Frail Older Patients' Experiences During Boarding in the Emergency Department: A Qualitative Study

To explore how frail older patients experience their stay and nursing care during boarding time at the emergency department.

A qualitative explorative interview study.

Purposive sampling was used, with a two-step selection process: (1) Patients 65 years or older spending at least 4 h at the emergency department waiting for a hospital bed, referred to as boarding time, were (2) screened for frailty using the FRail Elderly Support researcH group screening instrument. If screening identified a patient as frail, they were eligible for an interview. Individual semi-structured interviews (n = 19) were conducted during patients' boarding time at the emergency department. Data was collected between March and April 2019. The theoretical Fundamentals of Care framework shaped the interview guide. Interviews were transcribed and an inductive latent content analysis was performed.

The findings resulted in four main categories: Frail older patients felt disregarded, defenceless, and resigned during boarding time at the emergency department, yet also hopeful. The experience of hope resulted from confidence in the nurses, good nursing care, patience towards one's situation, and hope in emergency care.

The frail older patient experienced boarding time in the emergency department through an overarching theme: 'being left in no-man's land in the emergency department but still feeling hopeful'. A trusting nurse-patient relationship, integrating the provision of fundamental care, is a favourable factor for the well-being of the frail older patient.

The study addressed the increased number of older adults with complex health needs, coupled with overcrowded emergency departments. Frail older patients perceive the boarding time as being left in a 'no-man's-land', addressing unclear information and lack of caregiver responsibility. This highlights the need for tailored guidelines and care practices that promote person-centred care and ensure safety for this vulnerable group in emergency settings.

Not applicable.