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The role of locally-designed organizational artifacts in supporting nurses' work: and ethnographic study on the wards

Alessandra Talamo, Barbara Mellini, Barbara Barbieri

Abstract

Introduction: This paper aims to describe how nurses’ planning and coordination work is performed through the use of locally designed tools (i.e., diaries, planners, reminders, and organizers). These tools are investigated as the materialization of organizational work, thus offering a complementary perspective on nursing practice to that proposed by the professional mandate and supported by official artifacts in use.

Method: Ethnographic study.

Results: By analyzing locally designed artifacts, the rationale that enables nurses to make the flow of activities work is highlighted and explained. Evidence is provided by a description of how nurses’ tacit knowledge is reified and embedded into objects produced by the nurses themselves. Implications for the design of digital systems supporting nursing practice are discussed.

Conclusion: The analysis of these artifacts has allowed an understanding of practices used by the nurses to manage the workflow in the wards.

Keywords: locally designed artifacts, organizational artifacts, nursing, ethnography.

Il ruolo dei “Locally Designed artifacts” nel lavoro infermieristico: uno studio etnografico in reparto

Introduzione: il presente contributo si propone di descrivere le funzioni di alcuni strumenti “locally designed”, non sostenuti istituzionalmente, che supportano il lavoro quotidiano degli infermieri nei reparti ospedalieri. Questi strumenti, concepiti come artefatti organizzativi, possono essere considerati come “prodotti” del lavoro degli infermieri per la gestione del reparto nella sua complessità organizzativa. Tali artefatti sono dunque in grado di offrire una diversa prospettiva circa le pratiche lavorative degli infermieri in reparto, che potremmo definire “complementare” rispetto a quella “tradizionale” proposta dal mandato professionale degli infermieri (centrata sulla relazione di cura con il paziente) e sostenuta da artefatti istituzionali (es. la cartella clinica).

Metodo: studio etnografico.

Risultati: i risultati, discussi alla luce dell’Activity Theory, hanno evidenziato la necessità di sviluppare un nuovo dialogo in merito al lavoro degli infermieri in reparto, che tenga conto delle reali attività svolte, per la progettazione di nuovi strumenti organizzativi a supporto delle medesime.

Conclusioni: l’analisi di questi artefatti ha consentito, da una parte, l’emergere delle logiche e dei significati co-costruiti e attribuiti al “fare” organizzativo, dall’altra la comprensione delle prassi di cui si avvalgono gli infermieri per gestire i flussi di lavoro in reparto.

Parole Chiave: artefatti “locally designed”, artefatti organizzativi, professione infermieristica, etnografia.

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