www.nursingmanagement.com Nursing Management • April 2012 19 Evidence-based nursing B road demands for improving healthcare quality underscore the importance of evidence-based practice (EBP) as a solution to achieve safe and effective care. New resources are now in place to hasten delivery on the promise of EBP: the ACE Star Model of Knowl- edge Transformation and the Improvement Science Research Network. Nurse managers must know how to integrate these resources for employing EBP and conducting improvement research in their clinical settings. The struggle of uptake As we examine whether we’re transforming the quality of care, we encounter many indicators showing that we haven’t. Errors and ineffective care are still at unacceptable levels. There’s broad agreement among clinicians, researchers, health plans, and quality improvement professionals about the urgent need to accelerate the uptake of evidence-based findings and tools into practice. At the same time, there’s considerable uncertainty about the most effective mechanisms for doing so. Two key factors can lessen this struggle: (1) transfor- mation of research results to yield “forms” of knowledge specifically designed for clinical application and (2) discovery of “what works” in promoting EBP uptake to speed adoption of improvement changes. Two resources are hastening the uptake of EBP and adding to our knowledge about how this uptake occurs through rigorous study of improvement strategies. The ACE Star Model of Knowledge Transformation addresses the forms of knowledge needed for EPB uptake, and the new Improvement Science Research Network provides a platform for acute care settings to join together to conduct landmark studies evaluating improvement strategies. The ACE Star Model To engage clinicians and managers in EBP, the nature of knowledge (evidence) must be directly relevant to decision making for their particular practice. Rather than having practitio- ners submersed in the volume of research, it would be better to provide a summary of all that’s known on the topic. Likewise, rather than requiring frontline decision makers to master the technical expertise needed in scientific critique, their point-of-care decisions would be better supported by evidence-based recommendations. The ACE Star Model of Knowledge Transforma- tion offers a simple yet comprehensive approach to translate evidence into practice. 1 The Star Model highlights barriers encountered when moving evidence into practice and explains how various stages of knowledge transformation reduce the volume of scientific literature, providing forms of knowledge that can be directly incorporated into care and decision making. The Star Model emphasizes crucial steps to convert one form of knowledge to the next and incorporates best research evidence with clinical expertise and patient preferences. Illustrated as a five-point star, the model defines the following forms of knowledge: Point 1: Discovery, repre- senting primary research studies; Point 2: Evidence Summary, which is the synthesis of all available knowledge compiled into a single harmonious statement such as a systematic review; Point 3: Translation, often referred to as evidence-based clinical practice guidelines, combining the evidential base and expertise to extend recommendations; Point 4: Integration, which is considered evidence-in-action, in which practice is aligned to reflect best evidence; and Point 5: Evaluation, which is an inclusive view of the impact that the EBP has on patient health By Kathleen R. Stevens, EdD, RN, ANEF, FAAN Delivering on the promise of EBP The challenge of conducting research in a clinical setting is real and significant. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.