Improving the documentation of safeguarding information at triage using the CWILTED tool

The emergency department (ED) may be the first place where a child and young person who has been subject to abuse or neglect comes into contact with healthcare professionals. CWILTED ('concern', 'witness', 'incident', 'location', 'time', 'escort', 'demeanour') is a tool designed to enhance the quality of information relevant to safeguarding that is documented by triage nurses about children and young people attending the ED. In 2024, CWILTED was introduced at an ED in Dorset, England, following an audit which had shown that there was room for improvement in the documentation of safeguarding information. A second audit was then conducted, which showed that the introduction of the tool had had positive effects. This article reports on the second audit's findings, making comparisons with previous data where possible. It discusses human factors that influence triage and stresses the need to communicate information about a child's ED attendance to the GP to ensure that no safeguarding issues are missed.