Implementation of clinical practice guidelines using the Plan–Do–Study–Act framework: The methodology and experiences of the Academy of Nutrition and Dietetics Health Informatics Infrastructure Registry Study on gestational diabetes mellitus

Background: Registered dietitian nutritionists (RDNs) use clinical practice guidelines (CPGs) to inform evidence‐based practice. Despite the availability of CPGs, guidelines are not always translated into practice. This challenge is central to implementation science (IS), which seeks to understand h...

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Publicado en:Nutrition in Clinical Practice Vol. 40; no. 6; pp. 1465 - 1483
Autores principales: Knippen, Kerri Lynn, Woodcock, Lindsay, Papoutsakis, Constantina, Gonzales‐Pacheco, Diana M.
Formato: practice guidelines research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
      vid: 40
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/ncp.70043
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        atl: Implementation of clinical practice guidelines using the Plan–Do–Study–Act framework: The methodology and experiences of the Academy of Nutrition and Dietetics Health Informatics Infrastructure Registry Study on gestational diabetes mellitus
      aug:
        au:
          Knippen, Kerri Lynn
          Woodcock, Lindsay
          Papoutsakis, Constantina
          Gonzales‐Pacheco, Diana M.
        affil: Department of Public and Allied Health, Food and Nutrition Program, Bowling Green State University, Bowling Green Ohio,, USA
      sug:
        subj:
          Practice Guidelines
          Diabetes Mellitus, Gestational
          Academy of Nutrition and Dietetics Standards
          Dietitians
          Nutritionists
          Human
          Female
          Male
          Quantitative Studies
          Qualitative Studies
          Convenience Sample
          Questionnaires
          Conceptual Framework
          Semi-Structured Interview
          Audiorecording
          Quality Improvement
          Nutrition Education
          Implementation Science
          Coding
          Communication
          Confidence Intervals
          Thematic Analysis
          Funding Source
          Female
          Male
      ab: Background: Registered dietitian nutritionists (RDNs) use clinical practice guidelines (CPGs) to inform evidence‐based practice. Despite the availability of CPGs, guidelines are not always translated into practice. This challenge is central to implementation science (IS), which seeks to understand how evidence can be adopted and sustained. Methods: The Gestational Diabetes Mellitus (GDM) Registry Study was a multiphase, multisite hybrid implementation study that explored guideline implementation using quality improvement (QI) methods grounded in the Model of Improvement and guided by Plan–Do–Study–Act (PDSA) cycles. Following a baseline period, RDNs completed training, conducted a gap analysis, and identified 2 CPG implementation aims. Sites completed iterative PDSA cycles. Deidentified nutrition care data were entered into the GDM Study Registry and manually audited to evaluate process outcomes. RDNs participated in a closing interview. Qualitative data were analyzed using a constructivist approach and reflexive thematic analysis, supported by artificial intelligence (AI)–assisted qualitative software. Results: Six themes were identified, highlighting the value of assessing current practices and the flexibility of PDSA as an implementation strategy. Themes were mapped against the Normalization Process Theory and Consolidated Framework for Implementation Research and showed alignment between PDSA and implementation principles. The registry audit demonstrated improved process measures. The median normalization score across RDNs (9.00) and sites (9.42) was high, suggesting normalization. Conclusion: PDSA facilitated the work of normalization and enabled practice changes. This study contributes to IS by demonstrating how QI strategies, such as PDSA can help RDNs translate evidence into everyday nutrition care.
      pubtype: Academic Journal
      doctype:
        practice guidelines
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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