PROCESS OF DOING HOME VISIT

1. INITIATION PHASE
o the first contact between the nurse and the
family.
o can be stimulated by either a referral from a
health or social agency or a family request
o provides the foundation for an effective therapeutic
relationship.
o primary task of the nurse: establish the
HOME VISIT reason/need/purpose for the visit

 the tradition of providing services to families in their 2. PRE-VISIT PHASE

homes o personal preparation of the nurse taking into
 an important aspect of the nurse’s role in reducing health consideration safety and sensitivity of the home to
risks and promoting the health of populations be visited
o has several components:
PURPOSES ▪ PRELIMINARY CONTACT. The nurse should
• To get a more accurate assessment of the family contact the family by telephone before the home
structure, the natural or home environment, and visit to introduce self, to identify the reason for
behavior in that environment. the contact, and to schedule the home visit.
• To provide opportunities to identify both barriers and ▪ INFORMATION GIVING. If a referral has been
supports for reaching family health promotion goals. received, it is important and useful to ascertain
• To work with the client directly to adapt interventions to whether the family is aware of the referral.
match resources. ▪ CLARIFICATION OF NEEDS. A brief summary of
the nurse’s knowledge about the family’s situation
ADVANTAGES AND DISADVANTAGES will allow the family to clarify their needs.
▪ SCHEDULING OF VISIT. Make sure to consider
family’s convenience. Although the length of the
PROS CONS visit may vary, depending on circumstances,
approximately 30 to 60 minutes is usual.
Client convenience and Cost of pre-visit
availability of an preparation, travel to and 3. IN-HOME PHASE
option for those clients from the home, time spent o the actual visit to the home
unwilling or unable to travel with one client, and post- o affords the nurse the opportunity to assess the
visit preparation is high family’s neighborhood and community resources, as
well as the home and family interactions
Client control of the setting Nurses’ safety is sometimes o priority action: establish rapport
endangered o major portion of the home visit is concerned with
establishing the relationship and implementing
Nurse has the ability Unpredictability of home the nursing process.
to individualize services situations
4. TERMINATION PHASE
o purpose of the visit has been accomplished
o the nurse reviews with the family what has occurred
FUNDAMENTAL SKILLS TO EFFECTIVE HOME VISITS and what has been accomplished and becomes the
basis of the next visit
Building a trusting relationship with the family client is o begin at the first contact with the
the cornerstone of successful home visits. Five skills are establishment of a goal or purpose
fundamental to effective home visits:
5. POST-VISIT PHASE
o responsibility for the visit is not complete until the
interaction has been recorded
observing listening questioning o major task: documenting the visit and services
provided.
o record systems and formats vary from agency to
agency which instructs the nurse to become familiar
with the particular system used in the agency
probing prompting REFUSAL OF HOME VISIT

• The nurse needs to explore the reasons for the refusal;

there may be a misunderstanding about the reason for a
TYPES OF HOME VISIT visit, or there may be a lack of information about services.
• Voluntary
o visit requested by the client • The contact may be terminated as requested if the nurse
o characterized by easier entry for the nurse, client- determines either that the situation has been resolved or
controlled interaction, an informal tone, and mutual that services have been obtained from another source,
discussion of frequency of future visits and if the family understands that services are available
o ex: a new mother who has requested the nurse and how to contact the agency if desired.
come to the home and assist her with learning how
to care for the infant
Source:
• Required Stanhope, M. Public Health Nursing: Population-Centered
o often may be legally mandated Health Care In The Community (2012), 8th Edition,
o entry may be difficult for the nurse; the interaction Elsevier Publishing
may be nurse-controlled; there may be a more
formal, investigatory tone to the visit with distorted
nurse–client communication; and there may be no
mutual discussion
o ex: when a family member has been diagnosed with
tuberculosis and the nurse needs to make certain
that the client is taking medications regularly (DOTS)