Consensus on the content of an instrument to measure person-centred teamwork: An e-Delphi study.

AIMS AND OBJECTIVES: To establish consensus on items to be included in an instrument to measure person-centred teamwork in a hospital setting. The objective was to identify the items through a methodological literature review. Refine the items and obtain consensus on the items. BACKGROUND: A definition and related attributes of person-centred teamwork have been agreed upon. An instrument is needed to measure and monitor person-centred teamwork in hospital settings. DESIGN: Consensus, electronic Delphi design. METHODS: Items were identified through a methodological literature review. These items were included in three electronic Delphi rounds. Using purposive and snowball sampling, 16 international experts on person-centred care, teamwork and/or instrument development were invited to participate in three electronic Delphi rounds via Google Forms. Descriptive statistics were used to demonstrate their agreement on the relevance and clarity of each item. Items were included if consensus was 0.75. Content analysis was used to analyse written feedback from experts. RESULTS: The response rate was 56% (n = 9/16). Nine experts participated over an 8-week period to reach consensus on the items to be included in an instrument to measure person-centred teamwork in hospital settings. The experts' responses and suggestions for rephrasing, removing and adding items were incorporated into each round. CONCLUSION: A Delphi consensus exercise was completed, and experts reached agreement on 38 items to be included in an instrument that can be used to evaluate person-centred teamwork in hospital settings. RELEVANCE TO CLINICAL PRACTICE: We engaged with nine international experts in the academic and clinical field of person-centeredness, teamwork and/or instrument development. An online platform was used to allow the experts to give input into the study. The experts engaged from their own environment with full autonomy and anonymity. Person-centred teamwork, aimed at improving practice is now measurable. Person-centred teams improve outcomes of patients. Person-centred teamwork was specifically developed to assist low compliance areas in hospitals.

Reaching consensus on the definition of person-centred handover practices in emergency departments: A modified online Delphi.

AIM: To reach consensus on the definition and attributes of 'person-centred handover practices' in emergency departments. BACKGROUND: Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments. DESIGN: A three-round online Delphi survey. METHODS: Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. RESULTS: Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. CONCLUSION: Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments. REPORTING METHOD: The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. IMPACT (ADDRESSING): Improve handover practices and patient care. Improve person-centred care in emergency departments. PATIENT OR PUBLIC CONTRIBUTION: Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.

Consensus on the definition and attributes of person-centered teamwork: An e-Delphi study.

BACKGROUND: Effective health care relies on person-centeredness and teamwork, which are known to improve outcomes. These two concepts have been defined individually, but we could not find a definition of the combined concept. A preliminary definition was developed through a concept analysis; however, consensus on the concept has not been reached. AIM: The aim of this study was to reach consensus on the definition and attributes of person-centered teamwork. METHODS: A consensus design allowed experts to collaborate and share their experience and wisdom to refine and reach consensus on the definition and attributes of person-centered teamwork. An e-Delphi was used to engage the experts. RESULTS: Three rounds of online engagement with 12 experts were needed to reach consensus on the definition and attributes of person-centered teamwork. The attributes reached consensus of 82% after the first round. The definition had 82% consensus after the three rounds. The definition had been adjusted and refined according to the expert input. The newly adjusted definition was established. LINKING EVIDENCE TO ACTION: We successfully used the e-Delphi method to obtain consensus on the attributes and definition of person-centered teamwork. The definition of person-centered teamwork can be further developed and included in clinical practice to guide improved clinical outcomes. The consensus definition of person-centered teamwork provides a clear understanding of the meaning thereof, which may in turn enrich the usability thereof in clinical practice. Person-centered teams improve outcomes for persons receiving care in hospitals. Building person-centered teams are now better understood and the foundation of building these teams defined. We engaged with 12 experts in the academic and clinical field of person-centeredness and teamwork. The use and value of the Delphi method to obtain consensus is now better understood and can assist future research development.

Twelve tips for creating online learning units for the health professions in low-and middle-income countries.

