Experiences and perceptions of nurses and air ambulance service providers in carrying out aeromedical evacuations in Indonesia: A qualitative research
PDF
XML

Keywords

air ambulances
clinical competence
health personnel
humans
Indonesia
reference standards
aerospace medicine

How to Cite

Ambarwati, D., Warsini, S., Hapsara, S., & Haryanti, F. (2024). Experiences and perceptions of nurses and air ambulance service providers in carrying out aeromedical evacuations in Indonesia: A qualitative research. Belitung Nursing Journal, 10(2), 176–184. https://doi.org/10.33546/bnj.3232
Crossref
Scopus
Google Scholar

Link to Google Scholar

Funder - Crossref Registry

Accepted for publication: 2024-04-02
Peer reviewed: Yes

Share on Share on Facebook Tweet This Share on LinkedIn Share on reddit Send email

Abstract

Background: Basic non-military flight nurse training is essential for enhancing nurses’ competency in conducting aeromedical evacuations. Trained nurses possessing flight nurse proficiency are indispensable for ensuring stable patient conditions amidst the unique physical, physiological, and psychological challenges encountered during flights.

Objective: This study aimed to describe the experiences and perceptions of nurses and air ambulance service providers regarding aeromedical evacuations.

Methods: This study employed a qualitative descriptive design. Data were gathered from February to July 2023 through semi-structured online interviews with seven nurses and air ambulance service providers engaged in aeromedical evacuation. Content analysis was utilized to interpret the interview data.

Results: Seven themes were generated: 1) Experiences in aeromedical evacuation experiences, 2) Challenges faced by nurses and air ambulance service providers during aeromedical evacuations, 3) Essential knowledge for nurses involved in aeromedical evacuations, 4) Efforts to improve nurses’ knowledge and skills, 5) Leveling of flight nurse training, 6) Flight nurse training methods, and 7) Flight nurse training evaluation strategies.

Conclusion: Nurses and air ambulance service providers acknowledge the significant influence of the flight environment on changes in patient conditions during aeromedical evacuations. To effectively manage alterations in patient conditions during flights, healthcare workers equipped with aviation health competency are imperative. One approach to enhancing the competency of healthcare workers is through flight nurse training. The findings from this study serve as a valuable resource for policymakers and health-related institutions endeavoring to formulate aeromedical evacuation strategies.

https://doi.org/10.33546/bnj.3232
PDF
XML

Supporting Agencies

The RTA Program of the Universitas Gadjah Mada funded this study under Grant Number 5075/UN1.P.II/Dit-Lit/PT.01.0/2023

Copyright

Copyright (c) 2024 Dwi Ambarwati, Sri Warsini, Sunartini Hapsara, Fitri Haryanti

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

References

Abdillah, F. P., Estiyono, A., & Hendro, M. (2019). Pengembangan layout interior pesawat N219 air ambulance untuk meningkatkan teamwork tim paramedis udara pada proses transfer antar rumah sakit [Development of the interior layout of the N219 air ambulance aircraft to improve the teamwork of the air paramedic team in the transfer process between hospitals]. Jurnal Sains dan Seni ITS, 7(2), 113-117. http://dx.doi.org/10.12962/j23373520.v7i2.36482

Ambarwati, D. (2024). The influence of basic flight nurse training on nurses' knowledge, attitudes and skills [Unpublished manuscript]. Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada.

Boutonnet, M., Pasquier, P., Raynaud, L., Vitiello, L., Bancarel, J., Coste, S., de Saint Maurice, G. P., & Ausset, S. (2017). Ten years of en route critical care training. Air Medical Journal, 36(2), 62-66. https://doi.org/10.1016/j.amj.2016.12.004

Butler, W. P., Steinkraus, L. W., Burlingame, E. E., Smith, D. E., Fouts, B. L., Serres, J. L., & Burch, D. S. (2018). Clinical impact of cabin altitude restriction following aeromedical evacuation. Military Medicine, 183(suppl_1), 193-202. https://doi.org/10.1093/milmed/usx171

Central Bureau of Statistics Indonesia. (2021a). Area and number of islands by province [in Bahasa]. https://jakarta.bps.go.id/indicator/153/367/1/luas-daerah-dan-jumlah-pulau-menurut-provinsi-kabupaten-kota-kecamatan.html

Central Bureau of Statistics Indonesia. (2021b). Number of airplane passengers at major airports [in Bahasa]. https://www.bps.go.id/id/statistics-table/2/NjYjMg==/jumlah-penumpang-pesawat-di-bandara-utama--orang-.html

Cheung, S. S., & Ainslie, P. N. (2022). Advanced environmental exercise physiology. Champaign, USA: Human Kinetics.

