The interdisciplinary team experiences of managing patient safety during a fixed-wing inter-hospital aeromedical transport: A qualitative study

Dias, Carla Pena; Silva, Marina Aparecida Chrispim; Santos, Moema Souza; Ferreira, Flávio Lopes; Carvalho, Vânia de Paula; Alves, Marília

doi:10.1016/j.ienj.2021.101052

Cited by 3 publications

(7 citation statements)

References 9 publications

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“…Initially adapted from aviation, checklists were introduced to reduce risk in health care 32 . The effect of checklists in prehospital work is still under debate 5,19,33,34 . However, most will agree that they must be tailored to the providers’ competence 35 …”

Section: Discussionmentioning

confidence: 99%

“…32 The effect of checklists in prehospital work is still under debate. 5,19,33,34 However, most will agree that they must be tailored to the providers' competence. 35 In our study, the reason for medication errors was mainly the lack of an assistant to perform independent double checking in line with standard drug management safety principles.…”

Section: Areas Of Risk and Factors For Enhanced Safetymentioning

confidence: 99%

“…A Swedish study pointed out preparedness, good teamwork, and communication as essential for transporting critically ill patients in long-distance air ambulance 4 . In a similar study from a Brazilian team, experience, training, and checklists were highlighted as most important 5 . In a systematic review of patient safety in emergency medical services, the included literature was divided into the following 7 themes: adverse events and medication errors, clinical judgment, communication, ground vehicle safety, aircraft safety, interfacility transport, and intubation 6 .…”

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confidence: 99%

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Sky-High Safety? A Qualitative Study of Physicians’ Experiences of Patient Safety in Norwegian Helicopter Emergency Services

Rasmussen,

Sollid,

Kvangarsnes

2023

J Patient Saf

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Background Patients treated and transported by Helicopter Emergency Medical Services (HEMS) are prone to both flight and medical hazards, but incident reporting differs substantially between flight organizations and health care, and the extent of patient safety incidents is still unclear. Methods A qualitative descriptive study based on in-depth interviews with 8 experienced Norwegian HEMS physicians from 4 different bases from February to July 2020 using inductive qualitative content analysis. The study objectives were to explore the physicians’ experience with incident reporting and their perceived areas of risk in HEMS. Results/Findings The HEMS physicians stated that the limited number of formal incident reports was due to the “nature of the HEMS missions” and because reports were mainly relevant when deviating from procedures, which are sparse in HEMS. The physicians preferred informal rather than formal incident reporting systems and reporting to a colleague rather than a superior. The reasons were ease of use, better feedback, and less fear of consequences. Their perceived areas of risk were related to all the phases of a HEMS mission: the physician as the team leader, medication errors, the handover process, and the helicopter as a work platform. Conclusions The sparse, informal, and fragmented incident reporting provides a poor overview of patient safety risks in HEMS. Focusing on organizational factors and system responsibility and research on environmental and contextual factors are needed to further improve patient safety in HEMS.

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Section: Discussionmentioning

confidence: 99%

Section: Areas Of Risk and Factors For Enhanced Safetymentioning

confidence: 99%

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confidence: 99%

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Sky-High Safety? A Qualitative Study of Physicians’ Experiences of Patient Safety in Norwegian Helicopter Emergency Services

Rasmussen,

Sollid,

Kvangarsnes

2023

J Patient Saf

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“…7.498/96, which regulates Nursing Professional Practice, establishes that it is the nurses' exclusive role to organize, direct care for critical patients, and perform highly complex activities. In addition, COFEN Resolution 0551/17, which regulates the role of nurses in Pre-Hospital Mobile care and Interhospital Care in Air Vehicles, cites the need for professional specialization or of being already working in the area until the publication of the resolution (14) .…”

Section: Discussionmentioning

confidence: 99%

Aeromedical interhospital transport of an adult with COVID-19 on extracorporeal membrane oxygenation: case report

Carvalho

Silva

Ferreira

et al. 2022

Rev. esc. enferm. USP

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Objective: To describe the experience of aeromedical interhospital transport of an adult patient with severe hypoxemic respiratory failure due to SARS-CoV-2, on extracorporeal membrane oxygenation. Method: This is a case report, guided by the tool Case Report Guidelines, with a descriptive approach. Data were collected from the digital medical record and field notes after the approval by the Institution and the Human Research Ethics Committee. Results: The transport of a critically ill, unstable patient with acute respiratory syndrome 2 on extracorporeal oxygenation was an opportunity for the team to acquire new knowledge. The proper preparation of the fixed-wing aircraft and the profile of the team of specialist nurses contributed to the safety and quality in the three phases of flight: preflight, in-flight and post-flight. Conclusion: Air transport of adults on cardiopulmonary bypass to referral centers, under the care of an experienced multidisciplinary team, can contribute to positive results. The nurses’ autonomy, their leadership role and expertise in process management are highlighted. Thus, success was evidenced with the patient’s discharge after 45 days from the Intensive Care Unit.

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“…Nurses undertaking air ambulance service face numerous challenges, including environmental, equipment, and human resource limitations, as well as managing patients with complex and changing conditions (Dias et al, 2021). Working in the air means nurses are required to be patient-focused at all times, often at the cost of their own safety.…”

Section: Introductionmentioning

confidence: 99%

Experiences of nurses involved in air ambulance service: A qualitative study

Wang,

Hu,

et al. 2024

J. Ners

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Introduction: Nurses undertaking air ambulance service encounter environmental, equipment, and personnel limitations during their work. Moreover, they must cope with various types of injuries and illnesses, as well as changes in patient conditions. These factors pose a significant pressure on nurses. Currently, there is a lack of qualitative research on the experiences of nurses performing air ambulance tasks. The purpose of this study is to explore the experiences of nurses undertaking air ambulance service, with a focus on capturing their personal perceptions regarding this field of work. Methods: Twelve nurses were selected using purposive sampling, and semi-structured interviews were conducted to collect data. Content analysis was used to analyze the data. Results: The analysis identified three major themes: "Ambiguous and risky emergency missions," "Challenges during air transfer," and "Nurses’ personal limitations.” Eight categories were formulated within these themes, including "Mission uncertainty," “Urgency of medical conditions," “Hazards at high altitude," "Cabin environment limitations," "Inadequate equipment," "Incomprehensive operating mechanisms," "Physical discomfort," and "Recognition of professional shortcomings." Conclusions: Improving the performance and well-being of nurses engaged in air ambulance services necessitates the implementation of a psychological adaptation program. This includes the utilization of psychological stress assessment tools or engaging in role-playing activities. Successful patient rescues demand the establishment of comprehensive standard operating procedures, involving an interprofessional team. Supporting nurses in adeptly managing challenges during air ambulance services requires an expanded scope of education and training, facilitated through initiatives like situational simulation and similar approaches.

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The interdisciplinary team experiences of managing patient safety during a fixed-wing inter-hospital aeromedical transport: A qualitative study

Cited by 3 publications

References 9 publications

Sky-High Safety? A Qualitative Study of Physicians’ Experiences of Patient Safety in Norwegian Helicopter Emergency Services

Sky-High Safety? A Qualitative Study of Physicians’ Experiences of Patient Safety in Norwegian Helicopter Emergency Services

Aeromedical interhospital transport of an adult with COVID-19 on extracorporeal membrane oxygenation: case report

Experiences of nurses involved in air ambulance service: A qualitative study

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