The ACE Star Model traces how new clinical knowledge travels from a research study to routine bedside care, then back again.
Most EBP models in nursing capstones, such as the Iowa Model or Stetler, assume the evidence already exists and focus on finding and applying it.
The ACE Star Model asks an earlier question: where does evidence come from, and what has to happen to it before a nurse can safely use it? This guide covers the five points, where your project fits, a worked example and the mistakes to avoid.
The ACE Star Model at a Glance
The ACE Star Model, developed by Kathleen Stevens at the Academic Center for Evidence-Based Practice in San Antonio, has five points: discovery research, evidence summary, translation to guidelines, practice integration and evaluation. Each point is a different form of the same knowledge, and evaluation feeds back into new discovery.
Capstone students rarely start at discovery. Most enter at the evidence summary, then do their own work at translation, integration and evaluation, citing the published research behind the first two points.
What the ACE Star Model Is
Kathleen Stevens introduced the model in the early 2000s at the Academic Center for Evidence-Based Practice (ACE), based at the University of Texas Health Science Center at San Antonio. Its purpose was to map a journey that had not been well described: how a research finding becomes everyday care.
The model is drawn as a five-point star. Each point is a stage where the knowledge changes form, from a single study to a synthesis, a recommendation, a changed practice and finally measured outcomes.
The star is cyclical rather than linear. Evaluation does not close the process; it raises new questions and gaps that send the cycle back to discovery.
Because it describes a general pathway, the model works at every program level. What changes between BSN, MSN and DNP projects is how much of the cycle the project works through and how deeply.
The Five Points of the Star
The table summarizes each point and what it typically produces. Keep the distinctions sharp, because markers check that you understand them.
| Point | What it represents | Typical output |
|---|---|---|
| 1. Discovery research | New knowledge from primary research such as trials, cohort studies and qualitative studies | A single published study |
| 2. Evidence summary | Synthesis of a body of studies into one statement of what the evidence shows | Systematic review, meta-analysis or integrative review |
| 3. Translation to guidelines | Turning the summary into an actionable recommendation, weighing strength and applicability | Clinical practice guideline, protocol or care standard |
| 4. Practice integration | Moving the recommendation into routine use through organizational and individual change | Adopted protocol, new workflow or changed habit |
| 5. Evaluation | Measuring process and outcome effects, then feeding new questions back to discovery | Outcome data that closes or reopens the cycle |
Each point transforms the knowledge rather than repeating a task. A summary is not yet a recommendation, and a recommendation that exists on paper is not integration until nurses actually follow it.
Applying the Model Step by Step
Work through the points in order in your framework section. The notes below show how a typical capstone engages with each one.
1. Discovery: Where the Knowledge Starts
New knowledge enters through primary research. Capstone students almost never generate knowledge here; instead, they identify the primary studies behind the summaries they use.
Name this point briefly to show you know where your evidence comes from. Do not imply you carried out original research at that scale.
2. Evidence Summary: What the Research Shows
This is where most student work begins. Find existing systematic reviews, meta-analyses or integrative reviews on your question and state what they conclude together.
If no strong summary exists for your exact question, build a smaller synthesis from the primary studies in your literature review. Say clearly that you have done so.
3. Translation: From Evidence to Recommendation
State what the summary means your unit should do. A general finding such as "structured discharge teaching reduces readmission" becomes a defined teach-back script delivered at a set point before discharge.
Where a recognized clinical guideline already covers your topic, cite it and adapt it to your setting rather than deriving a new recommendation from scratch.
4. Practice Integration: Making It Routine
Describe how the recommendation becomes everyday practice: staff education, workflow or documentation changes, leadership support and the specific behaviors that need to change.
This is where a change theory such as Lewin's or Kotter's, or an implementation framework such as i-PARIHS, can support the broader ACE Star framing.
5. Evaluation: Measuring the Real Effect
Measure whether the change produced the outcome the evidence predicted. Include both the clinical outcome and how consistently staff followed the new practice.
State what questions your results raise. In this model, evaluation is meant to feed the next round of discovery rather than end the story.
Where Your Project Enters the Cycle
Naming your entry point is one of the clearest signs that you understand the model. The table shows typical scope by level.
| Level | Usual entry point | Where your own work sits |
|---|---|---|
| BSN | Evidence summary | Translation and a proposed integration and evaluation plan |
| MSN | Evidence summary or an existing guideline | Translation adapted to a population, with designed integration |
| DNP | Evidence summary or an existing guideline | Translation, led integration and measured evaluation with sustainability |
A BSN project can stop at a proposed evaluation plan, while a DNP project usually reports real data. Check your handbook for whether you must implement or only propose.
When the ACE Star Model Is the Right Choice
Choose the ACE Star Model when your program or committee wants you to show that you understand the full lifecycle of evidence, not just how to apply one guideline to one problem. It suits framework chapters that open with evidence-based practice as a whole.
It is especially useful when the evidence is uneven across the star. Strong systematic reviews may exist at point 2 while no widely adopted guideline yet turns them into a specific recommendation at point 3.