Davis, C. (2012). 'Care in the air': The role of in-flight staff. Emergency Nurse (through 2013), 19(10), 12-15.

De Jong, M. J., Dukes, S. F., Dufour, K. M., & Mortimer, D. L. (2017). Clinical experience and learning style of flight nurse and aeromedical evacuation technician students. Aerospace Medicine and Human Performance, 88(1), 23-29. https://doi.org/10.3357/AMHP.4697.2017

DeForest, C. A., Blackman, V., Alex, J. E., Reeves, L., Mora, A., Perez, C., Maddry, J., Selby, D., & Walrath, B. (2018). An evaluation of navy en route care training using a high-fidelity medical simulation scenario of interfacility patient transport. Military Medicine, 183(9-10), e383-e391. https://doi.org/10.1093/milmed/usx129

Doyle, L., McCabe, C., Keogh, B., Brady, A., & McCann, M. (2020). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing, 25(5), 443-455. https://doi.org/10.1177/1744987119880234

Drabble, L., Trocki, K. F., Salcedo, B., Walker, P. C., & Korcha, R. A. (2016). Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women. Qualitative Social Work, 15(1), 118-133. https://doi.org/10.1177/1473325015585613

Evans, C., Creaton, A., Kennedy, M., & Martin, T. (2016). Retrieval medicine. Oxford: Oxford University Press. https://doi.org/10.1093/med/9780198722168.001.0001

Gaeed, A. K., & Hassan, H. B. (2020). Effect of pioneer aeromedical evacuation program on flight medics’ practices toward emergency casualties at army aviation bases in Iraq. Indian Journal of Forensic Medicine & Toxicology, 14(3), 31-39. https://doi.org/10.37506/ijfmt.v14i3.10494

Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. https://doi.org/10.1016/j.nedt.2003.10.001

Gregoire, J. N., Alfes, C. M., Reimer, A. P., & Terhaar, M. F. (2017). Flying lessons for clinicians: Developing system 2 practice. Air Medical Journal, 36(3), 135-137. https://doi.org/10.1016/j.amj.2017.02.003

Imbriaco, G., Monesi, A., Giugni, A., Ferrari, P., Bigi, E., & Menarini, M. (2021). High-Fidelity Simulation training for helicopter emergency medical services flight nurses: A report from the first Italian experience. Air Medical Journal, 40(4), 264-268. https://doi.org/10.1016/j.amj.2021.03.002

Indonesian National Nurses Association. (2022). Guidelines for continuing nursing education for Indonesian nurses [in bahasa]. https://ppnijateng.org/wp-content/uploads/2022/06/2166-DPW-Pengantar-Pedoman-dan-Panduan_.pdf

Koh, C. H. (2021). Commercial air travel for passengers with cardiovascular disease: Stressors of flight and aeromedical impact. Current Problems in Cardiology, 46(3), 100746. https://doi.org/10.1016/j.cpcardiol.2020.100746

Krasinski, Z., Chou, A., & Stepak, H. (2021). COVID-19, long flights, and deep vein thrombosis: What we know so far. Cardiology Journal, 28(6), 941-953. https://doi.org/10.5603/CJ.a2021.0086

Maddry, J. K., Arana, A. A., Savell, S. C., Reeves, L. K., Perez, C. A., Mora, A. G., & Bebarta, V. S. (2017). Critical care air transport team evacuation of medical patients without traumatic injury. Military Medicine, 182(11-12), e1874-e1880. https://doi.org/10.7205/MILMED-D-17-00091

Maddry, J. K., Mora, A. G., Perez, C. A., Reeves, L. K., Paciocco, J. A., Clemons, M. A., Sheean, A., Kester, N. M., & Bebarta, V. S. (2022). Characterization of long-range aeromedical transport and its relationship to the development of traumatic extremity compartment syndrome: A 7-year, retrospective study. Military Medicine, 187(1-2), e224-e231. https://doi.org/10.1093/milmed/usaa462

Martin, J., & Kumar, K. (2020). Education needs of Australian flight nurses: A qualitative study. Air Medical Journal, 39(3), 178-182. https://doi.org/10.1016/j.amj.2020.02.001

