Hawler Medical University

College of Nursing
Community Health Nursing
4th stage
The lecturer: Assist. Professor
Dr.Kareem Fattah Aziz
Al-Barzinjy
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Lecture F (Home Visiting):

Definition home visit: supporting preventive health and prenatal practices assisting
mothers on how best to breastfeed and care for their babies helping parents
understand child development milestones and behaviors, promoting other positive
parenting techniques, and resolve health problems especially for older and disabled
individuals and others. Home visit is one of the essential parts of the community
health nursing.
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Home visiting purposes:
1. A home visit is one of the essential parts of the community health services to
identify health problems and resolving.
2. To find out needs of individual, family and community in relation to health,
socio- economic and cultural.
3. Prepare a map of the area to be visited and i.e. location, house, road, etc.,
prepare family folders.
4. Afford the opportunity to gain more accurate assessment of the family
structure and behavior in the natural environment.

5. Provide opportunity to make observations of the home environment and to

identify both barriers and supports for reaching family health promotion work

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 6. Meeting the family on their home ground may also contribute to family’s
sense of control and active participation in meeting their health needs.

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Factor influencing the growing of home health services:

1. Increasing elderly population: because chronic illness is more common in

elderly & need help & assistance
2. Growing of infectious diseases specially HIV/AIDS populations: for better
understanding of client need at home.
3. Advanced technology: technology allows all the services at home level.
4. Raising the cost of health care
5. Demands for consumer satisfaction.
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Advantages of home visit:

1. the family is seen in a familiar atmosphere which is were relaxed and makes
communication easier than at hospital or clinic
2. All family members can be seen & assessed by one person at one visit
3. The health workers, who know the neighborhood, are aware of local problems,
priorities, customs, difficulties, & resources.
4. High risk families can be identified & visited as a priority
5. The health workers, can observe, assess, & act up on obvious and latent health
problems. Health workers can follow these problems; Health workers can
follow these problems at subsequent visit.’
6. Visit can be done at one time. Ex personal hygiene, water supply, sanitation,
waste disposed, food storage
7. More accurate assessment is done
8. Better understanding & good relationship is established with the family
members.
9. Advice will be practical and suited to the family’s needs

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Limitation of home visit:
1. time consuming

2. limited equipment can only be carried to home

3. Appointment might be not kept ‫موعد‬

4. All education and practices in home visit should be in scientific level.

5. certain homes may be geographical not reachable

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Types of home care

Home for the aged. This is a kind of home health care provided for the elder more
than 65 years of age, who need a minimum care which is often characterized
as “supervised living or residential care.”

Basic home. It is a home for those individuals who need assistance in activity of
daily living (ADL), such as eating,
breathing or routine nursing care including administration of medication.

Skilled home. It is a home for those individuals with serious health problems who
need 24 hours nursing care or supervision.
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Principles of home visiting:

1. Family members should be included in all phases of the care process

2. The health workers (teams) are guests in the clients home therefore only make
these interventions that the clients agree with
3. Mutual health team or changed health team – client goal and intervention may
require long periods to achieve, therefore, patience is necessary

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4. Home visiting can be done by health professionals employed in various ways.
5. The health team functions autonomously in the family health care provision. The
family and the team develop a positively interpersonal relationship as they
work to achieve the goal
6. The health team is a visitor at a client therefore; the team must not wait to
be motivated.
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Phases and activities of home visiting

Phase 1. Initiation phase – clarify purpose of home visiting

-share information to family member
Phase 2. Pre-visit phase – initiate contact with family
-determine family willingness ‫رغبة‬
-schedule home visiting
-review records

Phase 3. On home phase – introduction him/her self

-warm greeting
-social interaction (to develop
trusting r/s
-implement nursing process.
Phase 4. Termination phase – review visit with family
- plan for future visit
Phase 5. Post – visit phase – Record visit
- plan for next visit
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Areas (points) to be assessed during Home visiting

1. General cleanliness
2. Solid waste disposal
3. Latrine
4. personal hygiene

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 5. vaccination of <1yr infants
6. vaccination of women
7. ANC antenatal care
8. Feeding of children <2 years
9. FP family planning
10.Presence of insects / rodents in the house
11.Presence of sick person in the house and action take
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Community Health Nursing Bag
Definition: A specially prepared bag for carrying supplies to the field a clean and
orderly way.
Purpose
• Helps the nurse to give service effectively in homes
• Reduces the danger of spreading infections
• Provides the necessary items needed in the field
• Identifies the nurse in the field because a home visiting bag is a part of the
uniform

Contents of the bag:

A. General supplies
B. Equipment
C. Others

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A General supply

Soap and soap dish

Plastic apron

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Plastic square to put the bag on
Aluminum cup for water
One or two small towels to dry the hand

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Instruments:

Thermometer
• Scissors
• Artery forceps
• Tape measure
• Plaster
• Cotton
• Gauze
• Bandage
• Antiseptic solution
• Syringe and needle
* Tetracycline eye ointment*
• Vaseline
•Tongue depressor,
• Disposable gloves
• Cord tie
• Anti pain
• Vitamin, A
• Test tube
• Baby scale
• analgesic or other drugs
• Small towel
• Soap and soap dish
• Plastic square
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Plastic apron is a garment or cloth that is worn over other clothing and covers
mainly the front of the body. It may have several different purposes and is today
perhaps most known as a functional accessory that protects one's clothes and skin
from stains and marks. However, various types of aprons may also be worn as a
decoration, for hygienic reasons, as part of a uniform, or as protection from certain
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dangers such as acid, allergens or excessive heat. It can also be used in work stations
to hold extra tools and pieces or protecting from dust and unwanted products.

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Basic principles of using the bag:

• Select safe area to place it

• Place on the plastic square
• Wash your hands before you do anything
• All wastes should be covered in newspaper and burned

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Responsibilities of nurses

Use the bag correctly

Keep the bag clean and orderly
Pay attention for broken equipment
Report all broken equipment
Do not miss equipment
Go through nursing process and form family focused nursing
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Home visit nurses may work alone or as part of a larger team and would be
responsible for participating in the following duties: Visiting individuals within
the community to provide healthcare services. Monitoring client vitals and
recording changes in condition. Taking patient histories, organizing health records,
health promotion and rising knowledge of prevention from diseases.
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Functions of the Community Health Nurse:

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 1. Clinician,
2. Educator,
3. Advocate,
4. Managerial,
5. Collaborator,
6. Leader,
7. Researcher.
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What to consider in planning for a home visit?

1, Give priority to the essential needs if the individual and his family.
2.Planning and delivery of care should involve the individual and family. The plan
should be flexible.
3.The physical needs psychological needs and educational needs of the individual
and family.
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Photo of community health nurses:

References;

Korfmacher, J., et al. (2008, August). Parent involvement in early childhood home visiting. In Child & Youth Care Forum (Vol.
37, No. 4, pp. 171-196). Springer US.

Dodge, K., et al. (2014). Implementation and randomized controlled trial evaluation of universal postnatal nurse home
visiting. Am J of Public Health, 104, S136-S143.

Goyal, N., et al. (2013). Dosage effect of prenatal home visiting on pregnancy outcomes in at-risk, first-time mothers. Pediatrics,
132 (Supplement 2), S118-S125.

Nievar, M. A., Van Egeren, L. A., & Pollard, S. (2010). A meta-analysis of home visiting programs. Infant Mental Health
Journal, 31, 499-520.