Health professions educators in low-and middle-income countries are often sceptical about developing online learning units. This scepticism stems from the belief that online programmes are limited in developing clinical competence, and there are concerns about digital proficiency and resource availability. A social constructivist approach in designing online work-based learning units may overcome such scepticism. In this article, we use our experience in developing an online learning unit for healthcare education to suggest 12 tips for developing online learning units in a low-and middle-income context. The tips are nested in a 'promoting theory-practice integration framework' and include context, establishing communities of learning and practice, establishing foundational knowledge, practise in a work-based environment, and showcasing attainment of learning outcomes. By integrating the guidelines and framework, healthcare educators will be better equipped to develop online learning units and contribute to learning.

A Qualitative Study of Occupational Therapists' Understanding of Spirituality in South Africa.

Occupational therapy is a holistic profession that assists clients to restore meaning to their lives-a vital spiritual task. Spirituality is a multifaceted and multidimensional construct that occupational therapists need to integrate into everyday practice. In this study, Occupational Therapy educators' and clinicians' understanding of spirituality in their practice was qualitatively explored by purposively selecting 24 participants who attended a workshop based on an appreciative approach, in Gauteng, South Africa. Data were collected through self-report interview schedules and focus group inquiries and were analysed using the creative hermeneutic method. Participants expressed spirituality in occupational therapy as connectedness, meaning of life and client-centred practice.

A Reflexive Lens on Preparing and Conducting Semi-structured Interviews with Academic Colleagues.

In qualitative research, researchers often conduct semi-structured interviews with people familiar to them, but there are limited guidelines for researchers who conduct interviews to obtain curriculum-related information with academic colleagues who work in the same area of practice but at different higher education institutions. Using a pragmatic constructivist stance, we address the practicalities of conducting semi-structured interviews with fellow educators who work in the same area of professional practice, where the researcher has to address the dual roles of "insider" and "outsider" as well as that of researcher and participant. Interviewing academic colleagues offers a unique opportunity for rich data collection, but researchers should adopt a flexible conversational style during interviewing within research parameters and be acutely aware of their positionality and fluidity of roles. This article contributes to existing knowledge by drawing on the work of previous scholars in various areas of research and research methodology thereby offering a practical and theoretical perspective on conducting qualitative research interviewing in higher education institutions where the role of researcher and participant can become blurred. These guidelines and insights will also benefit researchers who conduct research with peers who work together in the same area of expertise, in similar contexts and with whom there are varying levels of working relationships.

A process to gain access for research in the clinical setting.

Researchers and clinical nurses need to collaborate to develop the clinical setting. Negotiating access to do research in the clinical setting can be challenging. The task of gaining access is often omitted and scarcely described in the literature. The aim of this article is to describe a process to gain access based on the authors' individual and collective experience through reflective conversations. The process consists of four key components: researcher, review board, gatekeepers and participants. Each component is linked and a crucial step to gain access to the clinical setting and ultimately to the participants. The gaining access process may prepare novice researchers for the specific considerations, time and effort required to initiate research in the clinical setting.

Nurses' perspectives on alternative communication strategies use in critical care units.

BACKGROUND: Critically ill patients have the right to communicate and participate in their treatment to avoid adverse medical outcomes due to the severity of their illness, their responsiveness, and level of consciousness. This human right has often been neglected by health care professionals, as a result of limited alternative communication support provided to patients who are unable to speak due to, for example, endotracheal intubation. Despite the successful use of alternative communication strategies in critical care units (CCUs) in other countries, limited implementation in South African hospitals has been reported. AIMS AND OBJECTIVES: This study aimed to determine the perspectives of South African nurses working in CCUs on the frequency of use of alternative communication strategies to support patient-centred communication with critically ill adult patients. DESIGN: The study followed a quantitative non-experimental survey research design. METHODS: A total of 210 nurses working in both private and public hospitals completed a survey on their perspectives on the use of alternative communication strategies in CCUs. RESULTS: Nurse participants reported experience working with critically ill and communication-vulnerable patients. Nurse-patient communication mainly involved the use of pen and paper, facial expressions and gestures to obtain information relating to patients' needs and their health history. Limited use of speech-generating communication devices was reported. CONCLUSION: Nurse training on the use and implementation of alternative communication strategies, such as communication boards or electronic speech-generating devices, should be investigated to improve nurses' communication with communication-vulnerable patients in South Africa. RELEVANCE TO CLINICAL PRACTICE: The results are applicable in clinical practice due to patients' need for alternative communication. The nurses mainly used low-tech solutions, which are cheap and easy to access. However, there exists an opportunity to increase the use of available digital solutions.

