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The geography of patient safety: A topical analysis of sterility

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  • Mesman, Jessica

Abstract

Many studies on patient safety are geared towards prevention of adverse events by eliminating causes of error. In this article, I argue that patient safety research needs to widen its analytical scope and include causes of strength as well. This change of focus enables me to ask other questions, like why don't things go wrong more often? Or, what is the significance of time and space for patient safety? The focal point of this article is on the spatial dimension of patient safety. To gain insight into the 'geography' of patient safety and perform a topical analysis, I will focus on one specific kind of space (sterile space), one specific medical procedure (insertion of an intravenous line) and one specific medical ward (neonatology). Based on ethnographic data from research in the Netherlands, I demonstrate how spatial arrangements produce sterility and how sterility work produces spatial orders at the same time. Detailed analysis shows how a sterile line insertion involves the convergence of spatially distributed resources, relocations of the field of activity, an assemblage of an infrastructure of attention, a specific compositional order of materials, and the scaling down of one's degree of mobility. Sterility, I will argue, turns out to be a product of spatial orderings. Simultaneously, sterility work generates particular spatial orders, like open and restricted areas, by producing buffers and boundaries. However, the spatial order of sterility intersects with the spatial order of other lines of activity. Insight into the normative structure of these co-existing spatial orders turns out to be crucial for patient safety. By analyzing processes of spatial fine-tuning in everyday practice, it becomes possible to identify spatial competences and circumstances that enable staff members to provide safe health care. As such, a topical analysis offers an alternative perspective of patient safety, one that takes into account its spatial dimension.

Suggested Citation

  • Mesman, Jessica, 2009. "The geography of patient safety: A topical analysis of sterility," Social Science & Medicine, Elsevier, vol. 69(12), pages 1705-1712, December.
  • Handle: RePEc:eee:socmed:v:69:y:2009:i:12:p:1705-1712
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    References listed on IDEAS

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    1. Malone, Ruth E., 2003. "Distal nursing," Social Science & Medicine, Elsevier, vol. 56(11), pages 2317-2326, June.
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    Cited by:

    1. Iedema, Rick, 2009. "New approaches to researching patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1701-1704, December.
    2. Hooker, Claire & Hor, Suyin & Wyer, Mary & Gilbert, Gwendolyn L. & Jorm, Christine & Iedema, Rick, 2020. "Trajectories of hospital infection control: Using non-representational theory to understand and improve infection prevention and control," Social Science & Medicine, Elsevier, vol. 256(C).
    3. Willemine Willems, 2021. "Countering the Tragedy of the Health Care Commons by Exnovation: Bringing Unexpected Problems and Solutions into View," Sustainability, MDPI, vol. 13(23), pages 1-19, November.
    4. Ovretveit, John, 2009. "The contribution of new social science research to patient safety," Social Science & Medicine, Elsevier, vol. 69(12), pages 1780-1783, December.
    5. Andrews, Gavin J. & Shaw, David, 2010. ""So we started talking about a beach in Barbados": Visualization practices and needle phobia," Social Science & Medicine, Elsevier, vol. 71(10), pages 1804-1810, November.
    6. Nicolini, Davide & Waring, Justin & Mengis, Jeanne, 2011. "Policy and practice in the use of root cause analysis to investigate clinical adverse events: Mind the gap," Social Science & Medicine, Elsevier, vol. 73(2), pages 217-225, July.
    7. Buse, Christina & Brown, Nik & Nettleton, Sarah & Martin, Daryl & Lewis, Alan, 2020. "Caring through distancing: Spatial boundaries and proximities in the cystic fibrosis clinic," Social Science & Medicine, Elsevier, vol. 265(C).

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