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
