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Medication communication during ward rounds on medical wards: power relations and spatial practices

Liu, Wei, Manias, Elizabeth and Gerdtz, Marie 2013, Medication communication during ward rounds on medical wards: power relations and spatial practices, Health, vol. 17, no. 2, pp. 113-134, doi: 10.1177/1363459312447257.

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Title Medication communication during ward rounds on medical wards: power relations and spatial practices
Author(s) Liu, Wei
Manias, ElizabethORCID iD for Manias, Elizabeth orcid.org/0000-0002-3747-0087
Gerdtz, Marie
Journal name Health
Volume number 17
Issue number 2
Start page 113
End page 134
Total pages 22
Publisher Sage
Place of publication London, Eng.
Publication date 2013-03
ISSN 1461-7196
Keyword(s) Anthropology, Cultural
Attitude of Health Personnel
Communication
Decision Making
Hospitals, Teaching
Humans
Information Dissemination
Interprofessional Relations
Interviews as Topic
Medical Staff, Hospital
Medication Therapy Management
Nursing Staff, Hospital
Observation
Patient Care Team
Pharmacists
Power (Psychology)
Professional-Family Relations
Professional-Patient Relations
Victoria
Video Recording
Summary Communication plays a crucial role in the management of medications. Ward rounds are sites where health professionals from different disciplines and patients come together to exchange medication information and make treatment decisions. This article examines power relations and spatial practices surrounding medication communication between patients and health professionals including doctors, nurses and pharmacists during ward rounds. Data were collected in two medical wards of a metropolitan teaching hospital in Melbourne, Australia. Data collection methods involved participant observations, field interviews, video-recordings, together with individual and group reflexive interviews. A critical discourse analysis was undertaken to identify the location sites where power relations were reproduced or challenged in ward rounds. Findings demonstrated that traditional medical hierarchies constructed the ways in which doctors communicated about medications during ward rounds. Nurses and pharmacists ventured into the ward round space by using the discourse of preparation and occupying a peripheral physical position. Doctors privileged the discourse of medication rationalization in their ward round discussions, competing with the discourse of inquiry taken up by patients and families. Ward rounds need to be restructured to provide opportunities for nurses and pharmacists to speak at dedicated times and in strategic locations. By critically reflecting upon the complex process of medication communication during ward rounds, greater opportunities exist for enhanced team communication among health professionals.
Language eng
DOI 10.1177/1363459312447257
Field of Research 111099 Nursing not elsewhere classified
1117 Public Health And Health Services
1608 Sociology
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30076295

Document type: Journal Article
Collection: School of Nursing and Midwifery
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