Monitoring practice and alarm technology in anaesthesiology

Abstract

In this article we examine how one of the most pervasive technological implementations in the healthcare domain -the alarm system -is used in anaesthesiology as part of patient monitoring. The utility and appropriateness of alarms in healthcare domains have been widely addressed in the literature. However, we argue that we still know little about the practical use of alarm systems in actual healthcare practice. Studies rarely examine in detail the everyday monitoring practices during normal operations in the absence of, or before, problems become critical and alarming. They have mainly considered how medical professionals manage the interpretation of and response to alarms. Rather than examining how the anaesthesiologist identifies and responds to alarms and critical problems, in this article we focus on how the anaesthesiologist is actively and prospectively engaged in implementing a situated and emergent organization of patient monitoring, using a wide range of different technological and material resources.

Inquiry in health knowledge management

“…She steps forward and points at the indication of the blood pressure on the monitor screen and tells Michael, “I think this is pain” (Svensson, 2007, p. 18).…”

“…The authors cited above provide considerable evidence that an individual's own value commitments and their commitments to the values and norms associated with their role and/or professional group (viz, patient, health practitioner specialty, academic researcher, or a mixture of these, and other roles) are important in personal and organizational learning (knowledge creation). Caring informs the knowledge created during the patient‐health worker encounter in a particular context, such as in an operating theatre (Svensson, 2007), maternity care (Büscher and Jensen, 2007), or mental healthcare (Clarke et al , 2007). In such contexts knowledge emerges directly from individuals, their social resources, and emergent patterns of conduct, communication and collaboration.…”

Technology-Enhanced Learning of Human Trauma Biomechanics in an Interprofessional Student Context

“…Such a perspective also includes how bodies, gestures, and interaction with material objects are enacted. 10 Sociomaterial research has identified that experts' abilities in radiology, [11][12][13] anesthesiology, 14 surgery, 15 as well as in law and archaeology 16,17 rely on practices for classifying phenomena, including talk, gestures, and object manipulations. Consistent with these studies, Ivarsson 13 has shown that one's own body and gestures serve as fundamental resources in experts' readings of radiographs, e.g.…”

Does health care for systemic development?

“…A duty of care informs the knowledge created in the patient-health worker encounter in a particular context, such as in a rehabilitation clinic (Ellingsen, 2003), maternity care (Bu ¨scher and Jensen, 2007) or an operating theatre (Svensson, 2007). In such contexts knowledge emerges directly from individuals, their social resources and emergent patterns of conduct, communication and collaboration.…”

“…They seek to integrate the three perspectives developed above: application of standardized pre-existing codified knowledge and technology (knowledge application); effective channelling of individual capabilities via the norms guiding a local community of practice (knowledge normalization) and value-based personal and organizational learning (knowledge creation). As suggested by the quotes from Bu ¨scher and Jensen (2007) and Svensson (2007), such a pluralistic approach lies at the very heart of patient care. 'Self-reflection on, and expression of, personal values is required in any examination of how knowledge is, and ought to be, linked to power, and power to knowledge.…”