Introduction
The nursing profession is characterized by working in shifts, during which nurses must take time off from their duties. In the process, the outgoing nurse has to hand over crucial patient information to the incoming nurse. The action, described as a handoff in nursing, involves the transfer of responsibility and accountability. A key feature of handoff is communication that ensures the incoming nurse is fully informed of the patient’s needs and conditions, including diagnosis, prescriptions, and follow-ups. The information can help prevent adverse outcomes resulting from poor communication, such as medical errors, delays in patient transfers, erroneous treatment plans, delayed discharge, and test duplication.
The Situation, Background, Assessment, Recommendation (SBAR) is regarded as a reliable and valid tool that can enhance communication during patient handoffs by reducing the adverse events associated with poor handoffs (Shahid & Thomas, 2018). The purpose of this assignment is to describe the EBPs in handoff communication by applying the ACE STAR model. The model has demonstrated efficacy in promoting best practices and can support effective handoffs through enhanced communication, thereby improving future patient outcomes.
Description of ACE STAR Model
Overview of the Model
The ACE Star Model was developed in 2004 by Dr Kathleen Stevens with support and facilitation from colleagues at the University of Texas Health Science Center. It describes the transformation of knowledge across five major stages, broadly embraced by healthcare organizations and professionals as part of EBP to improve patient communication and outcomes (Loversidge et al., 2019). The first step involves collecting data through primary research, followed by a summary of the evidence for translation, integration, and evaluation.
Purpose of the Model
Stevens aimed to create a tool for healthcare practitioners to describe the series, nature, and elements of knowledge applied across the diverse facets of EBP. It facilitates effective interaction among nurses, enhancing understanding of patients’ needs and conditions while reducing medical errors and improving adherence to treatment plans. It is beneficial across different cultural and social contexts, especially for patients with limited health literacy and low English proficiency.
Classification of the Model
The model can be applied for both individual and organizational use in guiding change in nursing practice across different settings. It primarily guides the incorporation of EBP into the nursing curriculum, as it is easily understood due to its similarities with the nursing process. According to Schaffer et al. (2012), the ACE STAR model emphasizes the transformation of knowledge, thereby validating the donation of nursing interventions to improve the quality of care. It is highly relevant in improving nursing education and clinical practice.
Key Features of the Model
The key features of the ACE STAR model highlight its contribution to knowledge creation and education by promoting positive behavior and academic achievement in nursing students. The features are represented by the model’s acronym, which begins with the letter A, to acknowledge learners’ positive actions. C denotes the connection involved in building upbeat relationships between instructors and students. E stands for empowerment, which entails equipping students with the tools and skills for them to succeed academically and socially. S denotes the support given to learners who struggle academically or socially. T entails teaching by providing high-quality, customized learning to suit the needs of each student (Loversidge et al., 2019). A involves regularly assessing students’ progress and making necessary adjustments. The final letter, R, stands for response to student needs consistently and fairly.
Steps of the Model
The ACE STAR model supports EBP through five steps, beginning with the discovery of fresh knowledge through primary research. Step two involves summarizing the evidence through a stringent review process that is then translated into evidence and guidelines for clinical practice. The third step involves integrating the evidence and recommending changes in the nursing practice. The final stage entails evaluating the impact of EBP on health care quality improvement.
Relationships in the Model
The steps of the ACE STAR model are closely interlinked by the creation and transfer of knowledge from one step to the other. The first step entails collecting primary data, which is then analyzed to create new knowledge. In the second step, knowledge and facts are refined to yield more meaningful information. The information is translated in the third step into standard best practices applicable to clinical nursing. According to White et al. (2021), the fourth step involves integrating new practices to support high-quality decision-making for healthcare delivery. In the final step of evaluation, best practices are continually assessed to describe their impact on improving healthcare delivery and achieving better patient outcomes.
