{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:56Z","timestamp":1792471136393,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim(s)<\/jats:title>\n                    <jats:p>To explore how HEMS professionals perceive the role, competencies, training and professional development of nursing within aeromedical transport services in Spain, incorporating the perspectives of different professional profiles involved in HEMS operations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An interpretative qualitative study using phenomenologically informed thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi\u2010structured, in\u2010depth interviews were conducted and analysed using phenomenologically informed thematic analysis. Data were systematically coded through open coding and organised into themes and subthemes using ATLAS.ti.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Primary qualitative data were obtained from 17 purposively selected HEMS professionals through individual interviews. Interviews lasted 45\u201360\u2009min, were audio\u2010recorded and transcribed verbatim.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four main categories emerged from the analysis: (1) access to the HEMS environment; (2) technical skills and competencies; (3) professional perspective and role development; and (4) structured professionalisation of the HEMS profile. Participants perceived that extensive prior experience in critical care settings, specialised academic training, supervised practice and advanced clinical simulation were necessary. Fully online training was widely perceived as insufficient. Participants identified core competencies, including advanced technical skills, knowledge of aerophysiology, aviation safety training, Crew Resource Management and Helicopter Underwater Escape Training. In addition, participants identified emotional resilience and physical fitness as personal attributes relevant to HEMS practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>According to participants, HEMS nursing in Spain was described as a complex and highly specialised professional profile, characterised by extensive critical\u2010care experience, advanced technical competencies and structured, practice\u2010oriented training. The absence of a formalised training pathway contrasts with international standards and points to a perceived need for greater professional recognition and standardisation of competencies to support safe and high\u2010quality care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>The findings provide qualitative evidence that may inform the future development of structured training pathways, competency frameworks and professional recognition for HEMS nurses in Spain. The findings may also inform future research on standardised education, advanced simulation and aviation safety training. Further research is needed to determine whether these educational approaches improve clinical decision\u2010making, patient safety and operational effectiveness in aeromedical transport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>The findings highlight the lack of a clearly defined and standardised competency framework and training pathway for HEMS nursing professionals in Spain. Participants perceived effective HEMS practice as requiring extensive prior critical\u2010care experience, advanced technical competencies, supervised practical training and specific personal attributes, including emotional resilience and physical preparedness. These findings are relevant to HEMS nurses, educators, policymakers and healthcare managers involved in aeromedical services in Spain and may also contribute to international discussions on advanced nursing practice in air medical transport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No Patient or Public Contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70937","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:51:53Z","timestamp":1792468313000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nursing Competencies in Helicopter Emergency Medical Services (\n                    <scp>HEMS<\/scp>\n                    ) in Spain: A Qualitative Study of Professional Profiles and Advanced Training"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4128-673X","authenticated-orcid":false,"given":"Alejandro","family":"Artero\u2010Garc\u00eda","sequence":"first","affiliation":[{"name":"Emergency Department, INGESA Ceuta Coordinator of CoordinaSEMES Working Group, Coordinator of GTAM SEMES Nursing  Ceuta Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9235-7191","authenticated-orcid":false,"given":"Luciano","family":"Rodr\u00edguez\u2010D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences of Ceuta University of Granada  Ceuta Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1783-2893","authenticated-orcid":false,"given":"Carmen","family":"Casal\u2010Angulo","sequence":"additional","affiliation":[{"name":"Facultat D'infermeria i Podologia Universitat de Val\u00e8ncia  Valencia Spain"},{"name":"Valencian Regional Health Emergency Service (SES\u2010CV)  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8325-0838","authenticated-orcid":false,"given":"Regina","family":"Allande\u2010Cuss\u00f3","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry University of Seville  Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8286-3381","authenticated-orcid":false,"given":"Javier","family":"Fagundo\u2010Rivera","sequence":"additional","affiliation":[{"name":"Department of Medicine and Public Health, Faculty of Labour Sciences University of Huelva  Huelva Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9053-7730","authenticated-orcid":false,"given":"Juan","family":"G\u00f3mez\u2010Salgado","sequence":"additional","affiliation":[{"name":"Department of Medicine and Public Health, Faculty of Labour Sciences University of Huelva  Huelva Spain"},{"name":"Postgraduate Programme in Health and Safety Esp\u00edritu Santo University  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.33546\/bnj.3232"},{"issue":"2","key":"e_1_2_11_3_1","first-page":"111","article-title":"Cambios fisiopatol\u00f3gicos durante el transporte en helic\u00f3ptero sanitario