Evidence map›Paper›PMID 41039660›Full record

ArticleNutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition2025

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.

Kerri Lynn Knippen, Lindsay Woodcock, Constantina Papoutsakis, Diana M Gonzales-Pacheco

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kerri Lynn KnippenDepartment of Public and Allied Health, Food and Nutrition Program, Bowling Green State University, Bowling Green, Ohio, USA.ORCID https://orcid.org/0000-0002-3373-716X
Lindsay WoodcockData Science Center, Research, International, and Scientific Affairs (RISA), Academy of Nutrition and Dietetics, Bowling Green, Ohio, USA.ORCID https://orcid.org/0000-0002-0931-5346
Constantina PapoutsakisData Science Center, Research, International, and Scientific Affairs (RISA), Academy of Nutrition and Dietetics, Bowling Green, Ohio, USA.ORCID https://orcid.org/0000-0001-7173-275X
Diana M Gonzales-PachecoNutrition and Dietetics, College of Education and Human Sciences, University of New Mexico, Albuquerque, New Mexico, USA.ORCID https://orcid.org/0000-0002-4414-2321

Funding

The Gestational Diabetes Mellitus Registry Study was supported by the Academy of Nutrition and Dietetics Foundation through the Karen Goldstein Memorial Medical Nutrition Therapy research grant. The Academy of Nutrition and Dietetics supported the project through staff and infrastructure contributions, including the Data Science Center of the Research, International, Scientific Affairs, Academy of Nutrition and Dietetics. The Academy of Nutrition and Dietetics and the Commission on Dietetic Registration provided financial and material support for the development of the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII) and Nutrition Care Process Terminology (NCPT).
6 · The paper itself

Abstract

backgroundRegistered 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.

methodsThe 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.

resultsSix 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.

conclusionPDSA 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.

Indexed as

Diabetes, GestationalDieteticsNutritionistsPractice Guidelines as TopicEvidence-Based PracticeFemaleHumansImplementation SciencePregnancyQuality ImprovementRegistriesAcademy of Nutrition and Dietetics Health Informatics Infrastructuregestational diabetes mellitusimplementation sciencemedical nutrition therapyNutrition Care Processquality improvementregistered dietitian nutritionist

Identifiers

PMID41039660
PMCPMC12590319

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.