHAT IS THE DURATION OF YOUR WORK

WEEK? GIVE ANSWER ON EVERY LINE!

1. At the main place of work ________

hours per week

2. Additional paid employment at the main place of work ________ hours per week 3.

Additional paid employment at other institutions ________ hours

4. Private practice ________ hours per week

WHY DO YOU NEED THIS KIND OF INFORMATION?

WHAT IS THE MAXIMUM DURATION OF THE WORKING WEEK OF A NURSE, WHEN IT CAN SPEND TIME FOR SELF-EDUCATION, WHICH CAN YOU LOOK AT YOURSELF?

______ hours per week

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DO YOU HAVE FREE TIME TO DO SELF- EDUCATION (READ BOOKS, NEW ARTICLES IN THE AREA OF HEMODIALYSIS)

1. YES 2. NO

DO YOU THINK YOUR KNOWLEDGE AND HEMODIALYSIS SKILLS ARE OUT OF DATE AND NEED TO UPDATE YOUR KNOWLEDGE?

1. YES 2. NO

HAVE YOU HEARED BEFORE JOURNAL CLUB FOR NURSING?

1. YES 2. NO WOULD YOU LIKE TO FIND OUT

HEMODIALYSIS INNOVATIONS IN THE WORK PLACE?

1. YES 2. NO

DO YOU CONSIDER IT POSSIBLE TO STUDY AT THE WORKPLACE?

1. YES 2. NO

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Appendix 2. Cover letter

Dear Head Administrator!

The purpose of this study is to promote evidence-based nursing practice in Zhasandy buirek hospital by piloting the Nursing Journal club activity. Another purpose is to make the plan of how to put journal club activity into daily nursing practice.

The aim of the study is to analyze current nursing research with nurses and develop nurses’ skills to learn scientific articles and using that evidence-based information in practice.

I would kindly ask for your consent to hold a journal club for nurses in the conditions of your clinic, our club will not affect the work process and will be voluntary, the record of nurses for participation in JC will be held for the first time in 2019. Those who wants to improve their theoretical and practical skills, learn to use information retrieval, and overcome the fear of public speaking will supplement admission to the Journal club for nurses of the hemodialysis department.

Our meetings will be held once a month, each nurse will be a speaker during the JC, and of course, everyone will be a listener, the meeting will be 90 minutes, the information received by the medical siesta will be assessed and it will be decided in practice.

Sincerely:

Sadykova D.K.

KazMUCE

Supervisors:

PhD Ospanova D.A.

KazMUCE

PhD, Principal lecturer Hanna Hopia JAMK University of Applied Sciences

Application of Journal Club for Nurses in the Hemodialysis Unit