Factors associated with incomplete, delayed or erroneous pre-hospital medical documentation by paramedics: A scoping review

Accurate prehospital medical documentation (PMD) by paramedics during patient handover is critical for patient care. However, difficulties arising from time pressures, environmental constraints and systemic limitations, often result in the loss of information, negatively affecting patient care and clinical outcomes. The aim of this scoping review was to identify and map the factors associated with incomplete, delayed or erroneous PMD completed by paramedics in the context of patient handover to hospital staff. Studies focusing on PMD completed by paramedics in the pre-hospital environment. This scoping review followed the Joanna Briggs Institute methodology and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A comprehensive search of seven data bases was conducted in 2024. Eligible studies were screened and charted by two independent reviewers. The initial search yielded 6729 records. After removing duplicates ( n = 1598) and non-English titles ( n = 82), 5049 remained. These were screened by titles and abstracts, with 4992 excluded for lack of relevance. Fifty-seven articles underwent full-text review, and twenty-five articles were eligible for inclusion published between 1990 and 2024 were included for data extraction. Five categories affecting PMD were identified: professional/competencies, technical constraints, policy-related issues, dynamic and conflicting priorities, and human elements. Most studies were conducted in high-income nations. Notwithstanding technological advancements, paramedics continue to encounter difficulties in completing accurate PMD. Interventions must address both systemic challenges (e.g. documentation tool design, broadband reliability) and human factors (e.g. training, cognitive load). Further research is needed, particularly in LMIC settings.