Selecting a Goal Domain

Table of Contents

The school nurse selects a goal domain on the IHP template. The domain reflects wants, needs, or barriers the family is collectively experiencing that is either impacting a goal positively or negatively.In addition to educational data systems that reflect program and plan attainment, there are standardized definitions of domains that may impact student-centered outcome measures. The school nurse or leadership team may use this data in:

  • measuring performance in monitoring the quality of school health service delivery, 
  • coordination of care, 
  • evaluating community health services, 
  • an early warning measure for chronic absenteeism, and 
  • support in school health services. 

A student’s individualized health plan goal may be impacted by social determinants of the student’s health that involve holistic quality of life domains that are impacted outside of the traditional school setting ( NCQA, 2024).

Based on an extensive review of goals, listed are the most common domains that can be used in goal attainment to highlight measuring performance, coordination, as an early warning measure and support:

  1. Medication Management: Goals focused on the ability to manage medications. 
    Example: Student or family is focused on developing routine medication management skills 
  2. Improving Health and Wellness: Goals related to developing, improving and maintaining positive health and wellness habits. 
    Example: Student or family is  focused on checking blood sugars routinely, making healthy lunch choices
  3. Managing Conditions and Symptoms: Goals related to health care received or desired and to experiences with providers and the health care system. 
    Example: Student or family is focused on the student sustaining no injury from any emergency plan implementation.
  4. Access to Services and Supports: Goals focused on the ability to access, afford, and utilize appropriate health and community resources including access to transportation, stable food resources, assistance with financial concerns. 
    Example(s): The parents are experiencing transportation issues. The parents are experiencing financial issues impacting household utilities. The student has no healthcare insurance. The student is food insecure.
  5. Physical Function: Goals related to managing physical functioning, physical symptoms or conditions and improving or maintaining the ability to participate in physical activities. 
    Example: The student wants to participate at recess and there is no adaptive playground equipment. The student is having difficulty participating in an interscholastic activity. 
  6. Social and Role Function: Goals focused on engaging in meaningful activity like work, hobbies, or social interaction with family and friends. 
    Example: The student and/or family wants routine positive interactions and communication from school personnel, to include the nurse.
  7. Emotional and Mental Health: Goals related to managing mental health symptoms or participating in activities that impact emotional aspects of quality of life.
    Example: The student does not want to miss recess with their peers related to emotional response.
  8. Legal: Goals related to legal issues or legal involvement. 
    Example: The student or family is adjudicated and the student or their family needs legal assistance.
  9. End of Life: Goals related to end-of-life care and desires. 
    Example: The student has an IPOST (Iowa Physician Orders for Scope of Treatment).
  10. Housing: Goals related to individuals’ place of residence. 
    Example: The student requiring ongoing school health services is homeless and their family is living in a tent at a campground. The student and family are in need of assistance with permanent housing.
  11. Caregiver Needs and Concerns: Goals expressed by and for caregivers that focus on caregiving responsibilities and skills, finding respite care, and receiving social support. 
    Example: The student’s family is in need of respite or social support in managing their child with disability.
  12. Independence: Goals that center on living one’s life independently without help or assistance from others. 
    Example: The 19 year old student has 4+ health goals to learn how to make their own appointment, reorder supplies and fill out healthcare paperwork in preparation for secondary education and career readiness.