Using a framework to plan and evaluate the results of a specific intervention supports the successful implementation of evidence-based practice (EBP). The ACE Star Model of Knowledge Transformation is a process model developed to guide change in nursing and clinical practice. This paper will dwell upon the five stages of the Star model, i.e., knowledge discovery, evidence summary, translation, integration, and evaluation, and discuss the benefits and drawbacks of thereof compared to the Iowa model.
At the stage of knowledge discovery, scientific inquiry and traditional research methods are used. In the studied case, a surgical incision infection is observed in the female patient after an appendectomy, and Clostridium difficile diarrhea is likely to be found in the child after tonsillectomy. The primary research study revealed that the lack of handwashing between patients at medication dissemination, substituting handwashing with gloves, and avoiding wearing foot covers are the possible reasons for the spread of infection.
The evidence summary synthesizes and integrates the available evidence to become more manageable (Buttaro et al., 2019). The rate of patients’ readmission has increased, indicating that the above two cases are commonplace. It is necessary to prepare a systematic review, showing which medical workers contacted the readmitted patients the most often, according to the records. Besides, it is necessary to find out the reasons for their evading the rules. Finkelman and Kenner (2017) point out the necessity to synthesize the knowledge obtained at the previous into a single, meaningful statement. In the studied case, the statement would be the following: Hand hygiene in the surgery department is poor, resulting in readmission of patients with infectious diseases.
At the stage of translation into practice of recommendations, a documented guideline should be developed. Integration into practice is the fourth stage of the Star model, where “evidence is implemented and there is a change in practice” (Buttaro, et al., 2019, p. 9). Elcock et al. (2018) recommend to provide a sufficient supply of personal protection equipment close to the point of use and to apply standard infection precautions to blood and body fluid spillages. The knowledge and understanding of the personnel’s hand hygiene should be revisited, addressing the reasons for their failure to follow the rules listed at stage two.
At the stage of evaluation, the impact of the practice change should be evaluated. One shall consider the impact on patient health results, satisfaction of medical workers and patients, economic analysis, efficiency, and impact on the health status of the whole population (Finkelman & Kenner, 2017). At this stage, further issues are to be found and directed to the new cycle of the Star model.
The emphasis of the Star model is on knowledge transformation, while the Iowa model focuses on the organizational process. Thus, the Star model has a considerable drawback: it does not provide for team creation and a pilot change. The former could be practiced outside the model framework, but the latter presupposes re-initiating the model in case of failure. At the same time, the absence of these stages makes the implementation of the Star model less time-consuming, which is especially crucial in the conditions of limited time. Another significant benefit of the Star model is the necessary preparation of evidence summary, which generalizes the participants, settings, and treatment types.
The Star model is a simple but comprehensive method of learning and understanding evidence-based practice. It describes cyclic stages that evidence should pass to be synthesized into a user-friendly form for further decision-making. As long as the bulk of clinical information is not systematized into a brief and succumb statement with clear steps to address it, it is not usable.
References
Elcock, K., Wright, W., Newcombe, P., & Everett, F. (Eds.) (2018). Essentials of Nursing Adults (1st ed.). SAGE Publications Ltd.
Finkelman, A. W., Kenner, C. (2017). Professional nursing concepts: Competencies for quality leadership (4th ed.). Jones & Bartlett Learning.
Terry Mahan Buttaro, Patricia Polgar-Bailey, Joanne Sandberg-Cook, Trybulski, J. (2019). Primary care: Interprofessional collaborative practice (6th ed.). Elsevier.