title: En route care patient safety: thoughts from the field.
abstract: The purpose of this study was to describe the patient safety culture of en route care in the United States Air Force aeromedical evacuation system. Almost 100,000 patients have been transported since 2001. Safety concerns in this unique environment are complex because of the extraordinary demands of multitasking, time urgency, long duty hours, complex handoffs, and multiple stressors of flight. An internet-based survey explored the perceptions and experiences of safety issues among nursing personnel involved throughout the continuum of aeromedical evacuation care. A convenience sample of 236 nurses and medical technicians from settings representing the continuum was studied. Descriptive and nonparametric statistics were used to analyze the quantitative data, and thematic analysis was applied to the qualitative data. Results indicate that over 90% of respondents agree or strongly agree safety is a priority in their unit and that their unit is responsive to patient safety initiatives. Many respondents described safety incidents or near misses, and these have been categorized as personnel physical capability limitations, environmental threats, medication and equipment issues, and care process problems. Results suggest the care of patients during transport is influenced by the safety culture, human factors, training, experience, and communication. Suggestions to address safety issues emerged from the survey data.
authors.affiliation: Frederick Memorial Hospital, 400 West Seventh Street, Frederick, MD 21701.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: McNeill
authors.affiliation: Uniformed Services University of the Health Sciences Graduate School of Nursing, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Penny
authors.initials: P
authors.lastname: Pierce
authors.affiliation: USAF School of Aerospace Medicine, 2510 5th Street, Wright-Patterson AFB, OH 45433.
authors.forename: Susan
authors.initials: S
authors.lastname: Dukes
authors.affiliation: University of Washington School of Nursing, 1959 NE Pacific Box 357266, Seattle, WA 98195.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Bridges
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D017732:Air Ambulances; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D000067491:Near Miss, Healthcare; D009740:Nursing Staff / Q000523:psychology*; D015279:Organizational Culture; D061214:Patient Safety; D011795:Surveys and Questionnaires