Past: Used for teaching and increasing knowledge

1
Journal Clubs Provide the Perfect Duet A
Crescendo of Staff Development and A Prelude to
Improved Patient Care
Karen T. Bell, RN, MSN, CNN and Sheri Sauthoff,
RN, BSN, CNN
Dialysis Access Infection Prevention,
Cannulation Technique Modification
Journal Clubs
PTH Test Accuracy
Past Used for teaching and increasing
knowledge Present Find evidence-based research.
Apply research findings to patient care. Improve
outcomes Purpose Use the peer-reviewed
Nephrology Nursing Journals ANCC-CNE articles
which apply directly to our renal
patients Methods Search for evidence from the
last three years to modify our practice and
improve patient outcomes Outcomes With
CNS/Educator as mentor, 15 Journal Clubs were
presented by staff nurses who were primarily
responsible for initiating practice changes, peer
education and data collection

• Case Study Mysterious Parathyroid Hormone (PTH)
  Values after Parathyroidectomy in a Patient on
  Maintenance Dialysis8 directly related to two
  patients with similar PTH inconsistencies
• Results
• Assess / document arm in which reserved
  parathyroid tissue is placed post
  parathyroidectomy
• Drawing blood for PTH level from opposite arm
  provided more consistent results

• Articles Buttonhole Technique Strategies to
  Reduce Infections3 and Buttonhole Cannulation
  in Patients on Hemodialysis4
• Results
• Application of constant site cannulation
  technique in chronic unit (Graph 1)
• Revision of the procedure for Buttonhole
  cannulation
• Creation of a comprehensive Buttonhole Assessment
  Tool to decrease infection rates (Graph 2)
• Articles "Preventing Infection in HD Fistula
  Graft Vascular Accesses"5 and "Effectiveness of
  Guidelines to Prevent Intravascular
  Catheter-Related Infections in Patients on HD6
• Results Modification of access procedures
  yielding very low infection rates in the acute
  unit (Graph 3)

Graph 3
Graph 1
Graph 2
IV Iron and Anemia Management
Implications
Fluid Management

• Article "Improving IV Iron and Anemia Management
  In Hemodialysis Settings A Collaborative CQI
  Approach7
• Results
• Revision of Anemia Management Protocol in the
  chronic unit in Nov, 2009
• Regular replenishment of IV iron increased from
  21(11/09) to 41(12/09)
• Increased overall stability of patients
  hemoglobin levels
• Decreased usage of (expensive) erythropoiesis-stim
  ulating agent (ESA)

• Journal Clubs are an ideal venue to
• Empower nurses to find, present and use evidence
  to improve patient care
• Provide a forum for collegial collaboration that
  ends on a high note for everyone

Articles Pictures and Perspectives A Unique
Perspective on Intradialytic Weight Gain1 and
Dialysis Staff Encouragement and Fluid Control
Adherence in Patients on Hemodialysis (HD)2
Results Revision and increased use of a
patient education tool for managing fluid intake
specific to the HD patient
Citations 1. Sinclair Parker (2009) Nephrology
Nursing Journal, 36(6), 589-597. 2. Yokoyama,et
al (2009) Nephrology Nursing Journal, 36(3),
2289-297. 3. Ball (2010) Nephrology Nursing
Journal, 37(5), 473-478. 4. Birchenough,et al
(2010) Nephrology Nursing Journal 37(5),
491-499. 5. Deaver,K (2010) Nephrology Nursing
Journal 37(5), 503-506. 6. Bakke (2011)
Nephrology Nursing Journal 37(6), 601-616. 7.
Johnson,et al(2007) Nephrology Nursing Journal
34(2), 206-213. 8. Thompson Schiller (2009)
Hemodialysis International 13, 543-546.
We acknowledge our Journal Club presenters Neil
Bagamasbad, BSN Sigrid Bressler, BSN Reynold
Dilag, BSN Mary Ann Isales, BSN Melissa
Nasser, BSN Beth Overbey, BSN Maggie Quinn,
BSN Josh Tiongson, BSN Cecil Villanueva, BSN,
Vickylyn Yambao, BSN
karen.bell_at_uch.edu
sheri.sauthoff_at_uch.edu