From front line to battle planning: a nursing perspective of covid-19.

Aim: The aim of this paper is to reflect upon the experiences of a senior nurse in a patient-facing role, who led a tea providing direct care to those with coronavirus disease 2019 (covid-19). This would establish what those experiences meant to nurses during the initial outbreak to enable their coping mechanisms to face subsequent waves in the United Kingdom.

Background: The worst infectious disease outbreak of a generation rapidly made its impact known to the medical profession and its support infrastructure across the globe.

Caring for the carers: a COVID-19 psychological support programme.

The outbreak of COVID-19 and the subsequent pandemic brought unprecedented worldwide challenges born out of a rapidly escalating health and economic crisis. From emergency planners to healthcare workers on the front line, and everyone in between, the pandemic, and the uncertainty surrounding it, was likely to become a significant stressor, one with no immediate solution but with the potential to cause enduring distress beyond its conclusion. The UK Defence Medical Services recognised the need to provide an evidence-based programme of care intended to support personnel transitioning from assisting the national response back to normal duties.

A qualitative study to investigate the psychosocial effects of operational deployments on Medical Emergency Response Team personnel.

The stressors associated with emergency medical teams responding to critical incidents are well documented; however, the impact of such duties on the UK military personnel had never been investigated. This study explored the psychosocial effects of Medical Emergency Response Teams (MERT) operating in Afghanistan to inform the development of a Resilience Model. A structured and contextually relevant process could then be applied for a team's preparation for, delivery of and recovery from, their duties.

Factors affecting the delivery of healthcare on a humanitarian operation in West Africa: A qualitative study.

Introduction: Medical personnel in the UK Armed Forces are highly trained to deploy in support of military operations that assist humanitarian, peacekeeping, counter-terrorism and environmental catastrophes anywhere in the world. Such environments are often austere and successful outcomes demand an individual is highly resilient and able to adapt quickly to any situation. This qualitative study aimed to determine the factors that affect healthcare delivery on such missions by capturing the personal experiences of the first military personnel deployed on a humanitarian operation in support of the Ebola outbreak in West Africa between October 2014 and January 2015.

Nurturing a positive research culture: the Academic Department of Military Nursing perspective.

The structure and quality of nurse education in the UK has been scrutinised for many decades, culminating in a significant shift from ward-based learning at certificate level to that at diploma or degree level being delivered in higher education institutions. This professionalisation of nursing in the last decade of the 20th century was influenced by major changes in Department of Health policy, which demanded that a sound evidence base must be applied to nursing practice thereby replicating the model of evidence-based medicine. The requirement for care delivery to be evidence based is built on the premise that a continual research programme to investigate, disseminate and implement findings will enhance decision making in the clinical environment, thereby improving standards of care and patient outcomes.

Automating patient safety incident reporting to improve healthcare quality in the defence medical services.

There are many reasons for poor compliance with patient safety incident reporting in the UK. The Defence Medical Services has made a significant investment to address the culture and process by which risk to patient safety is managed within its organisation. This paper describes the decision process and technical considerations in the design of an automated reporting system together with the implementation procedure aimed to maximise compliance.

Measuring critical care air support teams' performance during extended periods of duty.

The Royal Air Force (RAF) Critical Care Air Support Teams (CCASTs) aeromedically evacuate seriously injured service personnel. Long casualty evacuation chains create logistical constraints that must be considered when aeromedically evacuating patients. One constraint is the length of a CCAST mission and its potential effect on team member performance.

The documentation of pain management during aeromedical evacuation missions.

Modern warfare has generated a significant increase in blast injuries, which demand careful management during planning and while undertaking air transfer. Pain management following multiple injuries can be challenging even when a patient is cared for in a stationary health care setting; this is further complicated by the additional stressors of flight. This article describes health care governance initiatives implemented by the Aeromedical Evacuation Squadron, based at Royal Air Force (RAF), United Kingdom.

Could simulated emergency procedures practised in a static environment improve the clinical performance of a Critical Care Air Support Team (CCAST)? A literature review.

Objective: The Royal Air Force Critical Care Air Support Teams (CCASTs) have a philosophy to undertake transfers of critically ill patients from anywhere in the world back to a UK medical facility in a stable or improved clinical condition. The training they receive is primarily taught by traditional didactic methods, with no standardisation of education between teams that are expected to deliver care to the same standard. Notwithstanding there being no current compromise to patient care during air transfer, it was important to consider the benefits of an alternative experiential teaching modality.

Collaboration in practice--assessment of an RAF CCAST.

Aeromedical evacuation of critically ill patients by the Royal Air Force is undertaken in a complex healthcare environment--one which demands effective teamwork to achieve the best possible outcome for the patient. A military team cannot rely purely on rank structure to guarantee a disciplined and efficient working unit. Furthermore, personnel must acknowledge the many potential hindrances of a Critical Care Air Support Team (CCAST) working environment that can affect optimal performance.

Evaluation of infection control practices during an AE.

The broadening global commitment of UK military personnel since the end of the Cold War has brought them into contact with a plethora of tropical diseases, some of which require isolation and air transfer to a UK medical facility. This presents a number of challenges to the safe repatriation of patients and attending medical and flight crews. During a recent repatriation of a patient with suspected Lassa fever from West Africa, the team's practices were evaluated and recommendations were made for improvements to future transfers by the deployable air isolator team.

The introduction of new critical care equipment into the aeromedical evacuation service of the Royal Air Force.

Changing world events over recent years and an increasingly complex patient casemix have led to a review of the equipment used by the Aeromedical Evacuation Squadron of the Royal Air Force. The initial special purpose aeromedical equipment (SPAME) project was completed in 2001 with the new equipment being brought into service in August of the same year. The project incorporated long term planning for replacing the equipment along with its rapidly developing technology, especially with that used for the care of the critically ill.