Trialling technologies to reduce hospital in‐patient falls: an agential realist analysis

Timmons, Stephen; Vezyridis, Paraskevas; Sahota, Opinder

Abstract

This paper analyses the 'failure' of a patient safety intervention. Our study was part of an RCT of bed and bedside chair pressure sensors linked to radio pagers to prevent bedside falls in older people admitted to hospital. We use agential realism within science and technology studies to examine the fall and its prevention as a situated phenomenon of knowledge that is made and unmade through intra-actions between environment, culture, humans and technologies. We show that neither the intervention (the pressure sensor system), nor the outcome (fall prevention) could be disentangled from the broader sociomaterial context of the ward, the patients, the nurses and (especially) their work through the RCT. We argue that the RCT design, by virtue of its unacknowledged assumptions, played a part in creating the negative findings. The study also raises wider questions about the kind of subjectivities, agencies and power relations these entanglements might effect and (re)produce in the hospital ward.

Citation

Timmons, S., Vezyridis, P., & Sahota, O. (2019). Trialling technologies to reduce hospital in‐patient falls: an agential realist analysis. Sociology of Health and Illness, 41(6), 1104-1119. https://doi.org/10.1111/1467-9566.12889

• Journal Article Type: Article
• Acceptance Date: Feb 14, 2019
• Online Publication Date: Mar 15, 2019
• Publication Date: Jul 1, 2019
• Deposit Date: Feb 20, 2019
• Publicly Available Date: Mar 16, 2020
• Journal: Sociology of Health & Illness
• Print ISSN: 0141-9889
• Electronic ISSN: 1467-9566
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 41
• Issue: 6
• Pages: 1104-1119
• DOI: https://doi.org/10.1111/1467-9566.12889
• Keywords: RCT; bed sensor; agential realism; fall; elderly patients
• Public URL: https://nottingham-repository.worktribe.com/output/1572703
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12889
• Additional Information: This is the peer reviewed version of the following article: Timmons, S. , Vezyridis, P. and Sahota, O. (2019), Trialling technologies to reduce hospital in‐patient falls: an agential realist analysis. Sociol Health Illn, 41: 1104-1119. doi:10.1111/1467-9566.12889, which has been published in final form at immons, S. , Vezyridis, P. and Sahota, O. (2019), Trialling technologies to reduce hospital in‐patient falls: an agential realist analysis. Sociol Health Illn, 41: 1104-1119. doi:10.1111/1467-9566.12889 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
• Contract Date: Feb 20, 2019