Vulnerability: A concept synthesis and its application to the Emergency Department

•Vulnerability is a concept with multiple definitions.•Vulnerability is impacted by life circumstances and or capability to obtain assistance when required.•Vulnerability is a journey which can include positive and negative repercussions.•Efforts to address vulnerability exist at the patient, healthcare professional and vulnerable population level.•Understanding the concept of vulnerability in the ED is important to inform the provision of tailored person-centred care. The aim of this concept synthesis was to add clarity to the concept of vulnerability with application to the Emergency Department (ED) by critiquing, analysing and amalgamating published concept analyses. The concept of vulnerability has been used widely, however it has various meanings. A clearer understanding of vulnerability and application to the ED may help healthcare professionals provide high quality care responsive to the needs of vulnerable individuals. Nine concept analyses of vulnerability were retrieved using Medline, CINAHL, and PsycINFO databases. After extracting data on each analysis, Walker and Avant’s concept synthesis method was used to structure this synthesis, with a thematic synthesis approach used in the analysis. Four themes associated with vulnerability emerged from the synthesis. The first theme, vulnerability as a journey, reflected elements within an individual’s life that perpetuate and exacerbate vulnerability. The second theme, vulnerability as susceptibility and risk, highlighted intrinsic and extrinsic elements that contribute to a state of risk. The third theme, positive and negative repercussions, emphasised lessons that can be learned from experience, with the fourth theme of a shared understanding indicating the importance of understanding the concept of vulnerability for patient care. Findings from this synthesis highlight the multiple elements associated with a vulnerable state, evident in the context of the ED. With multiple ED-specific elements contributing to vulnerability, clarity of the term is important to inform ED-specific interventions designed to meet the needs of vulnerable populations.