Incorporating Social Determinants of Health in Associate Degree Nursing Educatio

Problem: Deficits in quality of care during transitions from hospital to home result in hospital readmissions and preventable adverse events. Failure to consider the impact of social determinants of health (SDH), such as the social, behavioral, and economic characteristics that influence recovery after discharge, contributes to high readmission rates and compliance with discharge instructions. There is little evidence in the literature that undergraduate nursing students are including SDH during patient care transitions in current associate degree curriculums.;Purpose: The purpose of this study is to integrate assessment of SDH using a Patient Centered Assessment Method (PCAM) during patient care transitions into associate degree nursing education. It will evaluate student learning, suitability, and application of the PCAM assessment tools use in associate degree nursing education.;Previous Findings: There is no specific evidence that associated degree nursing students are being taught to consider SDH during patient care transitions. The American Nurses Association (2012) recommends that specific curricular components related to care transitions be incorporated across pre-licensure nursing programs.;Research Design: Mixed method quasi-experimental convergent design using paired t-tests, thematic analysis, and descriptive statistics.;Data Analysis: Initial thematic analysis showed gaps in practice through perceptions of senior baccalaureate nursing students. The Social Determinants of Health Knowledge Assessment (SDHKA) tool was developed and used to measure knowledge gained through use of the PCAM. Content and scale item analysis including Cronbach's alpha calculation were used to validate the SDHKA pretest and posttest. Paired t-tests were used to compare differences in the pretest and posttest means. Focus groups and reflective papers were used to analyze the students' perceptions on SDH and patient care transitions using thematic analysis.;Results: Initial thematic analysis showed common themes related to gaps in practice related to safety during patient care transitions: communication, comprehension, interdisciplinary teamwork, and resources and support. Cronbach's alpha analysis showed good reliability and item and scale item validity showed the items were relevant in capturing SDH during patient care transitions. Paired t-tests showed significance in 3 out of 13 SDHKA questions; overall, the observed means moved in the appropriate direction relating to the negative and positive questions, demonstrating a gain in knowledge. Thematic analysis with associate degree senior nursing students showed similar results as the baccalaureate students with common themes of communication, comprehension, discharge education, interdisciplinary teamwork and resources and support as most prominent themes in a clinical practicum using the PCAM assessment tool during patient care transitions.;Potential Significance: Incorporating the results of SDH assessment in care coordination activities during patient care transitions will enhance care coordination and development of a person-centered plan of care for nursing students. The potential outcome is improved quality of care and patient experience during critical transitions between the hospital and home.