Table 1 Explanation of the implementation strategies using the EPOC taxonomy [21–23]

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