Disjunctures in practice: ethnographic observations of orthopaedic ward practices in the care of older adults with hip fracture and presumed cognitive impairment
| العنوان: | Disjunctures in practice: ethnographic observations of orthopaedic ward practices in the care of older adults with hip fracture and presumed cognitive impairment |
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| المؤلفون: | Jane L. Cross, Tamara Backhouse, Simon P. Hammond, Bridget Penhale, Fiona Scheibl, Nigel Lambert, Anna Varley, Chris Fox, Fiona M. Poland |
| المصدر: | Ageing and Society. :1-22 |
| بيانات النشر: | Cambridge University Press (CUP), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Health (social science), Arts and Humanities (miscellaneous), Social Psychology, Public Health, Environmental and Occupational Health, Geriatrics and Gerontology |
| الوصف: | Organisational priorities for health care focus on efficiency as the health and care needs of populations increase. But evidence suggests that excessive planning can be counterproductive, leading to resistance from staff and patients, particularly those living with cognitive impairment. The current paper adds to this debate reporting an Institutional Ethnography of staff delivering care for older patients with cognitive impairment on acute orthopaedic wards in three National Health Service hospitals in the United Kingdom. A key problematic identified in this study is the point of disjuncture seen between the actualities of staff experience and intentions of protocols and policies. We identified three forms of disjuncture typified as: ‘disruptions’, where sequenced care was interrupted by patient events; ‘discontinuities’, where divisions in professional culture, space or time interrupted sequenced tasks; and ‘dispersions’, where displaced objects or people interrupted sequenced care flow. Arguably disruption is an integral characteristic of care work; it follows that to enable staff to flourish, organisations need to confer staff the autonomy to address systemic disruptions rather than attempt to eradicate them. Ultimately, organisational representations of ‘good practice’ as readily joined up, impose a care standard ‘stereotype’ that obscures rather than clarifies the interactional problems encountered by staff. |
| وصف الملف: | application/pdf |
| تدمد: | 1469-1779 0144-686X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8c5c3f271a1311a25b960b740fedc0ab https://doi.org/10.1017/s0144686x22000927 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....8c5c3f271a1311a25b960b740fedc0ab |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14691779 0144686X |
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