Knowledge, attitudes, and practices of nurses addressing social determinants of health in the emergency department

BACKGROUND: The emergency department (ED) serves as a safety net for individuals with limited access to primary care. ED nurses are often the first point of contact for those with few resources. Literature shows a link between social determinants of health (SDoH) and frequent ED use. 

PURPOSE: This qualitative descriptive study explored ED nurses' knowledge, attitudes, and practices in addressing SDoH, aiming to better understand this issue and elevate nurses' voices. 

METHODS: A qualitative descriptive design examined how ED nurses address SDoH and their related knowledge, attitudes, and practices. 

RESULTS: Eighteen ED nurses participated in semi-structured interviews. Thematic analysis yielded 45 codes, 17 categories, and six themes: practical wisdom, navigating barriers, integrated solutions, professional and ethical stewardship, time constraints and institutional influences, and educational empowerment. 

CONCLUSIONS: Results highlight the complexity of addressing SDoH in the ED and the need for more resources, education, and research on interventions and long-term outcomes.