SynthesisImplementation science : IS2024
Effects of implementation strategies on nursing practice and patient outcomes: a comprehensive systematic review and meta-analysis.
Synthesis in Implementation science : IS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Pooled it
- Implementation strategies for embedding patient-reported outcome and experience measures (PROMs/PREMs) in routine care: secondary analysis of an umbrella review.Journal of patient-reported outcomes · 2026Pooled it
- Implementation effectiveness, barriers, and real-world outcomes of neuromuscular training programs for ACL injury prevention in female athletes: systematic review with narrative synthesis using SWiM framework.Frontiers in public health · 2026Pooled it
- How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework.Implementation science : IS · 2025Pooled it
- Reported use of implementation science theories, models, and frameworks in 151 implementation trials: secondary analysis of a systematic review targeting nursing practice.Translational behavioral medicine · 2025Pooled it
- Nurses' knowledge and its determinants in surgical site infection prevention: A comprehensive systematic review and meta-analysis.PloS one · 2025Pooled it
- Trial
- Sustainable improvement of interprofessional care for better resident outcomes: protocol for the INTERSCALE hybrid type III effectiveness cluster-randomized trial comparing individualized and collaborative delivery of an evidence-based care model for long-term care.Implementation science : IS · 2026Trial
- Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): results of a 28-site cluster-randomized type 3 hybrid trial.Implementation science : IS · 2025Trial
- Influence of a Multifaceted Nursing Practice Bundle to Support Hospitalised Adults With Cognitive Impairment: A Longitudinal Qualitative Study.Journal of clinical nursing · 2026Article
- The Nursing Implementation Complexity Tool for Digital Technology Implementation in Nursing: Design Science Research Study.Journal of medical Internet research · 2026Article
- Adaptation Model for Patient and Caregiver Dyads in Hospital-to-Home Transition: Theory Development and Content Validation.Healthcare (Basel, Switzerland) · 2026Article
- Pilot evaluation of a pharmacist-led technical assistance program to address buprenorphine dispensing in community pharmacies.Exploratory research in clinical and social pharmacy · 2026Article
- From Evidence to Value: Integrating Evidence-Based Medicine, Patient Safety, Quality Improvement, Learning Health Systems, and Value-Based Healthcare.Journal of evaluation in clinical practice · 2026Review
- Italian Adaptation and Psychometric Validation of the Evidence-Based Practice (EBP) Competency Scale.Worldviews on evidence-based nursing · 2026Article
- Clinical Issues - August 2026.AORN journal · 2026Article
- The Shift From Efficacy to Implementation Science (2020-2026) in Nursing Practice for Digital Mental Health: Scoping Review and Bibliometric Analysis.JMIR nursing · 2026Article
- Determining the Organizational Culture and Readiness for Evidence-Based Practice Amongst Surgical Ward Nurses in Namibia: A Cross-Sectional Study.Health science reports · 2026Article
- Barriers and Facilitators to Oral HIV Pre-exposure Prophylaxis Use in Australia: A Scoping Review Comparing Findings to Canada, New Zealand, and the United Kingdom.AIDS and behavior · 2026Review
- De-implementation of low-value care: contrasting theories, models, and frameworks to generate methodological guidance.Implementation science communications · 2026Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImplementation strategies targeting individual healthcare professionals and teams, such as audit and feedback, educational meetings, opinion leaders, and reminders, have demonstrated potential in promoting evidence-based nursing practice. This systematic review examined the effects of the 19 Cochrane Effective Practice and Organization Care (EPOC) healthcare professional-level implementation strategies on nursing practice and patient outcomes.
methodsA systematic review was conducted following the Cochrane Handbook, with six databases searched up to February 2023 for randomized studies and non-randomized controlled studies evaluating the effects of EPOC implementation strategies on nursing practice. Study selection and data extraction were performed in Covidence. Random-effects meta-analyses were conducted in RevMan, while studies not eligible for meta-analysis were synthesized narratively based on the direction of effects. The quality of evidence was assessed using GRADE.
resultsOut of 21,571 unique records, 204 studies (152 randomized, 52 controlled, non-randomized) enrolling 36,544 nurses and 340,320 patients were included. Common strategies (> 10% of studies) were educational meetings, educational materials, guidelines, reminders, audit and feedback, tailored interventions, educational outreach, and opinion leaders. Implementation strategies as a whole improved clinical practice outcomes compared to no active intervention, despite high heterogeneity. Group and individual education, patient-mediated interventions, reminders, tailored interventions and opinion leaders had statistically significant effects on clinical practice outcomes. Individual education improved nurses' attitude, knowledge, perceived control, and skills, while group education also influenced perceived social norms. Although meta-analyses indicate a small, non-statistically significant effect of multifaceted versus single strategies on clinical practice, the narrative synthesis of non-meta-analyzed studies shows favorable outcomes in all studies comparing multifaceted versus single strategies. Group and individual education, as well as tailored interventions, had statistically significant effects on patient outcomes.
conclusionsMultiple types of implementation strategies may enhance evidence-based nursing practice, though effects vary due to strategy complexity, contextual factors, and variability in outcome measurement. Some evidence suggests that multifaceted strategies are more effective than single component strategies. Effects on patient outcomes are modest. Healthcare organizations and implementation practitioners may consider employing multifaceted, tailored strategies to address local barriers, expand the use of underutilized strategies, and assess the long-term impact of strategies on nursing practice and patient outcomes.
trial registrationPROSPERO CRD42019130446.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.