Integrative therapies in intensive care units: A scoping review.

AIM: We reviewed literature describing the incorporation of integrative therapies in intensive care units. We aimed to elicit an overall picture of research and find existing knowledge gaps on this topic. DESIGN: We conducted a scoping review guided by Arksey and O'Malley's methodological framework and were guided by the PRISMA-ScR Checklist. METHODS: Various databases were searched for relevant literature. English language articles published between 1999 and 2019 were retrieved. Data were extracted based on sample, sample size, methodology, findings and implications for practice. RESULTS: From 275 studies retrieved, 30 were included, based on the inclusion criteria. Three key themes related to integrative therapies in intensive care units emerged from the literature: 1) general information on integrative therapies; 2) interventions using integrative therapies; and 3) perceptions and attitudes of nurses on integrative therapies. Positive outcomes were observed in ICUs, and nurses showed positive attitudes towards using integrative therapies.

Patients' experiences of triage in an emergency department: A phenomenographic study.

BACKGROUND: Triage, predominantly done by nurses in the emergency department, is globally accepted as essential to prioritise the acuity of patient care. Patients with low acuity illness often express frustration and disgruntlement with the triage process and long waiting times. Consequently, some patients leave the emergency department unseen, which may negatively affect their health outcomes. In order to change practice efficiently, triage nurses should provide patients an opportunity to share their experiences. OBJECTIVE: This paper deals with exploring the understanding patients' emergency department triage experiences. DESIGN: A phenomenographic approach was used to explore and understand patients' triage-related experiences in an emergency department. METHODS AND CONTEXT: Semi-structured individual interviews were conducted with 10 purposively selected participants who were triaged as yellow or green in an emergency department in a public hospital in Botswana. Collaborative creative hermeneutic data analysis by 11 nurses working in the same context identified categories of description. RESULTS: Three categories of description emerged from patient experiences, namely triage environment, triage nurse and waiting times. Following data analysis, the nurses reflected that they were not aware of the consequences in the way triage was currently conducted. Consensus was reached that they should move away from focusing on a biomedical model towards person-centred triage, which then underpinned the outcome space for triage in the emergency department. CONCLUSION: The reality in the emergency department is that patients' needs, wishes and expectations are neglected, leaving them dissatisfied and disgruntled. Moving towards person- centred triage may improve their overall experience of triage. What is already known about this topic?

Twelve tips for supervisors to move towards person-centered research supervision in health care sciences.

The research supervisory role is becoming increasingly complex due to issues such as diversity of students; mismatched expectations between the student, supervisor and higher education institution and shorter and specific time-bound research outcomes. The current postgraduate research supervision culture and supervision practices should change. Moving towards person-centered research supervision practices may enhance the research environment, as healthful relationships between supervisors and postgraduate students may lead to increased postgraduate research outcomes. Using a World Café, we critically reflected on our existing research supervision practices. All healthcare educators involved in postgraduate research supervision were purposively selected to participate. During the café, we explored and shared ideas in a safe space. Twelve tips emerged, which can be implemented to move existing supervision practices towards person-centered research supervision practices. We present these twelve tips from the perspective of the four constructs of person-centeredness as outlined by McCormack and McCance - pre-requisites, environment, process, and outcomes. The use of these tips may enable both supervisors and students to flourish. Avoiding routine, ritual supervision practices and embracing person-centredness, will enable supervisors to form healthful relationships and put the postgraduate student at the heart of our supervision practices.

Family needs during critical illness in the Emergency Department: A retrospective factor analysis of data from three countries.

