Table 4.
Think-Aloud Interview Themes and Subthemes with Illustrative Quotations a
| Healthcare Personnel | Illustrative Quotation |
|---|---|
| Theme 1. (Lack of) Familiarity with PPE items or designs | |
| P03, nurse, hospital A | I’ve never used [surgical masks] in practice… I’ve seen them like, on movies. Movies, I guess surgical movies. |
| P63, other HCP, hospital B | (laughs) I’m more used to the gowns that tie at the neck… I’m not familiar with those [breakaway neck] gowns. |
| P15, physician, hospital A | Well, I don’t use this, [it’s] not the type of gown that we have in the hospital. I mean different institutes may have different gowns. |
| P68, physician, hospital B | We’ve used different models in different places or, you know, I see patients in different hospitals and so I, I have seen that one before, you know. |
| P48, physician, hospital A | … I guess I use whatever’s in the cart, but I think most the times it’s the yellow [gown]. I mean there are those blue ones that float around every once in a while but they’re kind of the same. |
| P13, nurse, hospital A | I’ve worked at a few different hospitals and everyone has something a little bit different… ’cause I’ve been working here for like 2 and a half years, so it’s just I’m like more used to the materials that they have here at this point. |
| P51, nurse, hospital A | So we had to do a tie mask, kind of like this one, but it didn’t have the sticky part. It just was a little bit different. But, yeah, I was a little frustrated and I felt like it took more time to figure out how do it right. And I’m not totally confident that I took it off the right way every time. |
| P19, nurse, hospital A | So usually… I pull up here and I get that off, but I think I was confused… because this is a different gown, so I took off my gloves first and then I went this way… I did it backwards of what I normally would do. |
| P70, other HCP, hospital B | No, we have the thumb things on some of our gowns but we don’t have that neck thing… I mean, do you normally, you tear it, or what do you do with that? |
| P63, other HCP, hospital B | Ours don’t have the thumb things so that kind of threw me off a little bit… I wanted to take my gloves off first ‘cause that’s gonna be the dirtiest thing when I come out of a room, but then I was like, well if it’s got the thing over my thumb, like… am I going to contaminate my wrists when I try to, when I was doing this part here, where I was trying to lift my um hands up… |
| P33, physician, hospital A | ‘Cause I’m not used to taking ‘em off, so I was trying to remember like which order I’m supposed to take ‘em off and where to touch and where not to, not supposed to touch. |
| P62, nurse, hospital B | … I’m trying to think through this… again, this new process, this new outfit, what’s the best way I can do this, trying to touch the least amount of times the outer part of the gown, which clearly is the contaminated part of the gown. |
| Theme 2. Influence of routine practice | |
| P29, nurse, hospital A | So I think for people, depending on what their practices are, it would be a big change. I think gloves people put on and off so often that the change how you do it would uh--, it’s a lot of muscle memory to change. |
| P53, physician, hospital A | Well so part of it was (laughs) since we’ve been doing all of the Ebola training recently, we remove those gowns differently. And we have a very specific way that we do that that’s different than these gowns. So, typically, with these gowns we just sort of grab and just pull it off and it breaks. |
| P61, physician, hospital B | Yeah, so that’s… something that we teach in the biocontainment unit. It’s something that I’ve done, you know, so I worked in containment laboratories before I worked clinically in containment, and that’s always been something that we’ve done, just to limit the amount of spray and splatter. |
| P18, nurse, hospital A | It’s very similar to gowns I’ve used before, where they have like the Velcro, one on each side, where they Velcro together, so I knew that it had to connect somehow, and that side was the only place that had, you know, something on it, so I knew I had to get sticky somehow. |
| P63, other HCP, hospital B | I’m more used to the gowns that tie at the neck, and so I was trying to look at these and see if … there was a tab, but then it didn’t seem like it was sticky, so then I was like well maybe it’s not a tab, I don’t know if I’m supposed to tear this… |
| P23, physician, hospital A | But I kept thinking, “How am I going to pull the next [Doffy] tab, on this side?” ‘Cause I always took off one glove and then the other, so I kept thinking, ‘Oh, how, well I can’t touch this tab, so what will I do?” |
| Theme 3. Training experience and needs | |
| P30, physician, hospital A | … I’m sure I’ve been trained at some point… I mean I developed this, the way I do it somehow, I’m sure. |
| P07, other HCP, hospital A | The one I use most within the hospital is the yellow one, so for this one and the last one especially I kind of had to think about it from when I learned how to put it on… First time using it but I was uh, taught how to use it. |
| P22, nurse, hospital A | I don’t know, I guess in college we learned and then, kind of like a habit, so I would say… |
| P20, student, hospital A | … We were trained to do it like one or two ways, to take the gloves off while you’re putting the gown in the trash, or take the gown off and then take the gloves off. So, I prefer to take the gown off and then the gloves, ‘cause I feel like I’m still touching things when I’m taking the gloves off and the gown. |
| P32, nurse, hospital A | … Well, we had it in school and then during orientation I think they briefly went over it but we never did a hands-on put-on put-off. |
| P51, nurse, hospital A | I think maybe the box had a brief little picture on it. I can’t remember so well how it all went. I don’t think anyone showed me. They just said you have to tie it, so I figured it out. I was happy when we went back to the other masks. |
| P23, physician, hospital A | …I only watched the video once, but… if I use it more, I think I would be more comfortable with the little tab that I pull, and… pulling this off if, you know, I’ve done it a few more times… with practice I suppose. |
| P30, physician, hospital A | Oh, I just think it would be practice more than anything. Just kind of getting used to how to get the glove into that beak position um… I don’t know that there’d be any verbal cues or instructions that would do that. |
| P34, other HCP, HOSPITAL A | Um maybe, there’s probably a video but nothing like a live—where you actually practice. Which is obviously more useful for learning, muscle memory. |
Note: HCP, healthcare personnel; N-95, N-95 respirator.
a
Quotations have been lightly edited to remove word repetitions (eg, stammering) and verbal hesitations (eg, “um”).