Self-Reported Completeness of Neurological Documentation in Prehospital Emergency Care: Associations With Neurological Training and Professional Experience.

BACKGROUND Neurological assessment is a critical component of prehospital emergency care, particularly in time-sensitive conditions including stroke and traumatic brain injury. Neurological documentation practices in this setting remain insufficiently characterized. This study aimed to evaluate self-reported completeness of neurological documentation among paramedics, then examine its associations with neurological training and professional experience. MATERIAL AND METHODS A cross-sectional study was conducted between June 2025 and March 2026 among 348 paramedics working in emergency medical services in southeastern Poland. Data were collected using a structured electronic questionnaire. Self-reported documentation completeness was assessed using a composite score based on the reported frequency of documenting 7 neurological examination elements rated on a 5-point Likert scale (range: 7-35). RESULTS Overall self-reported documentation completeness was moderate (mean score: 24.57). Respondents frequently reported documenting basic neurological parameters (eg, level of consciousness: 81.0%); more detailed components were reported less consistently. Only 9.2% of respondents reported consistently documenting temporal neurological changes. The greatest self-reported deficiencies involved documentation of temporal neurological changes and detailed focal neurological findings. Participation in neurological training was associated with higher completeness scores (26.20 vs 23.24; P<0.001). Self-reported documentation completeness was positively correlated with professional experience (ρ=0.359; P<0.001). CONCLUSIONS Self-reported neurological documentation completeness among paramedics was moderate and selective; self-reported rates were lowest for dynamic and detailed focal neurological components. Participation in neurological training and greater professional experience were associated with higher self-reported documentation completeness scores. These findings suggest that standardized documentation protocols and targeted educational interventions contribute to more consistent neurological documentation practices in prehospital settings.