en el archipi\u00e9lago canario y su relaci\u00f3n con las condiciones meteorol\u00f3gicas","volume":"37","author":"Artero Garc\u00eda A.","year":"2025","journal-title":"Emergencias: Revista de la Sociedad Espa\u00f1ola de Medicina de Urgencias y Emergencias"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.55633\/s3me\/109.2024"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/1980\u2010220x\u2010reeusp\u20102024\u20100129en"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010015\u20100994\u20106"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1067\/mmj.2001.115552"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2011.02.002"},{"issue":"2","key":"e_1_2_11_9_1","first-page":"135","article-title":"Clinical Simulations and Safety in Emergencies: Emergency Crisis Resource Management","volume":"32","author":"Casal Angulo C.","year":"2020","journal-title":"Emergencias"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","DOI":"10.4135\/9781452230153","volume-title":"Basics of Qualitative Research (3rd Ed.): Techniques and Procedures for Developing Grounded Theory","author":"Corbin J.","year":"2008"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1460408617721565"},{"key":"e_1_2_11_12_1","volume-title":"Qualitativewith ATLAS.Ti","author":"Friese S.","year":"2012"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ienj.2018.11.004"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/qhc.13.suppl_1.i2"},{"key":"e_1_2_11_15_1","first-page":"271","volume-title":"The Discovery of Grounded Theory: Strategies for Qualitative Research","author":"Glaser B. G.","year":"1967"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1525822X05279903"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2012.05.006"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2022.03.002"},{"key":"e_1_2_11_19_1","unstructured":"Lanzarot Moreno F. P.G\u00f3mez\u2010Calcerrada\u2010P\u00e9rez J.Sinisterra Aquilino andJ. M.Guti\u00e9rrez Rubio.2008. \u201cTraslado en helic\u00f3ptero medicalizado (HEMS) de pacientes portadores de un bal\u00f3n intraa\u00f3rtico de contrapulsaci\u00f3n (BIAC). Puesta al d\u00eda en urgencias emergencias y cat\u00e1strofes.\u201d8 no.3:125\u2013131."},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/10376178.2024.2424786"},{"key":"e_1_2_11_21_1","first-page":"282","article-title":"Helitransporte sanitario en las Islas Canarias","volume":"9","author":"Lubillo Montenegro S.","year":"1997","journal-title":"Emergencias"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2020.02.001"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431\u2010023\u201005178\u20108"},{"issue":"9","key":"e_1_2_11_24_1","first-page":"922","article-title":"Altitude\u2010Related Hypoxia: Risk Assessment and Management for Passengers on Commerical Aircraft","volume":"74","author":"Mortazavi A.","year":"2003","journal-title":"Aviation, Space, and Environmental Medicine"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.15694\/mep.2021.000145.1"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2020.06.002"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909\u2010025\u201007047\u20104"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030463"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903120802472012"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.4321\/S1887\u201085712015000400001"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135\u2010017\u20100574\u20108"},{"key":"e_1_2_11_32_1","unstructured":"SEMES.2020.\u201cInformaci\u00f3n respecto al transporte sanitario en Espa\u00f1a. Nota de prensa.\u201dhttps:\/\/www.semes.org\/informacion\u2010respecto\u2010al\u2010transporte\u2010sanitario\u2010en\u2010espana\/."},{"key":"e_1_2_11_33_1","unstructured":"SEMICYUC.2019.\u201cLa formaci\u00f3n en transporte para el traslado del paciente cr\u00edtico es un paso necesario para la seguridad del paciente. Nota de prensa.\u201dhttps:\/\/semicyuc.org\/2019\/12\/la\u2010formacion\u2010en\u2010transporte\u2010para\u2010el\u2010traslado\u2010del\u2010paciente\u2010critico\u2010es\u2010un\u2010paso\u2010necesario\u2010para\u2010la\u2010seguridad\u2010del\u2010paciente\/."},{"key":"e_1_2_11_34_1","article-title":"An\u00e1lisis del perfil del personal de enfermer\u00eda en el helitransporte sanitario. \u00bfQu\u00e9 formaci\u00f3n es necesaria para proporcionar unos cuidados adecuados?","volume":"18","author":"Sierra V. I.","year":"2022","journal-title":"RS. Biblioteca Lascasas"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931\u2010022\u201002177\u20105"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amj.2021.11.005"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/14780880903340091"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S405923"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.26820\/reciamuc\/"},{"issue":"4","key":"e_1_2_11_41_1","first-page":"245","article-title":"Transporte interhospitalario urgente desde los hospitales comarcales","volume":"20","author":"Vazquez Lima M. J.","year":"2008","journal-title":"Emergencias: Revista de la Sociedad Espa\u00f1ola de Medicina de Urgencias y Emergencias"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.20473\/jn.v19i1.50175"},{"key":"e_1_2_11_43_1","article-title":"\u2018We Like a Steady Climb\u2019 \u2014 Flight and Land Transport Nurses on the Up","author":"Will L.","year":"2025","journal-title":"Kai Tiaki Nursing New Zealand"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010023\u201001514\u20103"}],"container-title":["Nursing Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70937","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nop2.70937","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70937","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:51:56Z","timestamp":1792468316000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nop2.70937"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":43,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/nop2.70937"],"URL":"https:\/\/doi.org\/10.1002\/nop2.70937","archive":["Portico"],"relation":{},"ISSN":["2054-1058","2054-1058"],"issn-type":[{"value":"2054-1058","type":"print"},{"value":"2054-1058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70937"}}