Table 2 Detailed description of interventions

De Visschere et al. (2012) [31]

A supervised implementation of an oral healthcare guideline to improve the oral hygiene level of nursing home residents.

Organizational: Conduction of one oral healthcare team per ward consisting of two oral healthcare organizers, a physician and either an occupational or speech therapist.

Professional: 1.5 h presentation of the guideline, the oral healthcare protocol and the study to the director of nursing. 2 h theoretical and 1 h practical education for the members of the oral healthcare team covering the guideline.1.5 h training session for all ward nurses and nurse aids. Regularly bedside support of the oral healthcare organizers to ensure the delivery of the oral healthcare protocol and adherence to the guideline recommendations. Free oral healthcare products for all residents. Six-weekly meetings of the investigator, the project supervisor and the oral healthcare organizers to ensure implementation and to discuss problems.

Healthcare personnel, nursing home management.

Guideline dissemination^a

Multifaceted:

Clinical multidisciplinary teams, local consensus process, distribution of educational materials, education meetings, patient incentives.

Not prospectively identified.

Once in the beginning of the 6 months intervention period.

Bedside-support and team meetings frequently over the 6 months intervention period.

Köpke et al. (2012) [32]

A multifaceted guideline implementation based on the theory of planned behaviour to reduce physical restraint use.

Professional: 90 min. information session for intervention nursing homes to sensitize nurses about the matter of physical restraints and the message of the guideline by addressing their attitudes and experiences. Provision of a short version of the guideline. Distribution of posters, pens, mugs and notepads with the intervention’s logo. Flyers and brochures for relatives. Workshop for cluster-nurses on their role in the implementation process and in-depth information on avoiding physical restraints. A poster in the nursing homes foyer showing the contact nurses of the residents.

Healthcare personnel

Care as usual.

Standard information provided: three brochures about the use of physical restraints and how to avoid them. A short presentation on physical restraints.

Multifaceted:

Distribution of educational materials, education meetings, provision of promotional material.

Not prospectively identified.

Once in the beginning of the 6 months intervention period.

Tjia et al. (2015) [36]

A multifaceted, toolkit-based guideline implementation to reduce atypical antipsychotic prescribing rates.

Professional:

Arm 2: Mailed toolkit delivery with quarterly audit and feedback reports presenting aggregated facility-level data on atypical antipsychotic prescribing rates including benchmark comparisons with state and national prescribing levels. Provision of guideline-based information on efficacy and safety of atypical antipsychotics.

Arm 3: On-site toolkit delivery with quarterly audit and feedback reports presenting aggregated facility-level data on atypical antipsychotic prescribing rates including benchmark comparisons with state and national prescribing levels. Provision of guideline-based information on efficacy and safety of atypical antipsychotics. Academic detailing for prescribers. One educational session for nurses and one for certified nurse assistants on the use of antipsychotics in nursing homes. Pharmacist meeting with the nursing home management to discuss important messages from the toolkit, ways to implement change and to get commitment statements on using the information and delivering it to the prescribers. Follow-up telephone call to discuss progress.

Healthcare personnel, nursing home management.

Arm 1:

Mailed toolkit delivery (plain dissemination).

Multifaceted:

Distribution of educational materials, education meetings, audit and feedback, academic detailing.

Not prospectively identified.

Quarterly delivery of audit & feedback reports,

a single education meeting and multiple academic detailing visits during the 12 months intervention period. A single follow-up after 4–6 weeks after the academic detailing visits.

Van Gaal et al. (2011a/b) [33, 34]

Implementation of the patient safety programme “SAFE or SORRY?” to reduce the incidence of pressure ulcers, urinary tract infections and falls and to improve preventive care for residents at risk of those.

Professional: 1.5 h small-scale education meetings on the wards for all nurses on the causes of pressure ulcers, urinary tract infections and falls, their prevention and on assessment of patients at risk. Two 30 min. case discussions on every ward on these topics. Distribution of a CD-ROM containing educational material and a knowledge test. Three separate information leaflets on the prevention of pressure ulcers, urinary tract infections and falls provided to residents at risk. Chart feedback on process and outcome indicators for the three adverse events using a computerized registration system.

Healthcare personnel.

Care as usual.

Multifaceted:

Distribution of educational materials, education meetings, audit and feedback.

Not prospectively identified.

Once in the beginning of the 14 months intervention period.

Chart feedback frequently over the 14 months intervention period.

Ward et al. (2010) [35]

Employment of a project nurse to encourage the adoption of best-practice falls prevention strategies.

Organizational: Employment of a project nurse to encourage the facilities in using guideline-based strategies in fall risk and mobility assessment, the use of hip protectors, vitamin D supplementation, continence management, exercise programs, the use of appropriate footwear, medication review and post-fall management review.

Professional: Provision of information on the prevention of falls and fall injuries to the intervention nursing homes. An initial training session followed by three-monthly network meetings. Development of a resource set to promote fall prevention guidelines. Workshop on running exercise programs for the healthcare personnel of the intervention facilities.

Healthcare personnel.

Care as usual.

Multifaceted:

Clinical multidisciplinary teams, distribution of educational materials, education meetings.

Not prospectively identified.

Once in the beginning of the 17 months intervention period.

Three-monthly network meetings over the 17 months intervention period.