Marjon Borgert

116 Chapter 6 RESULTS In total, 1533 records were identi ed for possible inclusion through the initial search, of which a nal set of 47 studies met the inclusion criteria (Fig. 1). Total nuŵďer oĨ studies included in revieǁ͗ ϰϳ Identification Screening Eligibility Included 2 articles were merged, because they continued the implementation in the same hospital. Records identified through searching in the databases: MEDLINE/PubMed, OVID Embase, CINAHL, Cochrane CENTRAL (n=2491) Records identified by hand search (n=3) Records after duplicates removed (n=1533) Records screened (n=1533) Records excluded by Title and Abstract (n=1251) 282 full-text articles assessed for eligibility full-text articles excluded (n=233) Compliance not reported or described insufficiently (n=50) Implementation strategies not reported (n=33) Other wards than ICU (n=9) No care bundle reported (n=10) Other bundle than central line, ventilator and sepsis (n=4) Abstract/Letters (n=99) Non-English records (n=6) Records after conference abstracts removed (n=2292) Figure 1. Flow chart of the study selection procedure Quality assessment Seventy-seven percent (36/47) of the studies scored between 15-19 points on the Downs and Black quality assessment scale and were classi ed as ‘fair’. Thirteen % (6/47) of the studies scored 20 points or more and were classi ed as ‘good’. Eleven percent of the studies were classi ed as ‘poor’(5/47) (Supplementary File 2). We assessed reporting bias of the included studies, and no studies were found reporting negative results.