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Appears in Collections:Faculty of Social Sciences eTheses
Title: Materialities of clinical handover in intensive care: challenges of enactment and education
Author(s): Nimmo, Graham R
Supervisor(s): Edwards, Richard
Fenwick, Tara
Keywords: materialities socio-material panopticism actor-network ontology-in-practice actants handover intensive care enactment education outliers multiple ontologies agencies assemblages artefacts intra-action
Issue Date: 2014
Publisher: University of Stirling
Abstract: Abstract The research is situated in a busy intensive care unit in a tertiary referral centre university hospital in Scotland. To date no research appears to have been done with a focus on handover in intensive care, across the professions involved, examining how handover is enacted. This study makes an original contribution to the practical and pedagogical aspects of handover in intensive care both in terms of the methodology used and also in terms of its findings. In order to study handover a mixed methods approach has been adopted and fieldwork has been done in the ethnographic mode. Data has been audio recorded and transcribed and analysed to explore the clinical handovers of patients by doctors and nurses in this intensive care unit. Texts of both handover, and the artefacts involved, are reviewed. Material from journals, books, lectures and websites, including those for health care professionals, patients and relatives, and those in industry are explicated. This study explores the role of material artefacts and texts, such as the intensive care-based electronic patient record, the whiteboards in the doctors’ office, and in the ward, in the enactment of handover. Through analysis of the data I explore some of the entanglements and ontologies of handover and the multiple things of healthcare: patients, information, equipment, activities, texts, ideas, diseases, staff, diagnoses, illnesses, floating texts, responsibility, a plan, a family. The doing of handover is framed theoretically through the empirical philosophy of Mol’s identification of multiple ontologies in clinical practice (Mol, 2002). Each chapter is prefaced by a poem, each of which has relevant socio-material elements embedded in it. The significance of the findings of the research for both patient care and clinical education and learning is surfaced.
Type: Thesis or Dissertation

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