Understanding Personal Protective Equipment Use in Interdisciplinary Medical Settings: Design Considerations for Just-in-Time Interactive Compliance Alerts

We examine the use of personal protective equipment (PPE) in two interdisciplinary medical settings to inform the design of just-in-time alerts and reminders for correcting PPE noncompliance. We reviewed videos of 26 pediatric resuscitations occurring over the course of the COVID-19 pandemic at an urban pediatric teaching hospital. Through video review, we identified causes for PPE noncompliance, activities that were frequently performed without PPE, instances in which PPE was intentionally removed, and mechanisms by which healthcare providers corrected PPE noncompliance. We also interviewed 18 registered nurses working in the hospital’s emergency department (ED) and intensive care unit (ICU) to better understand observed PPE behaviors and practices. Our results suggest that alert design will require considering the urgency of correcting PPE noncompliance against the urgency of tasks being performed. We discuss our findings through the lens of the COM-B framework and conclude by exploring design opportunities for just-in-time alerts and reminders for prompting PPE noncompliance corrections in dynamic medical work.