Table 3.

Summary of implementation strategies used in included studies and reported outcomes

Study author, date (country)	Implementation strategies from EPOC taxonomy									Implementation strategies not included in EPOC taxonomy				Outcomes
	Educational materials	Educational meetings	Local consensus process	Educational outreach visits	Local opinion leaders	Patient mediated interventions	Audit & feedback	Tailoring interventions	Reminders	Adaptation of CPG to local context	External facilitation	Changes to Org Policy	Multi-faceted participatory Approach
Ammerman, 2003 (USA)		X												Ø Patient health status (attitudes/practices to prevent hypercholesterolemia; blood lipids, weight and dietary choices)
Charrier, 2008 (Italy)							X				X			+ Professional practice (adoption of guideline practices)
Cheater, 2006 (UK)	X	X		X			X	X						Ø Professional practice (adherence to urinary incontinence assessment guidelines)
Daniels, 2005 (USA)	X	X	X							X	X			+ Professional practice (compliance with asthma care guidelines)
Day, 2001 (UK)		X												+ Professional knowledge (knowledge of endotracheal suctioning) + Professional practice (ability to practice guideline recommendations effectively)
Donati, 2020 (Italy)		X					X							+ Professional practice (hand hygiene)
Elliott, 1997 (USA)	X	X		X	X			X			X			Ø Professional knowledge (knowledge of cancer pain management, pain intensity)
Evans, 1997 (USA)	X	X	X	X							X			+ Professional practice (identification/treatment of asthma) + Patient health status (continuity of care, patient education by professionals)
Fairall, 2005, 2010 (South Africa)	X		X	X				X		X				+ Professional practice (Increased case detection, improved therapy/practices by professionals, improved prescribing) Ø Expenditures (cost effectiveness)
Feldman, 2004(USA)	X	X		X						X	X			+ Professional practice (quality of life, satisfaction with home care services, survival at 9 days) + Resource use (emergency department use, hospital admissions)
Friese, 2019 (USA)	X						X	X	X			X		Ø Professional knowledge (knowledge of PPE) Ø Professional practice (PPE use)
Haegdorens 2018, 2019 (Belgium)		X												+ Professional practice (frequency and quality of vital signs) Ø Patient health status (unexpected death, cardiac arrest, unplanned ICU admission
Harrison, 2000 (South Africa)	X	X		X						X				+ Professional practice (quality of case management)
Hödl, 2019 (Austria)	X	X												+ Patient health status (adverse events caused by urinary incontinence)
Hodnett, 1996 (Canada)	X	X			X						X			Ø Professional practice (adherence to practice guidelines)
Jansson, 2014 (Finland)		X					X				X			+ Professional knowledge (knowledge of mechanical ventilation) + Professional knowledge (adherence to practice guidelines, improved simulation exposure)
Jansson, 2016a, 2016b (Finland)		X					X							Ø Professional knowledge (hand hygiene, pneumonia prevention by staff)
Kalinowski, 2015 (Germany)	X	X												Ø Professional practice (nonpharmacological pain management techniques) + Patient health status (pain management)
Kaner, 2003 (UK)		X		X										+ Professional practice (screening/adherence to protocol; patient management) Ø Expenditures (cost effectiveness)
Köpke, 2012 (Germany)	X	X									X		X	Ø Professional practice (decreased restraint use; adherence to guidelines)
Lozano, 2004 (USA)	X	X					X				X			+ Patient health status (Asthma symptoms, frequency of steroid use)
Mayou, 2002 (UK)	X	X						X						+ Patient health status (quality of life, anxiety/depression)
McDonald, 2005 (USA)	X		X	X					X	X				Ø Professional practice (nursing pain assessment) + Patient health status (symptom management and quality of life) + Expenditures (cost effectiveness)
Moon, 2015 (South Korea)	X	X												Ø Patient health status (incidence of delirium; in hospital mortality)
Murtaugh, 2005 (USA)	X			X					X	X				+ Professional practice (Adherence to nursing protocols; nursing assessment)
Naylor, 2004 (USA)	X	X								X				+ Patient health status (time to first hospitalization or death, quality of life, functional status)
Noome, 2017 (Netherlands)	X				X					X	X			+ Professional knowledge (knowledge of evidence-based practice in end-of-life care) Ø Professional practice (adherence to guidelines)
Pagaiya, 2005 (Thailand)	X	X		X			X							+ Professional practice (prescribing medication to manage diabetes)
Parker, 1995 (USA)		X												+ Professional knowledge (knowledge of diabetes management) Ø Professional practice (diabetes management)
Premaratne, 1999 (UK)		X		X							X			Ø Professional practice (steroid prescribing) + Patient health status (quality of life) Ø Resource use (attendance to emergency department, admission to hospital)
Rood, 2005 (Netherlands)	X					X			X					+ Professional practice (adherence to guidelines)
Ruijter, 2018 (Netherlands)	X							X						Ø Professional practice (adherence to guidelines)
Snelgrove-Clarke, 2015 (Canada)		X									X			+ Professional practice (patient safety, adherence to guidelines)
Titler, 2009; Brooks, 2008 (USA)	X	X	X	X	X		X				X	X		+ Professional practice (adoption of practices to address pain intensity) + Patient health status (pain intensity)
Tjia, 2015 (USA)	X	X					X						X	Ø Patient health status (toolkit awareness) Ø Professional practice (adherence to guidelines, antipsychotic prescribing)
Vallerand, 2004 (USA)	X	X									X			+ Professional knowledge (perceptions of pain)
Van Gaal, 2011a; 2001b (Netherlands)	X	X				X	X	X						+ Patient health status (patient safety)
VonLengerke, 2017 (Germany)		X						X		X			X	+ Professional practice (hand hygiene)
Weiss 2019 (USA)	X	X										X		Ø Patient health status (in-patient readmission, return visit to hospital)
Wright, 1997 (USA)		X												+ Professional practice (universal precautions)
Zhu, 2018 (China)		X												Ø Patient health status (hypertension prevention/ management)
Total	27	33	5	12	4	2	11	8	4	9	14	3	3

+ = positive effect on outcome; Ø = no effect on outcome