Table 2.

Characteristics of included studies

Author/date	Aim of study	Design	Method of data collection	Source of barrier/enabler data extraction	Participants
Daniels et al. (2013) [24] USA	To identify strategies for effective implementation of swallowing screening in patients with stroke symptoms that presented in ED	Qualitative	Staff interviews	Barrier and enabler themes	ED nurses (n = 8)
Gache et al. (2014) [30] France	To identify the main barriers to effective implementation of Stoke Care Pathway in France	Qualitative	Semi-structured interviews	Barrier typology derived from data	Emergency physicians, neurologists, geriatricians, social workers, health care workers in rehab and nursing homes (n = 33)
Grady et al. (2014) [25] Australia	To assess emergency physicians’ perceptions of individual and system enablers to the use of thrombolysis in acute stroke	A web-based survey	Questionnaire	Responder’s agreement to pre-defined enabler statements	Australian fellows and trainees registered with ACEM (n = 429)
Hargis et al. (2015) [26] USA	To identify factors that may limit the administration of rt-PA in the emergency department at multiple stroke centres	A web-based survey	Questionnaire	Responder’s agreement to pre-defined enabler statements	ED nurses and pharmacists (n = 37)
Johnson MJ et al. (2011) [31] USA	To describe emergency nurses’ perceptions of specific barriers and enablers to the care of stroke patients in the emergency department	Qualitative	Focus groups	Barrier and enabler themes	Emergency nurses currently employed in an emergency department (n = 10)
Meuer et al. (2011) USA	To describe the pre-identified barriers to clinicians compliant with guidelines recommending the use of thrombolysis	Qualitative	Focus groups and one-to-one interviews	Barrier listed in the coding guide with definitions	Emergency physicians, nurses, neurologists, radiologists, hospital administrators, and hospitalists and pharmacist (n = 30)
Skecksen A et al. (2014) Sweden	To identify and analyse the barriers and enablers to implementing national thrombolytic guidelines	Qualitative	Semi-structured interviews	Barrier and enabler themes	Stroke healthcare professionals (nurses and physicians) (n = 16)
Van Der Weijden et al. (2004) [32] The Netherlands	To explore the opinion on possible barriers for working according to key recommendations for the acute phase a stroke care among neurologists	Paper-based survey	Questionnaire	Responder’s agreement to pre-defined barrier statements	Registered neurologists (n = 16)
Williams J et al. (2013) [29] Australia	To identify barriers which prevent rural health care providers from utilising thrombolysis in acute ischamic stroke	Paper-based survey	Questionnaire	Responder’s agreement to pre-defined barrier statements	All rural sites within NSW Australia that had an implemented thrombolysis service as defined by the NSF and an Stroke Care Coordinator position were deemed eligible for inclusion (n = 11)

ACEM Australasian College for Emergency Medicine, ED Emergency Department, NSF National Stroke Foundation