{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:07:39Z","timestamp":1781143659144,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Speech and language therapists and nurses need to work together to keep patients with swallowing difficulties safe throughout their acute stroke admission. Speech and language therapists make recommendations for safe swallowing following assessment and nurses put recommendations into practice and monitor how patients cope. There has been little research into the everyday realities of ongoing swallow safety management by these two disciplines. Patient safety research in other fields of healthcare indicates that safety can be enhanced through understanding the cultural context in which risk decisions are made.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To generate new understanding for how speech and language therapists (SLTs) and nurses share information for ongoing management of swallows safety on stroke units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>An ethnographic methodology involving 40 weeks of fieldwork on three stroke wards in England between 2015 and 2017. Fieldwork observation (357 h) and interviews with 43 members of SLT and nursing staff. Observational and interview data were analysed iteratively using techniques from the constant comparative method to create a thematically organized explanation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>An explanation for how disciplinary differences in time and space influenced how SLT and nursing staff shared information for ongoing management of swallow safety, based around three themes: (1) SLTs and nurses were aligned in concern for swallow safety across all information\u2010sharing routes; however, (2) ambiguity was introduced by the need for the information contained in swallowing recommendations to travel across time, creating dilemmas for nurses. Patients could improve or deteriorate after recommendations were made and nurses had competing demands on their time. Ambiguity had consequences for (3) critical incident reporting and relationships. SLTs experienced dilemmas over how to act when recommendations were not followed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>This study provides new understanding for patient safety dilemmas associated with the enactment and oversight of swallowing recommendations in context, on stroke wards. Findings can support SLTs and nurses to explore together how information for ongoing dysphagia management can be safely implemented within ward realities and kept up to date. This could include considering nursing capacity to act when SLTs are not there, mealtime staffing and SLT 7\u2010day working. Together they can review their understanding of risk and preferred local and formal routes for learning from it.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>It is known that information to keep swallowing safe is shared through swallowing recommendations, which are understood to involve a balance of risks between optimizing the safety of the swallow mechanism and maintaining physiological and emotional health. There is increasing appreciation from patient safety research, of the importance of understanding the context in which hospital staff make decisions about risk and patient safety.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The paper provides new empirical understanding for the complexities of risk management associated with SLT and nursing interactions and roles with respect to ongoing swallow safety.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Findings can underpin SLT and nurse discussion about how swallow safety could be improved in their own settings.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12725","type":"journal-article","created":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T08:53:47Z","timestamp":1649494427000},"page":"852-864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Managing ongoing swallow safety through information\u2010sharing: An ethnography of speech and language therapists and nurses at work on stroke units"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4319-9550","authenticated-orcid":false,"given":"Rachel","family":"Barnard","sequence":"first","affiliation":[{"name":"School of Health Sciences, Division of Language and Communication Science City, University of London  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-7362","authenticated-orcid":false,"given":"Julia","family":"Jones","sequence":"additional","affiliation":[{"name":"Centre for Research in Public Health and Community Care (CRIPACC), School of Health and Social Work University of Hertfordshire  Hatfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7344-2262","authenticated-orcid":false,"given":"Madeline","family":"Cruice","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Division of Language and Communication Science City, University of London  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000445299"},{"key":"e_1_2_9_3_1","volume-title":"Serious incident response scheme: Guidelines for residential care providers. Version 1.3","author":"Australian Government. Aged Care Quality and Safety Commission","year":"2021"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2014.07.036"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2010.521566"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjnn.2018.14.Sup2.S13"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733017703700"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2021.1871785"},{"key":"e_1_2_9_9_1","volume-title":"Contemporary issues in bioethics","author":"Beauchamp T.L.","year":"2014"},{"key":"e_1_2_9_10_1","volume-title":"Interprofessional dysphagia framework","author":"Boaden E."},{"key":"e_1_2_9_11_1","volume-title":"Caring for people at risk of choking","author":"England. Care Quality Commission","year":"2018"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1525\/9780520946286"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102834.2009.00994.x"},{"key":"e_1_2_9_14_1","volume-title":"The foundations of social research","author":"Crotty M.","year":"1998"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.05.025"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/psb.1469"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2017.01.013"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733012462048"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215520927454"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-45"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315146027"},{"key":"e_1_2_9_22_1","volume-title":"Standards of proficiency: Speech and language therapists","author":"HCPC","year":"2014"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102014\u2010003279"},{"key":"e_1_2_9_24_1","volume-title":"To err is human: Building a safer healthcare system","author":"Kohn L.T.","year":"2000"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssci.2020.104914"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzx163"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102017\u2010007579"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460\u20106984.12324"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/13698570500390705"},{"key":"e_1_2_9_30_1","volume-title":"Future nurse: Standards of proficiency for registered nurses","author":"Nursing and Midwifery Council","year":"2018"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000388"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010018\u20100839\u20107"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1800.2004.00236.x"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747\u20100080.2010.01495.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3109\/13561820.2014.891574"},{"key":"e_1_2_9_36_1","volume-title":"The role of the speech pathologist in supporting informed choice and shared decision making in dysphagia: Working with \u2018risk feeding\u2019","author":"Speech Pathology Australia","year":"2019"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010014\u20109578\u2010x"},{"key":"e_1_2_9_38_1","volume-title":"Interpretative description","author":"Thorne S.","year":"2016"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470802127098"},{"key":"e_1_2_9_40_1","volume-title":"To care is human: The factors influencing human experience in healthcare today","author":"Wolf J.A.","year":"2018"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u2010277X.2005.00605"}],"container-title":["International Journal of Language &amp; Communication Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.12725","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1460-6984.12725","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.12725","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T06:03:30Z","timestamp":1697090610000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1460-6984.12725"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,9]]},"references-count":40,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/1460-6984.12725"],"URL":"https:\/\/doi.org\/10.1111\/1460-6984.12725","archive":["Portico"],"relation":{},"ISSN":["1368-2822","1460-6984"],"issn-type":[{"value":"1368-2822","type":"print"},{"value":"1460-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,9]]},"assertion":[{"value":"2021-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}