Table 1 Patterns coded within the data and examples of associated quotations and codes

Frequency

This relates to how often concepts appeared in the data. As an example, the code “perception about CHG soap” had the highest frequency, being coded 46 times in all the interviews combined. Therefore, frequency was one way that informed the discussion and conclusions about the importance or significance of perceptions about CHG. Below are examples of quotations associated with this code:

Quotation 1: “Yeah, I mean it gives you justification for why you are doing it because sometimes it is nice to say this is why we do it not just you have got to do it. I think people understand why and the importance there and do it more.”

Quotation 2: “Because I think it, I just don’t think it’s, I look more from a skin standpoint and how it’s affecting the patients and their skin and how dry it’s getting.”

• Perception about CHG soap

Sequence

This refers to the order in which concepts appeared. For example, when participants described the sequence of conducting a bath and the different steps involved as shown in the quotation below:

“So like from start to finish, from grabbing the supplies, to getting your help, conduct the bath and then documenting it.”

• Gathering supplies

• Getting help to do a bath

• Conduct and document bath

Correspondence

This refers to how concepts occurred in relation to certain activities. For example, activities such as changing the patient’s linen which might have happened during the bathing process and potentially interrupted or prolonged the time of the bath and necessitated the need for assistance.

“…depending on the patient, if I need, I can start a bath by myself, but if I need someone to help me roll them to get his back and change the linen, then I get help.”

• Getting help to do a bath

Similarity

This refers to whether the concepts were happening the same way or had the same meaning. For example, two participants could have meant or implied the same idea using different sentences. These two quotations relate to workload.

Quotation 1: “Techs call off a lot. If we don't have a health tech, then I will do as much as I can, and then when it comes to the turning part I'll ask for help. And if, depending on how the staffing is, so staffing could be an issue. If it's really busy, and there's like say, for example, we usually, minimal staff for us is three…”

Quotation 2: “And sometimes our techs are pulled if there's a sitter need on a floor. Sometimes they need sitters, and a lot of times when it happens they look to us for our sitter or for our health tech. You know, we might give her up for two, three hours. They might have a huge need, and they can't get anybody. So they'll say, well, we have to take her because it's a suicide watch or whatever, and they have to have somebody. So then, again, we're left without a health tech.”

• Heavy workload and staffing shortage

Difference

This relates to how different concepts were. For example, quotation 1 below refers to clinical stability of a patient while quotation 2 refers to environmental factors affecting CHG bathing.

Quotation 1: “A lot of it depends on a patient. Because if a patient is a really stable, our health techs can do that, but if they’re not, if it’s an unstable patient, then it’s appropriate for the nurse to be involved.”

• Clinical stability

Quotation 2: “The rooms are small with a lot machines and some do not have warm water in the sinks.”

• Environmental factors

Causation

If concepts appeared to lead to another or to one of the outcomes (completed bath, interrupted bath and bath not done). For example, in the quotation below, getting assistance leads to a faster bath which reduces the likelihood of patient refusal of baths.

“… because if you have two people on staff and could do the bath, one person can do the cleaning and then one person can do the rinsing. And then the timeframe for the bath can be shorter if you have someone good that you work with. The patient will not refuse the next bath if the previous is done fast.”

• Patient refusal

• Short bath duration

• Getting help to do a bath