Anticipatory vigilance: A classic grounded theory of risk reduction and management in the perioperative setting

This research aimed to investigate the main concern facing nurses in minimising risk within the perioperative setting and to generate an explanatory substantive theory of how they resolve this through anticipatory vigilance. In the context of the perioperative setting, nurses encounter challenges in minimising risks for their patients on a continuous basis. Current explanations of minimising risk in the perioperative setting offers insights into how perioperative nurses undertake their work. Currently research in minimising risk is broadly related to dealing with errors as opposed to preventing them. To date, little is known about how perioperative nurses practice and maintain safety. This study was guided by the principles of classic grounded theory as described by Glaser (1978, 1998, 2001). Data was collected through individual unstructured interviews with thirty seven perioperative nurses (with varying lengths of experiences of working in the area) and thirty three hours of non-participant observation within eight different perioperative settings in the Republic of Ireland. Data was simultaneously collected and analysed. The theory of anticipatory vigilance emerged as the pattern of behaviour through which nurse’s deal with their main concern of minimising risk in a high risk setting. Anticipatory vigilance is enacted through orchestrating, routinising and momentary adapting within a spirit of trusting relations within the substantive area of the perioperative setting. This theory of offers an explanation on how nurses resolve their main concern of minimising risk within the perioperative setting. The theory of anticipatory vigilance will be useful to nurses in providing a comprehensive framework of explanation and understanding on how nurses deal with minimising risk in the perioperative setting. The theory links perioperative nursing, risk and vigilance together. Clinical improvements through understanding and awareness of the theory of anticipatory vigilance will result in an improved quality environment, leading to safe patient outcomes.

The legitimation of risk and democracy: A case study of Bt cotton in Andhra Pradesh, India

This thesis explores the inter-related attempts to secure the legitimation of risk and democracy with regard to Bt cotton, a genetically modified crop, in the state of Andhra Pradesh in India. The research included nine months of ethnographic fieldwork, extensive library and newspaper research, as well as university attendance in India, undertaken between June, 2010 and March, 2011. This comparative study (involving organic, NPM and Bt cotton cultivation) was conducted in three villages in Telangana, a region which was granted secession from Andhra Pradesh in July, 2013, and in Hyderabad, the state capital. Andhra Pradesh is renowned for its agrarian crisis and farmer suicides, as well as for the conflict which Bt cotton represents. This study adopts the categories of legitimation developed by Van Leeuwen (2007; 2008) in order to explore the theory of risk society (Beck, 1992; 1994; 1999; 2009), and the Habermasian (1996: 356-366) core-periphery model as means of theoretically analysing democratic legitimacy. The legitimation of risk and democracy in relation to Bt cotton refers to normative views on the way in which power should be exercised with regard to risk differentiation, construction and definition. The analysis finds that the more legitimate the exercise of power, the lower the exposure to risk as a concern for the collective. This also has consequences for the way in which resources are distributed, knowledge constructed, and democratic praxis institutionalised as a concern for social and epistemic justice. The thesis argues that the struggle to legitimate risk and democracy has implications not only for the constitution of the new state of Telangana and the region’s development, but also for the emergence of global society and the future development of humanity as a whole.