Assumptions in the Model
The ACE Star Model conceptual framework focuses on identifying and addressing the social determinants of health, assuming that multiple factors shape people’s health. These include genetics, physiology, anatomy, individual behavior, social environment, physical environment, and healthcare access and quality (Loversidge et al., 2019). The model assumes that the interplay among factors within these domains affects healthcare delivery. The assumption is important since it defines the foundation for promoting health equity and improving health outcomes across all communities.
Application to Professional Practice
The ACE STAR model plays a key role in evaluating the readiness for change in healthcare organizations. It facilitates the successful planning and implementation of new initiatives and EBP, including the SBAR solution to address handoff challenges. The purpose is fulfilled by assessing an organization’s readiness to implement future changes, identifying barriers to change implementation, and developing systems to overcome these impediments (White et al., 2021). Therefore, when implementing an electronic structured nurse handoff tool or report, the ACE STAR model helps ensure a successful, sustainable implementation.
The key components of the ACE STAR model can be connected to typical actions that should guarantee success in implementing the handoff tool. It begins by raising awareness within the organization of the need for change and the specific concern the handoff tool aims to address: poor communication. The model provides a framework for assessing the organization’s readiness for change and for identifying potential barriers to implementation.
During implementation, the model supports staff and other stakeholders’ engagement to build support for introducing SBAR. During implementation, the ACE STAR model ensures the process is effective by properly training nurse members to use the tool and providing ongoing support and troubleshooting. It also supports sustainability through SBAR by continuously monitoring and evaluating its effectiveness and making necessary changes to ensure it continues to meet organizational needs.
The ACE STAR model proved highly relevant in facilitating reductions in medical errors by implementing SBAR to improve the handoff process. In the first stage of discovery, the organization identified errors that commonly occurred in the post-acute care center due to improper medication administration (Ruhomauly et al., 2019). The failure resulted in distorted information, so the incoming nurse was not fully informed about the proper medication suited to the patient’s needs and condition.
The preferred solution involved implementing electronic health record (EHR) systems in place of paper-based medical record systems, using SBAR. According to White et al. (2021), effective implementation of EHR systems can help to reduce medical errors. It further enhances adherence to guidelines and facilitates effective handoff communication, requiring outgoing nurses to register all patient information, including the medication that best suits their needs and preferences. In the final stage of evaluating the outcome, it became apparent that the process had improved, with fewer cases of medical errors associated with poor handoff communication. The use of SBAR EBP improved communication between incoming and outgoing nurses, thereby enhancing patient safety and outcomes.
Conclusion
In summary, effective handoff communication is highly critical in transferring critical patient information from one nurse to another. It can be facilitated by applying SBAR, which is valid and reliable for ensuring adequate communication in a hospital setting. Healthcare is enhanced by applying evidence-based practices using established models, such as the ACE STAR model.
The model developed by Dr Stevens has been a valuable resource for supporting nursing education and promoting EBP in clinical practice. The model’s key features supported the implementation of an electronic structured nurse handoff tool by providing structured guidance throughout the planning and implementation process. By following the model, the organization ensured a comprehensive approach to EHR implementation, addressing all key factors required for success. The model enhances effectiveness by supporting new learning through ongoing monitoring and evaluation, ensuring the handoff tool is sustainable for long-term success.
References
Loversidge, J. M., Zurmehly, J., & Sigma Theta Tau International. (2019). Evidence-informed health policy: Using EBP to transform policy in nursing and healthcare. Sigma Theta Tau International.
Ruhomauly, Z., Betts, K., Jayne-Coupe, K., Karanfilian, L., Szekely, M., Relwani, A., McCay, J., & Jaffry, Z. (2019). Improving the quality of handover: implementing SBAR. Future Healthcare Journal, 6(Suppl 2), 54–54.
Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2012). Evidence-based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209.
Shahid, S., & Thomas, S. (2018). Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care – A narrative review. Safety in Health, 4(1), 1–9.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2021). Translation of evidence into nursing and healthcare (3rd ed.). Springer Publishing Company, Llc.