Medication Safety During Transitions of Care From Paramedicine to Emergency Nursing Care: A Scoping Review Protocol

Transitions of care in the emergency department are critical points for patient safety, particularly during handovers from emergency medical services (EMS) personnel to emergency department clinicians. This rapid and high-pressure environment often prioritizes urgent clinical care over structured communication, increasing the risk of information loss and medication errors, which can lead to serious patient harm, prolonged hospital stays, preventable complications, and death.

To systematically map academic and gray literature examining medication-related safety risks during transitions of care from EMS personnel to emergency department clinicians.

This scoping review will follow the Joanna Briggs Institute guidance to report the outcomes using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. The database search will be guided by the population, concept, and context framework and will include studies involving EMS personnel and emergency department clinicians. The databases searched will include CINAHL, PubMed, Scopus, Web of Science, APA PsycInfo, Cochrane Library and ProQuest Dissertations & Theses Global and ERIC, alongside gray literature from OpenGrey, World Health Organization Institutional Repository for Information Sharing, Australian Commission on Safety and Quality in Health Care, National Institute for Health and Care Excellence Comission, Proquest Health & Medicine / Health Management, Patient Safety Network, Clinical Excellence Comission, and government health and EMS websites. Two reviewers will independently screen titles, abstracts, and full texts, with a third reviewer resolving discrepancies. The extracted data will be synthesized narratively and displayed in tables and charts to summarize themes and key findings.

This review will examine medication safety in the context of the emergency medical services-to-emergency department transition of care. The scoping review will examine the international English-language literature to highlight knowledge gaps and inform future research projects with outcomes that guide strategies that strengthen medication safety, optimize handover communication, and enhance patient outcomes across emergency care transitions.