Identifying and Reducing Insulin Errors in the Simulated Military Critical Care Air Transport Environment: A Human Factors Approach.

This article focuses on identifying and reducing insulin medication errors during high-fidelity simulations in the Critical Care Air Transport (CCAT) Advanced course, which trains U.S. Air Force en route critical care teams. Using the Human Factors Analysis Classification System (HFACS), errors were categorized as decision-based (inappropriate insulin dosing orders) or skill-based (incorrect preparation or administration). Interventions including didactic sessions, hands-on insulin preparation training with a two-person check, and cognitive aids significantly decreased both decision-based and skill-based errors compared to baseline. The study supports incorporating structured training, cognitive aids, and clinical practice guidelines to mitigate medication errors in the operational CCAT environment and suggests further application of human factors approaches to improve patient safety during critical care air transport.