Table 10 Limitations of the interventions

Cleary et al. [38]

Australia

Sustainability of the intervention is challenging

Ferguson et al. [39]

Australia

Difficulty in gaining consent from patient to be observed; skills of observer

Williams et al. [40]

Australia

Too intensive thus affecting motivation and ability to attend all sessions

Travaglia et al. [41]

Australia

Resistance from colleagues to change, and nurse/ midwives taking clinical leadership roles, time constraints

MacPhail et al. [23]

Australia

Time away from clinical duties

Short timeline from progamme implementation and limited evaluation of participants’ leadership knowledge and skills

Leggat et al. [42]

Australia

*

Dierckx de Casterelé[45]

Belgium

*

Miller and Dalton [25]

England

Time away from the clinical setting

Leeson and Millar [26]

England

*

Enterkin et al. [27]

England

Intervention too long

Phillips and Byrne [31]

England

Maintaining momentum generated by the intervention

Castillo and James [32]

England

*

Stoll et al. [33]

England

*

Miani et al. [34]

England

Resistance to change from frontline healthcare providers who did not taking part in the programme. Short period of time to enable change

Runnacle et al. [35]

England

*

Lunn et al. [28]

Ireland

*

McNamara et al. [29]

Ireland

*

Fealy et al. [36]

Ireland

*

Patton et al. [37]

Ireland

*

Pearson et al. [30]

Scotland

Intervention very demanding

Martin et al. [46]

Switzerland

Kling [43]

USA

*

Abraham [44]

USA

*

Lekan et al. [24]

USA

Without control group changes cannot be conclusively attributed to the intervention