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Addressing patients’ communication support needs through speech-language pathologist-nurse information-sharing: Employing ethnography to understand the acute stroke context
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Managing ongoing swallow safety through information-sharing: an ethnography of speech and language therapists and nurses at work on stroke units
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Abstract:
Aims To generate new understanding for how speech and language therapists and nurses share information for ongoing management of swallow safety on stroke units. Design: Ethnographic methodology, involving 40 weeks of fieldwork on three stroke wards in England between 2015 and 2017. Methods: Fieldwork observation (357h) and interviews with 43 members of speech and language therapy (SLT) and nursing staff. Observational and interview data were analysed iteratively using techniques from the constant comparative method to create a thematically organised explanation. Results: An explanation for how disciplinary differences in time and space influenced how SLT and nursing staff shared information for ongoing management of swallow safety, based around three themes: (1) SLTs and nurses were aligned in concern for swallow safety across all information sharing routes, however (2) ambiguity was introduced by the need for the information contained in swallowing recommendations to travel across time, creating dilemmas for nurses. Patients could improve or deteriorate after recommendations were made and nurses had competing demands on their time. Ambiguity had consequences for (3) critical incident reporting and relationships. SLTs experienced dilemmas over how to act when recommendations were not followed. Conclusion: This study provides new understanding for patient safety dilemmas associated with the enactment and oversight of swallowing recommendations in context, on stroke wards. Findings can support SLTs and nurses to explore together how information for ongoing dysphagia management can be safely implemented within ward realities and kept up to date. This could include considering nursing capacity to act when SLTs are not there, mealtime staffing, and SLT seven-day working. Together they can review their understanding of risk and preferred local and formal routes for learning from it.
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Keyword:
P Philology. Linguistics; RC Internal medicine
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URL: https://openaccess.city.ac.uk/id/eprint/27976/ https://openaccess.city.ac.uk/id/eprint/27976/10/Intl%20J%20Lang%20Comm%20Disor%20-%202022%20-%20Barnard%20-%20Managing%20ongoing%20swallow%20safety%20through%20information%E2%80%90sharing%20An%20ethnography%20of.pdf https://openaccess.city.ac.uk/id/eprint/27976/3/IJLCD%20Risk%20Paper%20Accepted.pdf http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1460-6984
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Communication between therapists and nurses working in inpatient interprofessional teams: Systematic review and meta-ethnography
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Is the content of patient’s written emotional disclosure associated with improved health outcomes for asthma patients?
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Childhood autism in the UK and Greece: a cross-national study of progress in different intervention contexts
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A Counter-Reformation Reaction to Slovenian and Croatian Protestantism: The Symbol of St. Athanasius in a Creed of 1624
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Cavallini Ivano. - : Hollitzer Verlag, 2018. : country:AT, 2018. : place:Vienna, 2018
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A role for virtue in unifying the knowledge and caring' discourses in nursing theory
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Every day, streams of changes: networks in time, place, process in the ‘snapshots project’
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In: http://www.axonjournal.com/ (2014)
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Undergraduate paramedic students' empathy levels: A two-year longitudinal study
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The inpatient psychiatric unit as both a safe and unsafe place: Implications for absconding
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In: Muir-Cochrane, E, Oster, C, Grotto, J, Gerace, A, Jones, J. (2013). The inpatient psychiatric unit as both a safe and unsafe place: Implications for absconding. International Journal of Mental Health Nursing, Vol. 22, No. 4, p. 304-312 http://dx.doi.org/10.1111/j.1447-0349.2012.00873.x (2013)
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The inpatient psychiatric unit as both a safe and unsafe place: Implications for absconding
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Cognitive and subjective effects of mephedrone and factors influencing use of a 'new legal high'
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In: Addiction , 107 (4) pp. 792-800. (2012) (2012)
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Cognitive and subjective effects of mephedrone and factors influencing use of a 'new legal high'.
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In: Addiction , 107 (4) pp. 792-800. (2012) (2012)
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Effect of Priming on Energetic and Informational Masking in a Same-Different Task
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