AIMS AND OBJECTIVES: To examine underlying factor structure of the Critical Care Family Needs Inventory-Emergency Department across three countries to identify similarities and differences. BACKGROUND: Understanding family needs assists nurses to provide family-centred care to deliver optimal outcomes for critically ill patients and their families in Emergency Departments. DESIGN: Retrospective secondary analyses of data collected in three cross-sectional surveys. METHODS: Convenience samples involved recruitment of family members accompanying a critically ill relative into four Emergency Departments in Australia (2), South Africa (1) and Taiwan (1). Item-matched raw data from 374 responses to 40 items from the surveys were collated and analysed using confirmatory factor analysis methods. Reporting adhered to an adapted STROBE checklist. RESULTS: The factor structure of the 40-item Critical Care Family Needs Inventory-Emergency Department differed between countries. Analyses of the Australian data revealed a four-factor solution comprised of 18 items across four categories of family need (support, communication, participation and comfort); the Taiwanese data also demonstrated a four-factor solution comprised of 13 items (support, communication, participation and comfort); alternatively, the South African data revealed a two-factor solution comprised of nine items (communication and participation). Fifteen items did not match across the countries. However, loading for four items common across all three countries was related to family participation (3) and communication (1). CONCLUSIONS: The findings suggest family members from different countries responded to Critical Care Family Needs Inventory-Emergency Department items in different ways. Consistent with concepts of family-centred care, the study identified participation and communication needs that were common across the countries. The outcomes illustrate the challenge of providing appropriate care for family members during critical illness of a relative in the ED. RELEVANCE TO CLINICAL PRACTICE: Family perceptions of important needs during critical illness in the Emergency Department differ across countries; hence, the Critical Care Family Needs Inventory-Emergency Department has limited utility. Participation and communication needs emerged as common family needs.

Mindfulness-based interventions to support wellbeing of adults in low socio-economic settings: a realist review.

BACKGROUND: Mindfulness as a modality involves training the innate human capacity for present-moment awareness with a view to cultivating a more harmonious and integrated life experience, especially in the face of hardship. Over the past four decades, the field of mindfulness has grown rapidly. Despite a substantial body of literature outlining the many benefits of mindfulness practice within a range of contexts and populations, the authors noticed that studies addressing the adaptation, application and value of mindfulness-based interventions (MBIs) for adults within socio-economically challenged setting were scant. To address this gap, we conducted a realist review of studies pertaining to MBIs within low socio-economic settings, to determine the extend and nature of research in this sector and culminating in a program theory which may be useful for the design of interventions going forward. METHODS: We selected realist review as the methodology as it is well suited to investigating the complex nature of social interventions. The value of realist review is that the exploration of the causal relationships between the mechanisms (M) within a specific context (C) towards particular outcomes (O) offers a deeper understanding of the intervention which may assist in more effective delivery going forward. The review follows the guidelines presented by the Realist and Meta-narrative Evidence Synthesis - Evolving Standards project. RESULTS: Of the 112 documents identified, 12 articles met the inclusion criteria. Of these 12 studies, 10 were conducted in the United States, with little representation across the rest of the globe. The interventions described in these articles were varied. We identified mechanisms that offered beneficial outcomes for participants across a range of contexts, with indications of how interventions might be adapted towards greater accessibility, acceptability, and feasibility within communities. CONCLUSION: By reviewing the various programs in their respective contexts, we developed a program theory for implementing socio-culturally adapted MBIs in low socio-economic settings. In the future, this program theory could be tested as a means to create a sense of wellbeing for people living in low socio-economic settings.

Understanding of 'person-centred care' in an oncology ICU: Associative group analysis.

Purpose: To describe how healthcare professionals, patients, and their significant others understand the concept of 'person-centred care' in an oncology ICU. Methods: This study followed the associative group analysis (AGA) method, a quali-quantitative research approach.The population included healthcare professionals, their patients, and significant others in a four-bed oncology adult intensive care unit. Whole population sampling (n = 22) allowed all healthcare professionals to participate. Maximum variation purposive sampling was used to identify patients and their significant others (n = 22). Data were collected during either face-to-face or telephonic individual interviews. Free associations were weighted using a validated weighting system. Words with similar meanings were then grouped into themes. The themes were then deductively grouped according to the domains of the Person-centred Practice Framework. Results: Participants had a limited understanding of person-centred care and could only identify six of the 23 constructs of the Person-centred Practice Framework. Healthcare professionals embraced the idea of person-centred care, but their understanding of the concept remains vague. Person-centred care remains conceptual in this oncology intensive care unit because the interpretation and operationalisation of the concept are misaligned at various health service levels. Conclusion: Organisations should invest in work-based learning to enable staff to understand the concept of person-centred care. Healthcare workers also need to self-evaluate how they work and be able to adjust their working style to be more person-centred.