Naming that gap and positioning your project as doing some of the translation is a stronger framing than saying you followed an existing guideline.
When Another Model Fits Better
If your project's real story is organizational readiness, staff buy-in or a past change that stalled, an implementation model such as i-PARIHS carries that story better. Many strong capstones use ACE Star as the outer frame and a change theory to detail point 4.
Worked Example: Reducing CAUTI
Here is how the five points play out on a common capstone topic: reducing catheter-associated urinary tract infections (CAUTI) on a general medical unit with a nurse-driven catheter removal protocol.
Discovery. Primary studies have compared nurse-driven catheter removal with removal that waits for a physician order, generally finding fewer catheter days when nurses can act on defined criteria.
Evidence summary. A systematic review of this research concludes that nurse-driven removal protocols are associated with shorter catheter dwell time and lower CAUTI rates, with the strongest effects where removal criteria are explicit and built into daily assessment.
Translation. National infection prevention guidance turns this into a recommendation: assess catheter necessity daily against defined criteria and allow nurses to remove catheters when criteria are met.
Integration. The unit adds a daily catheter necessity check to the nursing assessment flowsheet, trains staff on the criteria over two weeks and secures an approved nurse-driven removal protocol from medical leadership.
Evaluation. The project compares catheter days and CAUTI rate for 12 weeks before and after rollout, plus checklist completion. Results show which criteria staff apply inconsistently, a question for future work.
The student's own contribution sits at points 3 to 5. Points 1 and 2 are cited from published work, which is exactly how the model should be applied in a capstone.
ACE Star Compared with Other EBP Models
Committees often ask why you chose this model. The table gives the key contrast with the models you are most likely to be compared against.
| Model | How it differs from ACE Star |
|---|---|
| Iowa Model | Starts at a clinical trigger and moves through appraisal, piloting and adoption, rather than starting upstream at knowledge generation |
| PARIHS and i-PARIHS | Give structured attention to context, recipients and facilitation during implementation, where ACE Star's integration point is light |
| Stetler Model | Built for an individual practitioner applying evidence, without ACE Star's account of where evidence comes from |
| Johns Hopkins EBP Model | Organizes work as practice question, evidence and translation with detailed appraisal tools, treating generation and summary as a given |
A good answer to "why ACE Star?" is usually that your project needed to show where its evidence came from and how it was transformed before it could be applied. The Iowa Model guide is useful if you are weighing the two.
Where the Model Sits in Your Capstone
Each point maps naturally to a chapter or section. Use this to keep the framework visible throughout the paper rather than only in one chapter.
| Capstone section | ACE Star point |
|---|---|
| Introduction and background | Brief acknowledgment of discovery: the research base behind your topic |
| Literature review | Evidence summary: your synthesis of reviews and primary studies |
| Framework chapter | Full explanation of the model and your entry point |
| Proposal or recommendation | Translation: your specific, actionable recommendation |
| Implementation plan | Integration: education, workflow changes and leadership support |
| Results or evaluation plan | Evaluation: what the data show or will show, and what it means for future work |
Common Mistakes with the ACE Star Model
- Claiming all five points at equal depth, including discovery, when the real work sat at translation to evaluation.
- Merging summary and translation. One says what the evidence shows; the other says what to do about it.
- A vague integration point that says "staff training" without naming the education, workflow and leadership steps.
- Treating evaluation as the end rather than naming the question your results raise.
- Choosing ACE Star for a readiness story that an implementation model would explain better.
- Citing a secondary summary of the model instead of Stevens' original work and ACE's own materials.
What Evaluation Should Measure
Aim for at least two kinds of outcome. Patient outcomes show the clinical effect, and process outcomes such as protocol compliance show whether the change actually happened. Where relevant, add an efficiency measure such as length of stay.
How NurseCapstone Helps with the ACE Star Model
Send your practice problem, setting, program level and the sources you have. A writer drafts a model framework section that names your entry point, summarizes your evidence and builds the translation, integration and evaluation points around your project.
Use it as a reference for your own chapter. Work is written from scratch and plagiarism-checked, and free revisions within the scope of your original request are included.
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Frequently Asked Questions
The Iowa Model starts from a clinical trigger and moves forward through appraising and applying evidence. The ACE Star Model starts further upstream and traces the whole path from research to practice and back.
At point 2, the evidence summary. They use existing reviews, then do their own work at translation, integration and evaluation.
A summary says what a body of research shows. A translation says what a specific team should do in response, such as a protocol with defined criteria.
Yes. Name your entry point, acknowledge the summary you drew on and focus on translation with a proposed integration and evaluation plan.
Lightly. If barriers are central to your project, pair it with i-PARIHS or a change theory such as Lewin's or Kotter's at the integration point.
Yes. ACE Star maps the path of the evidence, while a change theory explains how you moved people through the change at point 4.
Kathleen Stevens, at the Academic Center for Evidence-Based Practice at the University of Texas Health Science Center at San Antonio.