Table 2 Characteristics of included studies

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)