{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:40:01Z","timestamp":1789756801715,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Registered dietitian nutritionists (RDNs) use clinical practice guidelines (CPGs) to inform evidence\u2010based 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013Do\u2013Study\u2013Act (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)\u2013assisted qualitative software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ncp.70043","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T04:11:21Z","timestamp":1759464681000},"page":"1465-1482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Implementation of clinical practice guidelines using the Plan\u2013Do\u2013Study\u2013Act framework: The methodology and experiences of the Academy of Nutrition and Dietetics Health Informatics Infrastructure Registry Study on gestational diabetes mellitus"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3373-716X","authenticated-orcid":false,"given":"Kerri Lynn","family":"Knippen","sequence":"first","affiliation":[{"name":"Department of Public and Allied Health Food and Nutrition Program, Bowling Green State University Bowling Green Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0931-5346","authenticated-orcid":false,"given":"Lindsay","family":"Woodcock","sequence":"additional","affiliation":[{"name":"Data Science Center, Research, International, and Scientific Affairs (RISA), Academy of Nutrition and Dietetics Bowling Green Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7173-275X","authenticated-orcid":false,"given":"Constantina","family":"Papoutsakis","sequence":"additional","affiliation":[{"name":"Data Science Center, Research, International, and Scientific Affairs (RISA), Academy of Nutrition and Dietetics Bowling Green Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-2321","authenticated-orcid":false,"given":"Diana M.","family":"Gonzales\u2010Pacheco","sequence":"additional","affiliation":[{"name":"Nutrition and Dietetics, College of Education and Human Sciences, University of New Mexico Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2022.08.123"},{"key":"e_1_2_9_3_1","unstructured":"HoesingH.Clinical Practice Guidelines: Closing the Gap Between Theory and Practice. A White Paper by Joint Commission International.2016."},{"issue":"10","key":"e_1_2_9_4_1","first-page":"1754","article-title":"Nature of the evidence base and approaches to guide nutrition interventions for individuals: a position paper from the Academy of Nutrition Sciences","volume":"131","author":"Hickson M","year":"2024","journal-title":"Br J Nutr"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2016.07.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2020.11.001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzy080"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/chp.47"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2023.08.017"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzu047"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/chp.106"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.04.025"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/NT.0000000000000732"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.11154"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-015-0089-9"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10677"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2023.11.001"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2020-002246"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-045948C"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-021-00201-1"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-12730-9"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/frhs.2022.1005802"},{"key":"e_1_2_9_23_1","volume-title":"The Improvement Guide: A Practical Approach to Enhancing Organizational Performance","author":"Langley GJ","year":"2009"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-005076"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4482-6"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.08.094"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2013-001862"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000388"},{"key":"e_1_2_9_29_1","unstructured":"The Academy of Nutrition and Dietetics.Nutrition Terminology Reference Manual (eNCPT): Dietetics Language for Nutrition Care.Electronic Nutrition Care Process Terminology (eNCPT).https:\/\/www.ncpro.org\/"},{"key":"e_1_2_9_30_1","first-page":"1","article-title":"Implementation science using the Plan\u2010Do\u2010Study\u2010Act (PDSA) cycle: addressing hospital malnutrition with the global malnutrition composite score","author":"Bechtold ML","year":"2025","journal-title":"Nutr Clin Pract"},{"key":"e_1_2_9_31_1","unstructured":"Academy of Nutrition and Dietetics.Evidence Analysis Library.https:\/\/www.andeal.org\/"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-29"},{"key":"e_1_2_9_33_1","unstructured":"Institute for Healthcare Improvement.Aim Statement Worksheet.https:\/\/www.ihi.org\/resources\/tools\/aim-statement-worksheet"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2018.03.014"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2008.01.021"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S015"},{"key":"e_1_2_9_37_1","unstructured":"Institute of Medicine (US) and National Research Council (US).Committee to Reexamine IOM Pregnancy Weight Guidelines.2009."},{"key":"e_1_2_9_38_1","unstructured":"Institute for Healthcare Improvement.Quality improvement essentials toolkit.2017.https:\/\/www.ihi.org\/resources\/tools\/quality-improvement-essentials-toolkit."},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2018.10.025"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.01.002"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2017.07.015"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2019.08.174"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2023.1011958"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15426"},{"issue":"2","key":"e_1_2_9_46_1","first-page":"1","article-title":"Implementation of step\u2010down intermediate care (IC) in Buckinghamshire, UK: a qualitative evaluation study of healthcare professionals' experiences and perspectives","volume":"30","author":"Liapi F","year":"2024","journal-title":"Health Soc Care Commun"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16346"},{"key":"e_1_2_9_48_1","unstructured":"OpenAI.ChatGPT [large language model]. ChatGPT\u20104. Updated2023."},{"key":"e_1_2_9_49_1","unstructured":"AILYZE. 1 AILYZE.www.ailyze.com"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50"},{"key":"e_1_2_9_51_1","first-page":"1","article-title":"Implementation science in nutrition practice: a review of the Consolidated Framework for Implementation Research","author":"Sivakumar B","year":"2025","journal-title":"Nutr Clin Pract"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2021.03.013"},{"key":"e_1_2_9_53_1","unstructured":"Commission on Dietetic Registration Quality Management Committee.Quality Standards and Interoperability Team Process Improvement Action Plan Worksheet.2024. Accessed April 14 2025.https:\/\/www.cdrnet.org\/vault\/2459\/web\/\/Process%20Improvement%20How%20To%20Guide%20-%20UPDATED.pdf"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2019.04.017"},{"key":"e_1_2_9_55_1","unstructured":"Council on Research 2022\u201023 Implementation Subcommittee.Implementing Evidence: From Guidelines to Daily Practice.Evidence Analysis Center Academy of Nutrition and Dietetics.2023. Accessed April 14 2025.https:\/\/www.andeal.org\/guideline-implementation"},{"key":"e_1_2_9_56_1","unstructured":"Council on Research 2023\u201024 Implementation Subcommittee Evidence Analysis Center.Recommendation Prioritization Tool.Academy of Nutrition and Dietetics.2024. Accessed April 14 2025.https:\/\/www.andeal.org\/guideline-implementation"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2020.11.001"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2018.11.004"}],"container-title":["Nutrition in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.70043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T09:42:09Z","timestamp":1762422129000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ncp.70043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,2]]},"references-count":57,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/ncp.70043"],"URL":"https:\/\/doi.org\/10.1002\/ncp.70043","archive":["Portico"],"relation":{},"ISSN":["0884-5336","1941-2452"],"issn-type":[{"value":"0884-5336","type":"print"},{"value":"1941-2452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,2]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}