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School of Nursing creates Center for Evidence-based Nursing (4-27-00)

The School of Nursing at The University of Texas Health Science Center at San Antonio has established the Academic Center for Evidence-based Nursing (ACE), the only such program to date in the United States with an interdisciplinary focus.

Evidence-based practice, or EBP, is an approach to clinical practice whereby research is applied directly to patient care. "It is the bridge between research and clinical application," said Kathleen R. Stevens, Ed.D., RN, center director and professor in the nursing school’s Department of Family Nursing Care. "Our center will be the first to promote the trend toward EBP in the nursing field."

Transferring research to practice traditionally has taken 15 to 20 years. In the evidence-based approach, world literature is scanned for research findings, which are synthesized and packaged for clinical use. Current knowledge is expected to reach the patient much faster, producing better clinical outcomes.

The ACE will add a nursing perspective to an already impressive presence of evidence-based practice organizations in San Antonio. Those entities are the five-year VERDICT (Veterans Evidence-based Research Dissemination Implementation Center) project at the South Texas Veterans Health Care System, Audie L. Murphy Division; the federal Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center also at Audie Murphy; and the global Cochrane Collaboration.

"There is no other place in the world where the three components come together," said Dr. Stevens.

She credits Mary Ann Matteson, Ph.D., RN, chair of the Department of Family Nursing Care, with having the foresight to suggest establishing a center and finding the seed money to get it started.

The center’s first project, in collaboration with the University Health System (UHS) in San Antonio, is a smoking-cessation program for adolescents. Titled "Teen Smoking Cessation: Impact of Evidence-Based Practice," the project’s first year has been funded by $150,000 in state tobacco settlement money from the UHS.

The first phase will examine programs that have worked in the past, cultural sensitivities and motivational incentives. Researchers will hold focus groups of San Antonio adolescents to gather evidence for implementing an intervention program in the project’s second phase.

"A huge proportion—about 80 percent—of teens who smoke say they have tried to quit, so the desire is there," Dr. Stevens said.

Researchers will examine school-based programs, such as the successful national program implemented by the American Lung Association (ALA). The ALA program

resulted in a 21 percent cessation rate, said Dr. Stevens, but cultural specifics need to be developed for it to achieve the same success in this community. "We hope that by adding additional evidence, we can increase the quit rate," she said.

The smoking cessation project is an ideal way to kick off the evidence-based nursing center because it incorporates the principles of EBP and all of the Health Science Center’s missions: research, education, patient care and service.

The ACE will have a presence on the World Wide Web, which is vital to an organization of this type, Dr. Stevens said. The Web can bring together thousands of collaborators worldwide and greatly facilitates the gathering of research to bring that knowledge to bear on clinical practice.

Besides her teaching activities at the nursing school, Dr. Stevens is an investigator with VERDICT and editor of the Online Journal of Knowledge Synthesis for Nursing.

She has worked in the U. T. System for 25 years and most recently served as director of nursing research at the U. T. M.D. Anderson Cancer Center in Houston.

Contact: Jennifer Lorenzo