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Table 4 Mental models informing item allocation decisions

From: Exploring healthcare providers’ mental models of the infection prevention “patient zone” - a concept mapping study

Mental model Description Example of Correct allocation Example of Incorrect allocation Shortcoming
Patient contact An object belongs inside the patient zone if it comes into contact with the patient. [The computer is] only in the room for medical rounds. It has contact only with my hands.” [Computer, correctly allocated outside] As soon as there is patient contact, the clothing is contaminated with the patient’s flora.” [HCP professional attire, incorrectly allocated inside] This mental model falls short when it comes to mobile objects that have contact with multiple patients.
Sectors The patient zone is a geographic zone defined by proximity to the patient or equivalent to the perimeter of the patient’s room. Inside the patient room is equivalent to inside the patient zone. The trolley is mostly located outside the patient room.” [Trolley, correctly located outside] Every place that the patient is using or staying at is patient zone. Also in a two-bed patient room.”[Bathroom, incorrectly allocated inside] This mental model falls short when it comes to rooms with multiple patients.
Incorrectly assumes that items change zone attribution, whereas experts describe patient zone attribution as a fixed characteristic.
Disinfection Version A: The item belongs inside the patient zone if it needs to be disinfected.
Version B: The item belongs outside the patient zone if it needs to be disinfected.
[Infusion pump is outside the patient zone] because it always needs to be disinfected.” [Infusion pump, correctly allocated outside] [They are inside the patient zone, because] hands have to be disinfected whenever you go to a patient.” [HCP hands, incorrectly allocated inside] The 5-moment concept patient zone is intended to inform whether an item needs to be disinfected and not the other way around. The deduction can be based on incorrect behavior (e.g. not disinfecting an item between patients).
Context-dependency An item can be inside or outside the patient zone, depending on the context. Depending on the situation, they [the hands] are inside the zone when the HCP is doing intervention on the patient.” [HCP hands, incorrectly allocated inside] Incorrectly assumes that items change zone attribution, whereas the patient zone is actually a fixed attribution.
  1. HCP healthcare provider