Mason, R., Latimer, A., Vrablik, M., & Utarnachitt, R. (2019). Teaching flight nurses ultrasonographic evaluation of esophageal intubation and pneumothorax. Air Medical Journal, 38(3), 195-197. https://doi.org/10.1016/j.amj.2018.11.007

Matsumoto, H., Motomura, T., Hara, Y., Masuda, Y., Mashiko, K., Yokota, H., & Koido, Y. (2013). Lessons learned from the aeromedical disaster relief activities following the great East Japan earthquake. Prehospital and Disaster Medicine, 28(2), 166-169. https://doi.org/10.1017/S1049023X12001835

Ministry of Defense Indonesia. (2014). Minister of Defense Regulation Number 34 of 2014 concerning Medical Evacuation in disaster management within the Ministry of Defense and the Indonesian National Army [in Bahasa]. Retrieved from https://www.kemhan.go.id/kuathan/wp-content/uploads/2017/02/Peraturan-Menteri-Pertahanan-Nomor-34-Tahun-2014-tentang-Evakuasi-Medik-dalam-Penanggulangan-Bencana-di-lingkungan-Kementerian-Pertahanan-dan-Tentara-Nasional-Indonesia.pdf

Ministry of Health Indonesia. (2021). Minister of Health Regulation Number 14 of 2021 concerning Standards for Business Activities and Products in the Implementation of Risk-Based Business Licensing in the Health Sector [in Bahasa]. Retrieved from https://peraturan.bpk.go.id/Details/203315/permenkes-no-14-tahun-2021

Ministry of State Secretariat. (2021). Groundbreaking of Bali International Hospital, President hopes Indonesian citizens will no longer seek treatment abroad. https://www.presidenri.go.id/siaran-pers/groundbreaking-rs-internasional-bali-presiden-berharap-wni-tak-lagi-berobat-ke-luar-negeri/

Mitchell, T. A., Hutchison, T., Becker, T. E., Aden, J. K., Blackbourne, L., & White, C. E. (2014). Nontherapeutic laparotomy in American combat casualties: a 10-year review. Journal of Trauma and Acute Care Surgery, 77(3), S171-S175. https://doi.org/10.1097/TA.0000000000000367

Morales, K. A., Krause-Parello, C. A., Hatzfeld, C. J. J., Simpson, C. M., Friedmann, E., Kolassa, J., & Wilson, C. C. (2019). Strategic Aeromedical Evacuation (AE): Examining biological and psychosocial stress in AE patients. Military Behavioral Health, 7(1), 31-39. https://doi.org/10.1080/21635781.2018.1543062

Reimer, A. P., Clochesy, J. M., & Moore, S. M. (2013). Early examination of the middle-range theory of flight nursing expertise. Applied Nursing Research, 26(4), 276-279. https://doi.org/10.1016/j.apnr.2013.07.006

Savell, S. C., Arana, A. A., Medellin, K. L., Bebarta, V. S., Perez, C. A., Reeves, L. K., Mora, A. G., & Maddry, J. K. (2019). Descriptive analysis of cardiac patients transported by critical care air transport teams. Military Medicine, 184(7-8), e288-e295. https://doi.org/10.1093/milmed/usy426

Thibeault, C., & Evans, A. D. (2015). AsMA medical guidelines for air travel: stresses of flight. Aerospace Medicine and Human Performance, 86(5), 486-487. https://doi.org/10.3357/AMHP.4225.2015

Thomson, D. P. (2015). Effects of flight. In Emergency Medical Services (2nd ed., pp. 368-371). Wiley. https://doi.org/10.1002/9781118990810.ch51

Vijai, M. N., Ravi, P. R., & Pathania, A. (2018). Critical care air transport: Experiences of a decade. The Journal of Medical Research, 4(1), 53-58.

Wicaksana, Y. S. W. (2023). Patients seeking treatment at foreign countries increased after the pandemic, recorded from passport permits at Malang Immigration [in Bahasa]. Radar Malang. https://radarmalang.jawapos.com/kesehatan/813278538/pasien-berobat-ke-ln-melonjak-setelah-pandemi-terdata-dari-izin-paspor-di-imigrasi-malang

Yadollahi, A., & Yazdani, S. (2020). Defining cognitive, higher order thinking, and psychomotor meta-skills: three-curricular content concept analysis. Journal of Medical Education, 19(3), e110334. https://doi.org/10.5812/jme.110334