Clinical practice guidelines for person-centred handover practices in emergency departments: a scoping review.

OBJECTIVE: To review the available information on clinical practice guidelines for person-centred and current handover practices between emergency care practitioners (ECPs) and healthcare professionals in emergency departments (EDs). Collating existing clinical practice guidelines may improve handover practices. ELIGIBILITY CRITERIA: Clinical practice guidelines for person-centred handover practices between ECPs and healthcare professionals in EDs. ECPs transporting and handing patients over to healthcare professionals in EDs. Healthcare professionals including doctors and nurses working in EDs, who are involved in handovers with ECPs. Studies conducted in EDs, emergency rooms or emergency centres in any geographical area. No language or time restrictions were applied. The search included published and unpublished studies, opinion papers as well as primary sources, and evidence synthesis. All qualitative and quantitative research designs were included. SOURCES OF EVIDENCE: The literature on clinical practice guidelines for person-centred handover practices was reviewed. Three electronic databases were searched: MEDLINE (PubMed), CINAHL (EBSCO) and Scopus from inception to May 2023 with no time limits set for the inclusion of published literature in the review. Six guideline organisations were also searched. CHARTING METHODS: A data extraction tool was developed, pilot-tested and used to extract data from the included studies. RESULTS: 19 studies met the inclusion criteria. Various mnemonics exist for handover practices. Where mnemonics are not used, participants have identified important information that should be included during handover practices. We did not find any clinical practice guidelines or information on person-centred handover practices in any of the reviewed articles. CONCLUSIONS: Currently, there is no gold standard for person-centred handover practices, which has led to various practices being implemented. Currently, there is a paucity of literature on person-centred handover practices. Most articles expressed a need for standardised handover practices; however, not all aspects of handover practices can be standardised and should be kept patient and context-specific. TRIAL AND PROTOCOL REGISTRATION: This scoping review protocol was registered on Figshare (10.6084/m9 /m9.figshare.21731528).

A concept analysis of person-centred handover practices: The meaning in emergency departments.

BACKGROUND: Transfer of patients from the prehospital to the in-hospital environment is a frequent occurrence requiring a handover process. Habitually, emergency care practitioners and healthcare professionals focus on patient care activities, not prioritising person-centred handover practices and not initiating person-centred care. AIM: The aim of this concept analysis was to define the concept person centred handover practices. METHODS: The eight steps for Walker and Avant's method of concept analysis. RESULTS: Thirty-one articles were included for final review including qualitative and quantitative studies, literature reviews and audits. This concept analysis guided the development of an concept definition of person-centred handover practices between emergency care practitioners and healthcare professionals in the emergency department as person- centred handover practices are those handovers being performed while including all identified defining attributes such as structure, verbal, and written information transfer, interprofessional process, inclusion of the patient and/ or family, occurs at the bedside, without interruption. CONCLUSIONS: Results suggested that person-centred handover practices involve verbal and non- verbal interprofessional communication within a specific location in the emergency department. It requires mutual respect from all professionals involved, experience and training, and the participation of the patient and / or family to improve patient outcomes and quality patient care. A definition for the concept may encourage the implementation of person-centred handover practices in emergency departments.

Mapping the evidence of emergency nursing research in who Afro-region states: A Scoping Review.

