To Lift or Not to Lift: An institutional Ethnography of Patient Handling Practices

2.50
Hdl Handle:
http://hdl.handle.net/10755/160940
Type:
Presentation
Title:
To Lift or Not to Lift: An institutional Ethnography of Patient Handling Practices
Abstract:
To Lift or Not to Lift: An institutional Ethnography of Patient Handling Practices
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:de Ruiter, Hans-Peter, PhD
P.I. Institution Name:Minnesota State University
Title:School of Nursing
Contact Address:360 Wissink Hall, Mankato, MN, 56001, USA
Contact Telephone:612-338-5274
Co-Authors:H. de Ruiter, School of Nursing, Minnesota State University, Mankato, MN;
The handling (lifting,turning etc) of patients is an integral part of the care work in health-care institutions. Handling patients puts healthcare providers at risk for musculoskeletal injuries (MSI's). In the last decade a concerted effort has been made to decrease caregiver injuries by implementing Safe Patient Handling Programs (SPHP). SPHP's represent a change in institutional thinking from the historical belief that MSI's are inherent to care work, to the contemporary idea that injuries are preventable. Despite these efforts, healthcare providers continue to be at risk for injury. This study starts with the assumption that care workers are positioned at the intersection between the patient and the hospital policies and guidelines that govern their care. In order to understand the caregiver's continued exposure to injury, this study examines the work of caregivers during their shift and the policies and guidelines they encounter that impact their decisions. This study is an Institutional Ethnography (IE), a unique research approach that makes visible how complex actions in everyday care work are coordinated by institutional texts such as polices and guidelines. It was conducted in two healthcare facilities on units which had instituted SPHP's and had state-of-the-art lifting equipment. Two sources of data were used for this study. The first were actual observations of every day lifting. The second source of data is the institutional texts that impacted the handling of patients. Key findings of this study are: 1. Caregivers are subjected to multiple policies simultaneously that require conflicting actions, 2. The knowledge needed to handle patients safely is primary contextual knowledge, 3. The conflicts between institutional texts is an important reason why caregivers continue to be exposed to risk of injury, 4. Practice that does not lead to adverse outcomes is invisible, 5. Documentation is the primary tool for reflecting patient handling practices, yet the patient health record does not reflect actual practice but rather is a reflection of the institutional priorities. These findings have implication on actual documentation practices, health-care policy making and the moral impact on caregivers.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTo Lift or Not to Lift: An institutional Ethnography of Patient Handling Practicesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160940-
dc.description.abstract<table><tr><td colspan="2" class="item-title">To Lift or Not to Lift: An institutional Ethnography of Patient Handling Practices</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">de Ruiter, Hans-Peter, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Minnesota State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">360 Wissink Hall, Mankato, MN, 56001, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">612-338-5274</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">hans-peter.de-ruiter@mnsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">H. de Ruiter, School of Nursing, Minnesota State University, Mankato, MN;</td></tr><tr><td colspan="2" class="item-abstract">The handling (lifting,turning etc) of patients is an integral part of the care work in health-care institutions. Handling patients puts healthcare providers at risk for musculoskeletal injuries (MSI's). In the last decade a concerted effort has been made to decrease caregiver injuries by implementing Safe Patient Handling Programs (SPHP). SPHP's represent a change in institutional thinking from the historical belief that MSI's are inherent to care work, to the contemporary idea that injuries are preventable. Despite these efforts, healthcare providers continue to be at risk for injury. This study starts with the assumption that care workers are positioned at the intersection between the patient and the hospital policies and guidelines that govern their care. In order to understand the caregiver's continued exposure to injury, this study examines the work of caregivers during their shift and the policies and guidelines they encounter that impact their decisions. This study is an Institutional Ethnography (IE), a unique research approach that makes visible how complex actions in everyday care work are coordinated by institutional texts such as polices and guidelines. It was conducted in two healthcare facilities on units which had instituted SPHP's and had state-of-the-art lifting equipment. Two sources of data were used for this study. The first were actual observations of every day lifting. The second source of data is the institutional texts that impacted the handling of patients. Key findings of this study are: 1. Caregivers are subjected to multiple policies simultaneously that require conflicting actions, 2. The knowledge needed to handle patients safely is primary contextual knowledge, 3. The conflicts between institutional texts is an important reason why caregivers continue to be exposed to risk of injury, 4. Practice that does not lead to adverse outcomes is invisible, 5. Documentation is the primary tool for reflecting patient handling practices, yet the patient health record does not reflect actual practice but rather is a reflection of the institutional priorities. These findings have implication on actual documentation practices, health-care policy making and the moral impact on caregivers.</td></tr></table>en_GB
dc.date.available2011-10-26T23:13:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:13:15Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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