A nursing intervention is a purposeful, evidence-based action a nurse performs to achieve a patient’s health outcome. This responsibility extends beyond managing physical symptoms to addressing the environment and relationships that profoundly affect well-being. Health is deeply interwoven with a patient’s life circumstances, which is the focus of the social domain in nursing.
Defining the Social Domain in Nursing Practice
The social domain in nursing practice encompasses the non-medical factors that influence a person’s health, often referred to as the Social Determinants of Health (SDOH). This domain includes the patient’s community context, economic stability, neighborhood environment, and social support systems. A nurse considers a patient’s relationships with family, friends, and community, as well as their access to resources like food, safe housing, and transportation.
The social domain focuses on external and relational factors, unlike the physical domain (body functions) or the psychological domain (mental and emotional state). The social domain examines the societal context of the patient’s life. Recognizing this external context is necessary because up to 80% of health outcomes are estimated to be influenced by social and behavioral causes.
Identifying Social Determinants and Needs
The initial step in addressing the social domain is a comprehensive assessment to determine if a social intervention is required. Nurses use structured screening tools, which may be integrated into electronic health records, to systematically gather data on a patient’s social needs. These tools often ask direct questions about employment, financial stability, housing security, and access to nutritious food.
The nurse evaluates the patient’s social support system, assessing the quality and quantity of relationships with family and caregivers, and checking for signs of social isolation. Environmental safety is also assessed by inquiring about housing stability, neighborhood safety, and the ability to navigate the community for essential services. This information-gathering process allows the nurse to move from identifying a problem, such as financial strain, to formulating a specific care plan to address the social barrier.
Core Nursing Interventions in the Social Domain
Resource Coordination and Referral
This intervention involves linking patients directly to non-clinical, community-based services. For instance, a nurse might connect a patient struggling with food insecurity to a local food bank or refer them to a state-wide network that coordinates social services.
Discharge Planning Focused on Environment and Support
This ensures the patient’s home environment is safe for recovery after a hospital stay. This involves arranging for home health services or coordinating with family members to address immediate needs like transportation to follow-up appointments. The nurse acts as a liaison, ensuring the transition from the clinical setting back to the community is supported with necessary resources.
Enhancing Social Support and Interaction
This focuses on patients experiencing isolation or loneliness. The nurse may encourage participation in support groups or community activities that align with the patient’s interests. For patients with limited mobility, the nurse might facilitate access to technology, such as video conferencing, to maintain connections with remote family members.
Advocacy
Advocacy is a powerful social intervention where the nurse acts on behalf of the patient to overcome systemic barriers or access issues. This can mean intervening with insurance providers to secure coverage for services related to social needs. Nurses also work within the healthcare system to ensure policies consider a patient’s social context.