Table 1.
| Implementation strategy | Examples within the implementation of care bundles |
|---|---|
| Professional interventions | |
| Distribution of educational materials | (Web based) toolbox with educational materials, written material for self-study |
| Educational meetings | Educational meetings, seminars, workshops, teaching sessions |
| Local consensus processes | Development care bundle or materials or discussing about patients who developed an infection |
| Educational outreach visits | Use of a trained person who met professionals on the ICU to give information with the intent of changing practice |
| Local opinion leaders | Nursing and/or medical leadership |
| Audit and Feedback | Audits and feedback on infections rates or bundle compliance. Use of dash boards |
| Reminders | (Run) charts, checklists with bundle elements, daily goal sheets, insertion, HOB alarms |
| Tailored | Focus groups or (survey to) identify barriers |
| Mass media | Posters, fact sheets, newsletters, brochures to reach a great number of staff |
| Other; Time-out procedure | Time-out procedure, empower to stop procedure |
| Patient interventions | |
| Patient-family interventions | Family education of the bundle elements or family participation |
| Organisational interventions | |
| Revision of professional roles | Shifting of roles among staff |
| Clinical multidisciplinary teams | (Daily) multidisciplinary rounds, multidisciplinary teams |
| Skill mix changes | Changes in the number of staff |
| Continuity of care | Group of doctors to remove catheters daily |
| Satisfaction of providers | Nursing and medical champions, material rewards and staff engagement |
| Other; Implementation teams | Special team is actively involved to implement the care bundle, improvement teams |
| Structural interventions | |
| Changes in medical record system | Changes in a medical record system for electronic documentation |
The EPOC taxonomy contains more items. We only used the taxonomy which was relevant in our study