WELCOME

HOME VISIT

DEFINITION
The home visits is an important aspect of public health nurses to meet the health needs of the patient and family and the purpose of public health nurse is for health supervision of the public.

PURPOSES
1. Case finding
Public

health and protection neglect cases disease

Abuse,

Communicable School

related health conditions

PURPOSES
2. Illness prevention and health promotion
Prenatal Child

and well baby care

development

Elderly care

PURPOSES.
3. Care of the sick and terminally ill
Home

health

Hospice

PRINCIPLES OF HOME VISIT

Home

visits should be planned on the basis

of need
Respect

the persons feelings and needs at

the time of the visit.

The

other persons point of view.

PRINCIPLES.
Be

sure of the scientific soundness of

the subjects you discuss

Use

safe technical skills including hand

washing, inspection etc.

Have

full understand of your agency s

policies.

PRINCPLES.
Collect

the facts about the home , the patient and the environment Work with the person and family plan jointly. Evaluate your own work quality is more important than quantity. Make a note of important facts in your diary. Record the work performed by us in each visit.

NURSING SKILLS USED DURING HOME VISIT

Expert

interviewing skills and effective

communication techniques are essential for effective family intervention.

NURSING SKILLS.
Acute observation skills: The environment is new to you, and observation of environment and client are equally important. In addition to focusing on the family members' concerns and the purpose of the visit, you need to be observant about neighborhood, travel safety, home environmental conditions, number of household members, client demeanor and body language, and other nonverbal cues.

Assessment of Home Environmental Conditions

Conditions

in the neighborhood and home environments reveal important assessment information that can guide planning and intervention with families. While traveling to and arriving at the family home, you have been gathering information about resources and barriers encountered by the family. This information is used during planning with the family.

PHASES OF HOME VISIT

1. Pre visit or planning phase
Determine Prioritize Review

which clients need to be seen

the scheduled visit

the chart, orders, client

diagnosis, goals of care and reasons for the home visit

1. Pre visit or planning phase.

Secure

direction to the home inventory of the bag needed

Conduct

equipment and supplies and educational materials

Review

safety consideration

2. Implementation Phase
Initiate

the visit, establish good rapport appropriate hygienic practices

Practice

before client assessment

Review

plan for visit with client expectation of client

Determine

regarding home visit

2. Implementation Phase.
Conduct Modify

assessment

the plan of care based on client

needs and situational dictates

Perform Deal

nursing intervention Environmental,

with distraction:

behavioural and nurse initiated

3. Evaluation Phase
Evaluate effectiveness of intervention based on established short term(responds during visit) and long term outcome criteria(effects of intervention at subsequent visits or other client contact)

4. Documentation Phase

Document based on established outcome criteria and agency requirements

Validate diagnosis and additional health needs based on visit. Evaluate goals and objectives. Review action taken, response of clients and outcome of interventions

Record both objective e(nurse based) and subjective (client based)data.

5. Termination Phase

Termination begins with first visit as nurse prepare the client for time limited nature of home visiting

Review goal attainment with client/family and make recommendations and referrals as necessary for continued health care issues

Develop strategies for appropriate closure with clients who die, refuse visits, or are terminated because of non reimbursable services

STEPS IN HOME VISIT

Establish

a friendly rapport with the

family members
Make

a survey and prepare a map. of data and analysis .

Collection Establish Prepare

goals.

plan of action.

STEPS.
Nursing

interventions.

Interpretation of results. up.

Follow

Evaluation.

What does the public health nurse do? The nurse can help the client:
Get

needed medical appointments

Have a healthy pregnancy successfully

Breastfeed Raise Keep

healthy children children safe

Plan the size of the family

Contd.

Make healthy food choices Evaluate childrens health & development Get accurate immunization information Get treatment for/prevent lead poisoning Obtain Medical & community resources Deal with loss Maintain sobriety Develop a crisis plan of action

30 STEPS
Assessment
1.

Studies referral, record, or other available

data about the family. 2. Gathers community resource information potentially appropriate to the family. 3. Obtains appropriate supplies or educational material in anticipation of family needs.

