Qualitative Themes and Illustrative Quotes From Key Stakeholders Regarding Methods of Disinfection, Tenwek Hospital, Bomet, Kenya
| Theme | Process | Quote |
|---|---|---|
| Equipment damage | Autoclave | Autoclave will not work for resuscitation equipment because of the plastic. |
| Boiling | Worried that boiling over time will make the rubber harder and distort the shape. | |
| Chemical | If we had a way to heat the water, [boiling] would be okay to try because the chemical breaks down the equipment faster. | |
| Steaming | The only thing that can be boiled or steamed is the rubber, not the metal parts. | |
| Insufficient capacity | Autoclave | Autoclaving they can put in that machine for 45 minutes. In 45 minutes, I can have 2 deliveries. |
| If we have enough supply, I will go for autoclave. | ||
| Boiling | In our setting, it cannot be like practical because we might not have time unless there is another person who is just in for that. | |
| We need a heater and something to put them in. How much heat would be needed? There’s not a consistent way to determine the heat level. | ||
| Chemical | Handling is a problem…sometimes we have an emergency and there is no suction bulb so someone will go and drop it and then pick it and rinse it assuming it is ready. | |
| Steaming | It is more or less the same as boiling. 20 minutes is a long time. You need to locate someone to do that work. | |
| Process adherence | Overall | With disinfection there is more temptation for someone to pick it before even the time is over…with the steam there is no way you would pick it before the timer. Also, with the disinfection you have to rinse with sterile water before you use. |
| Autoclave | So, that’s sort of the issue I see with that. It’s just sort of the cultural thing of waiting til the last minute and autoclaving requires a little bit of thinking ahead. | |
| Chemical | …assuring that it goes through the process is a problem. That’s the big challenge. | |
| Effectiveness | Autoclave | On the other hand, we know it works, it’s used for everything. |
| Boiling | But is it effective? | |
| Steaming | Is it effective? |