Introduction: The introduction of emergency nursing in Africa has resulted in the establishment of several training schools across the continent. This has translated into a growing body of emergency care research being carried out by nurses; however, the breadth and extent of evidence remains unclear. The aim of the review was to map and collate the available literature on emergency nursing research in WHO Afro-region states. Methods: The review adopted the methodology of the Joanna Briggs Institute (JBI) scoping reviews. The review protocol was registered on 27 June 2022 (osf.io/5wz3x). The Population (nurse), Concept (emergency nursing research), Context (WHO Afro-region) (PCC) elements guided the development of the inclusion and exclusion criteria. Papers were searched across seven electronic data bases and two search engines using a three-search strategy. The screening was performed initially on the abstract and title and lastly on full text. The reporting for the review was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Results: One hundred and thirteen papers were included in the review. Publication of emergency nursing research occurred from 2000 to 2022. The year 2017 and 2019 recorded the highest number of publications (n = 14). The country with the most publications was South Africa (n=50). Emergency nursing research used predominantly quantitative methodologies (n=58). The professional groups involved in research were nurses (n=69) as well as nurses and doctors (n=26). The identified papers focused primarily on emergency nursing education (n=23) and epidemiology (n=24). Conclusion: There is a notable increase in the number of publications on emergency nursing research in WHO Afro-region states, however from only 11 countries. Since most of the research is still at descriptive level, there is need to encourage emergency nursing research on interventions and measuring outcomes and impact in the emergency care system.

Healthcare professionals and pregnant and post-natal women's perceptions of interprofessional collaboration in a maternity care facility: A qualitative study from Botswana.

OBJECTIVE: To explore the perceptions of healthcare professionals and pregnant and post-natal women regarding interprofessional collaboration in a maternity care setting in Botswana, a low-to-middle-income country in Sub-Sahara Africa. DESIGN: A descriptive qualitative design using in-depth interviews with forty participants, including healthcare professionals and women in maternity wards. Data were transcribed and thematically analysed. SETTING: Antenatal, delivery and post-natal maternity wards in a referral hospital that provides basic and specialist care in Botswana. PARTICIPANTS: We interviewed 13 pregnant and post-natal women and 27 healthcare professionals in the maternity care wards. FINDINGS: Participants perceived several interrelated factors that influenced the delivery of interprofessional collaborative care. Interpersonal factors such as poor communication, disrespectful behaviours and inadequate teamwork practices prevented interprofessional collaboration. Other barriers to collaboration included lack of understanding of each other's roles and responsibilities, ineffective coordination of resources, hierarchical power struggles and poor collaborative leadership. KEY CONCLUSIONS: Effective interprofessional collaboration remains elusive in this maternity care setting. Healthcare systems in low-to-middle-income countries may benefit from interventions for healthcare professionals to learn and practice interprofessional collaborative care.

Do professional nurses practice what they preach? A qualitative study on professional socialisation of student nurses in the clinical learning environment.

While working alongside professional nurses, student nurses develop professional identity and learn the professional nursing role, a process known as professional socialisation. Professional nurses should model professional behaviour to be emulated by student nurses. We used a qualitative exploratory design to explore if professional nurses behave in a manner that supports professional socialisation of student nurses in a clinical learning environment. According to our observations, two main categories emerged regarding professional nurses' behaviour. The first category was unprofessional conduct with sub-categories that included disrespect, infringed patient privacy, breached confidentiality, inappropriate dress code and lack of punctuality. The second category was ward disorganisation which was related to delegating duties and structured orientation programmes for student nurses. In this study, professional nurses did not behave in a manner consistent with professional socialisation in the clinical learning environment. Student nurses may struggle to develop professional identity, leading to reduced confidence and poor patient quality care. Student nurses need to be professionally socialised in a clinical learning environment and professional nurses need to be empowered on how to carry out this process.

Documentation of wounds in emergency departments through a forensic lens.

BACKGROUND: Nurses document wounds to direct and evaluate the care. People admitted to emergency departments with wounds should be regarded as potential forensic patients, requiring meticulous documentation for evidence purposes. AIM: To explore the documentation of wounds in emergency departments through a forensic lens and compare it between different levels of emergency departments. METHODS: In this descriptive retrospective study, we randomly sampled 515 paper-based medical files of patients who sustained wounds admitted to three selected emergency departments. The files were analysed using a structured data collection tool the data were descriptively analysed. RESULTS: All files included information on the type of wound (100%) and the site of the wound (100%) with most files including the mechanisms of injury (98.6%). Few files included information on blood loss (18.1%) and the size of the wound (15%). Only one file included information on the contents of the wound. No files included information on the wound's shape and the surrounding skin's condition. CONCLUSION: Wounds were poorly documented in emergency departments, irrespective of the level of care. Nurses in emergency departments should have strict guidelines for documenting wounds since accurate documentation protects patients' human rights and protects nurses.