30 STEPS.
Planning 4. Contacts family to set up an appropriate time for the home visit. 5. Ascertains correct address and directions to the family for the home visit. 6. Formulates a written plan for nursing intervention with each family member. 7. Organizes a chart with forms and charting tools based on the focus of the visit. 8. Plans a route to the family's home that is he most direct, being resource efficient.

30 STEPS.
Implementation Travels the community with safety, locating family home with ease Knock on the door loudly enough to be heard and in a friendly manner. Introduces self to family members in an ap propriate manner. Clearly states the reason for the visit. Allows a few moments of socialization before beginning the visit.

30 STEPS.
Smiles,

speaks in a pleasant, friendly tone of voice, and maintains eye contact. Uses aseptic technique when providing nursing care. Respects the dignity, privacy, safety, and comfort of family members. Listens attentively to ascertain what family members are saying or implying. Converses with family members during the home visit.

30 STEPS.
Communicates

accurate and meaningful in formation to family members. Responds to family members in a way that encourages them to continue talking. Uses appropriate words of explanation for family member understanding. Utilizes opportunities for incidental teaching. Commends progress made by individual family members.

30 STEPS.
Explains

nursing measures before, during, and

after each procedure.

Shares

the results of nursing measures with

family members when indicated.

Closes

the home visit by summarizing the main

points of the visit.

Makes

plans for the next visit, considering

30 STEPS.
Evaluation Utilizes information gathered on the home visit to plan care for next visit. Documents home visit in an appropriate and timely manner. Completes a selfevaluation of the home visit.

ADVANTAGES OF HOME VISIT

The

home visit permits the nurse to see the

home and family situation in action.

Family

members will be more relaxed in their

own surroundings.
The

home visit permits the more realistic

teaching the actual situation, since socio economic background becomes clear.

ADVANTAGES.
Family

practices can be observed to

form a basis for teaching.

Other

members of the family can be who may have greater

contacted

influence and control on the member under nursing care

 The

family gains confidence in this direct

personalized contact
The

nurse has an opportunity to observe

actual care given by family members.

The

home visit provide an opportunity top

look for new health problems.

DISADVANTAGES OF HOME VISIT

Nurses

value system and style of practice may

not be compatible with providing services in the home.

More time consuming than care provided in a hospital or clinical setting.

No

easy access to emergency equipment and

consultation

DISADVANTAGES.
Personal Cannot

safety concerns.

work with groups more difficult to control

Distractions Potential

for caregiver exhaustion

CHALLENGES OF HOME VISIT

Control A

belongs to the client.

feeling of isolation and lack of support are no nurses or other team

There

members in the next room to confirm an assessment or to distinguish an abnormal finding.

CHALLENGES.
Difficulty

in communicating with the

various team members can be a stressor

The

home

environment

and

family

support system are unpredictable and not always conducive to optimal care

CHALLENGES.
Dealing

with multi problem family is emotionally for the nurse

difficult

especially in the home setting

Concern

of personal safety is an issue

as violence has increased in all delivery settings

ELEMENTS OF HOME VISIT

A

focus on families in greater needs of rather than universal

services programmes

Intervention that begin in pregnancy and continue through the second and fifth years of life.

ELEMENTS.

Flexibility and family specificity regarding duration and frequency of visits , according to the familys needs and risk level

Active promotion and positive health related behaviors

Use

of a broad, multi problem focus to address

the full compliment of family needs

ELEMENTS.
Assistance

to

family with reduction of

stress by improving social and physical environment

Use

of

nurses

and

professional

specifically trained in home visiting.

Personal Safety on the Home Visit

Neighborhood,

Travel, and Personal

Safety.
Arriving Friction Family The

at the Home. Between Family Members.

Members Under the Influence.

Presence of Strangers.

THANK U