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Accelerating Evidence-Based Nutrition Practice

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On November 3, the Journal of the Academy of Nutrition and Dietetics published an article entitled “Implementation Science in Evidence-Based Nutrition Practice: Considerations for the Registered Dietitian Nutritionist,” co-authored by Christina Badaracco.

While extensive literature exists about implementation science in other clinical areas, little guidance exists in nutrition, thereby hindering acceleration of new evidence-based practices (EBP). This article adds both practical and theoretical guidance to the growing body of literature about implementation science and quality improvement in nutrition care. Further, it provides important justification for future work to improve implementation of evidence-based nutrition practice guidelines. It is important that registered dietitian nutritionists (RDNs) fully embrace implementation science to continue to advance the field of nutrition and improve dietetics practice quality and health outcomes for patients receiving their care.

Stakeholders throughout the healthcare system engage in research to improve clinical practices and patient outcomes. However, many barriers to embedding such innovations into practice remain, thus impeding their effectiveness and potential benefits to patients and providers.

The article provides a broad overview of implementation science and frameworks that can be used by RDNs to support systematic uptake of EBP. The authors focus on the normalization process theory (NPT) for systemic action planning to explain how EBP become adopted by and normalized within healthcare institutions. Explanations of the 4 domains—coherence, cognitive participation, collective action, and reflexive action—include implications for practicing RDNs. The article concludes with a case study based on the NPT undertaken by an RDN working together with interdisciplinary clinicians to implement the Malnutrition Screening Tool in a hospital setting.

To successfully improve patient care, it is important that the field of implementation science coincide with quality improvement both to optimize current practices and to develop and adopt improved iterations. In addition to accelerating the adoption of EBP and improving outcomes, engaging in this work is a practical way to advance the role of research dietitians.

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