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Home Visit Plan Date: Family Members: Name Relation to the Family Head Father Mother Eldest Child

Second Child Third Child Fourth Child Youngest Child Age/Sex Birth Date Month Dec Feb July Sept Nov Dec March Year 1980 1982 2001 2002 2004 2007 2010 Marital Status If not in school, highest educational attainment Elementary graduate Elementary graduate Grade 5 Grade 3 Grade 2 N/A N/A If still in school, present educational level Occupation Physical Health Type of Work Helper Housewife Student Student Student N/A N/A Place of Work Wet Market N/A Labogon Elementary School Alive and well Alive and well Alive and well Alive and well Alive and well Alive and well Alive and well

Demetrio Nuena Candelaria Nuena Diecel Nuena Dizza Nuena Desly Nuena Dicirie Nuena DC Nuena

31/M 30/F 11/F 10/F 8/F 4/F 2/F

Married Married Single Single Single Single Single

Address: Type of Case Load: Heath Promotion and Prevention General Objectives: to be able to assess a family. Identify concerns and problem and give them health teachings. Activities Rationale Resources Greet the family and introduce To be able to establish rapport to the Time and human resource self to them family buy identifying oneself Inform the family what are the purposes and objectives of the student nurses visit, time frame Notify the family first what to expect and the task to be accomplished during the course of student nurses visit Ask the family about their environmental sanitation and how they manage it Assess familys understanding To give the family an idea of the purpose and length of the visit To promote cooperation among the family members in accomplishing the tasks set To be able to establish trust to the family by letting the family express their concerns To be able to know the degree of Time and human resource

Time and human resource

Time and human resource

Time and human resource

Evaluation After 2 minutes of student family interaction, the student was able to greet the family and introduce herself After 2 minutes of student family interaction, the student was able to state the objectives, the purpose and the time frame of the visit After 2 minutes of student family interaction, the student was to inform the family what to expect and the task to be performed during the visit After 15 minutes of student family interaction, the student was able to ask the family about their environmental sanitation specifically water sanitation and management After 5 minutes of student family

about the topic discussed by asking them to answer questions related to the familys concerns Explore familys thoughts, feelings, and practices Offer self to the family to render help Summarize all significant findings

understanding of the family and to know appropriate intervention and health teachings to be given To assist the nurse in understanding the client better To be able to render help to the family To clarify to the family the correct information and to make the family aware To avoid conflicts with the schedule and to ensure that the family members are around next visit To show gratitude and courtesy to the family Time and human resource

Time and human resource Time and human resource

Agree with the family for the schedule of next home visit Thank the family for their time and say goodbye

Time and human resource

Time and human resource

interaction, the student was able to assess the understanding of the family about the teaching given by letting the family answer some questions After 10 minutes of student family interaction, the student was able to get some thoughts from the family about the topic. After 2 minutes of student family interaction, the student was able to offer self to render help to the family After 5 minutes of student family interaction, the student was able to summarize all significant findings and concerns of the family After 2 minutes of student family interaction, the student was able to agree with the family the schedule of the next visit After 2 minutes of student family interaction, the student was able to thank the family for their time and cooperation and said goodbye to them