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HOME VISITING

The home visit:

A home visit is conducted to visit clients where they live in order to assist them in their efforts to achieve a high level of wellness as possible (Empower).

Home visit con t.

-To visit families in their home is a privilege.

-Home is a private space. (you are a stranger).

-You are the guest and they are the experts.

Home visiting con t.

-Work with families where they live, (streets, homeless shelter, with relatives).

- Use of expert nursing skills.

- Use of non judgmental approach.

Therapeutic Relationship With the Client / Family.

-Gibb s trust model. -Initiation of relationship -Acceptance and trust -Data flow. -Goal setting and decision making -Self control.

The aim of Home Visit:

To improve health and the quality of life (health promotion). -Initiate and maintain relationship. -Assessment of family (environment).

Aims con t.
-Source for data. -Follow-up care. Follow(Implementation Of Nursing Process In The Home).

Advantages of home visiting.

Costs less than hospitalization. Clients are able to have a greater control over interaction. Family accepts change (more amenable) to health education.

Advantages con t.
Able to observe factors that influence family health. Able to observe family interaction. Allows for early intervention.

Advantages con t.
Able to identify environmental resources and hazards.

Allows for assessment of family over longer period of time than hospitalization.

Advantages con t.
Facilitates family participation in health care. Facilitates family focus and individualized care

Disadvantages of home visiting. visiting.

Change in value system and style of practice. (not compatible with providing services at home). Less coverage in proportion to time spent. No easy access to emergency equipment or consultation. Personal safety concerns.

Disadvantages con t.
Work individually, (cannot work with groups). Distraction difficult to control.

Family resents intrusion into home and/or prefers health care setting. Can be exhausting to the care giver.

Previsit Preparation.(Planning)
Factors to be considered in planning a home visit:

- Geographic lay-out of the area. lay- Number of houses to be visited. - Number of families needing close supervisionsupervisionreason for visit (referral).

PrePre-visit Preparation con t.

- Yearly plan schedule for a visit in a year. - Distance (further the home, lesser the no. of
home visited).

- Transport. - Time spent in a home.

Factors to be considered in the suitability of the home visit. visit.

Acceptance of the visit. Working time of the family. Special functions in the family. Safety.

Activities performed- H/V performedAssessment of home environmental conditions. -reveals important assessment & information.(guide planning and intervention with families). -gather information about resources/difficulties encountered by families. Assessment of household members.

Planning to meet the health needs of families during home visit.

Lack of planning & preparation greatest barrier to successful family health visit. Successful family visit Good planning & preparation, accurate documentation & followfollow-up.

Phases of home visit.

Contacting Phase: Phase: When the nurse becomes aware of an individual/family who is desiring or needing a visit. Referral- self / agency (e.g. social welfare). ReferralClarify reason for referral.

Contacting phase con t.

Clarify purpose of h/visit, who ref. family & why. Know where to go. Determine whether any special equip. is needed or is available in the home.

Entry Phase.
From going to see phase to the seeing phase. Observe and interact with families. Learn about them and their life situation . Provide health education.

Entry phase con t.

Complete treatment if required. Reviewing plans of care with the family. Identifying health needs of all household members. Referring family members to app. Resources.
Conduct all visits in a caring way, providing comfort, support, information, and counseling, as indicated.

Termination Phase.
Summarize accomplishments of the visit, and with the family. Discuss plans for the next home visit.

Termination phase con t.

Discuss referrals with the family if any. Reinforce family strengths. Documentation Clean up. Thank the family for their time.

Implementation of the nursing process in the home.

Assessment involves all family members both as individual and family as a unit. Family nursing diagnosis is important in developing appropriate plans & intervention, in collaboration with the family.

Assessment.

Use of acute observation skill.

Purpose of the 1st. H/visit begin to identify family strengths & health needs, coping abilities, home environment.

Assessment con t.
Use of assessment tools, (interviewing, observation, questionares, or checklist). **(assessment tools - remind the nurse about areas to
explore with the family).

assessment -- health education (same time). **(teaching **(teaching h/promotion activities to the family may begin only after members express an interest & recognize a need).

Nursing diagnosis & planning care.

On the basis of assessment diagnosis. establish the nursing

: for the entire family/ individuals within the family. : long term/short term goals established within the family strengths/weakness. : expected outcomes, including measurable results within a specific time frame are established.

Cultural health practices.

Influence all aspects of nursing process. Understand them behavior. understand client

Plan interventions that are consistent with client health beliefs.

Intervention.
Begins with the first visit. Decisions are made in the planning process. Prioritize health needs- deal with important needsones first. (this is the responsibility of both the client and the nurse).

Intervention con t.
Family members can absorb limited information only. Arrange for second visit,(con t. assessment). Include family members in the care of the client.

Intervention con t.
Common interventions are teaching about various health considerations e.g. - Family stress.

- Referrals. - Promoting family strengths.

Evaluation.
Ongoing process. The nurse & the family must continually assess the progress of the family towards achievement of expected outcomes. Consider modifications to the plans.

Reference.
Allender J.A. & Spradley, B.W.2005, Community Health Nursing, Promoting & Protecting the Public s Health.2005,Lippincott, W & Wilkins. Health.2005,Lippincott,

Thank you!
Any Questions?

Enjoy your home visiting

Sr. T. Naisau. 05/11/2008.