“international health organizations and nursing organizations”

1. SHAHINA BANO
• A home visit is a purposeful interaction in a home (or residence) directed at promoting and maintaining
the health of individuals and the family (or significant others).
• A major distinction of a home visit is that tile health professional goes to the client rather than the client
coming to the health professional
• Home visiting involves a process of initiating relationships with family members, negotiating &
implementing a family-focused plan of care, & evaluating health outcomes & family satisfaction
• Each home visit involves several phases or steps: preplanning the visit, traveling to the home and
initiating the visit, accomplishing the interventions, evaluating and summarizing the visit with the family,
ending the visit and leaving the home, and conducting positive activities.
• Efficiency is increased when community & public health nurses wisely manage their time and equipment.
• A home visit is a purposeful interaction in a home directed at promoting and maintaining the health of
individuals and the family.
• Home visit is the process of providing nursing care to the client’s own setting. The setting may be in a
single or multiple unit structure and may be located in a rural or urban setting.
• A comprehensive range of community nursing services is provided by Community Health. The main focus
of this service is to enable people to be cared for in their own homes rather than as patients in hospitals.
• Therefore Community Nurses do a considerable amount of wound management and palliative care,
antenatal and post natal care, and also stomal nursing care is offered.
• They also carry out assessments in the home and liaise with other agencies and service providers. They
provide assessment, care and support for individuals and families of all ages,
PURPOSE
Basic goals of home visit:
➢ Promoting support systems that are adequate and effective & encouraging use of health-related
resources.
➢ Promoting adequate, effective care of a family member who has a specific problem related to illness or
disability.
➢ Encouraging normal growth and development of family members and the family and educating the family
about health promotion and illness prevention
➢ Strengthens family functioning and relatedness
➢ Promoting a healthful environment

2. Advantages & Disadvantages of Home Visiting
Advantages
1) Home setting provides more opportunities for individualized care
2) most people prefer to be cared for at home
3) environmental factors impinging on health, such as housing condition & finances, may be observed and
considered more readily
4) Information collection and understanding lifestyle values are easier in families' own environment
5) Participation of family members is facilitated
6) Individuals and family members may be more receptive to learning because they are less anxious in their
own environment and because the immediacy of needing to know a particular fact or skill becomes more
apparent
7) Care to ill members in the home can reduce overall costs by preventing hospitalizations & shortening the
length of time spent in hospitals or other institutions
8) A family focus is facilitated
Disadvantages
1. Travel time is costly
2. Less efficient for nurse than working with groups or seeing many clients in an ambulatory site
3. Distraction such as TV and noisy children may be more difficult to control
4. Clients may be resistance or fearful of the intimacy of home visits
5. Nurses safety can be an issue
Phases of Relationships
1. A pre-initiation or preplanning phase
2. an initiation or introductory phase
3. A working phase
4. An ending phase
What does the Public Health Nurse do?
1. Get needed medical appointments
2. Have a healthy pregnancy
3. Breastfeed successfully

3. 4. Raise healthy children
5. Keep children safe
6. Plan the size of the family
7. Make healthy food choices
8. Evaluate children’s health & development
9. Get accurate immunization information
10. Get treatment for/prevent lead poisoning
11. Obtain Medical & community resources
12. Deal with loss
13. Develop a crisis plan of action
Families Retain much Control
❖ The family can control the nurse's entry into the home by explicitly refusing assistance, establishing the
time of the visit, or deciding whether to answer the door.
❖ The nurse if there to offer services & engage the family in a dialogue about health concerns, barriers &
goals.
❖ As with all nurse-client relationships, the nurse's commitment, authenticity, and caring constitute the art
of nursing practice that can make a difference in the lives of families
Nursing Care Is More Interdependent with Families
• Because families have more control over their health in their own homes, & because change is usually
gradual, greater emphasis must be placed on mutual goals if the nurse & family are to achieve long-term
success.
• Except in emergency situations, the client determines the priority of issues with which to be dealt
• Families are sometimes unaware of what they do not know. The nurse must suggest health related topics
that are appropriate for the family situations
Increasing nurse- Family Relatedness- Fostering a Caring Presence
Nursing efforts are not always successful. However, by being concerned about the impact of home visits
on the family & by asking questions regarding herhis own motivations, the nurse automatically
increases the likelihood that home visits will be of benefit to the family.
Although being related is necessary, it is inadequate in itself for high quality nursing. A CHN must also be
competent.

4. CHN also depends on assessment skills, judgment, teacher skills, safe technical skills, and the ability to
provide accurate information.
The three characteristics of a helping relationship "positive regard, empathy, & genuineness“
 Presence; being related interpersonally in ways that reveals positive regard, empathy, genuineness, and
caring concern.
 Positive regard; involves recognizing the value of persons because they are human beings. Accept the
family, not necessarily the family's behavior. All behavior is purposeful; & without further information,
you can't determine the meaning of a particular family behavior.
 Empathy is the ability to put you in someone else's shoes, to be able to walk in herhis footsteps so as to
understand hisher journey.
• Empathy requires sensitivity to another's experience including sensing, understanding, & sharing the
feelings & needs of the other person, seems- things from the other's perspective's
 Genuineness- means that what you say and do is consistent with your understanding of the situation
• The nurse can promote genuine self-expression in others by creating an atmosphere of trust accepting
that each person has right to self-expression, 'actively seeking to understand'.
Creating Agreements for Relatedness
 Nurses are expert in caring for the ill; in knowing about ways to cope with illness, to promote health, and
to protect against specific diseases; & in teaching & supporting family members.
 Family members are experts in their own health. They know the family health history, they experience
their health states, & they are aware of their health-related concerns.
 Contract is legally binding agreements. This is not true of nurse-client contracts.
 Nurses are legally & ethically bound to keep their word in relation to nursing care; clients aren’t legally
bound to keep their agreements.
 However, establishing a mutual agreement for relating increases the clarity of who will do what, when,
where, for what purposes, and under what conditions.
 Because of some people's negative response to the word contract agreement may be better.
Increasing Understanding through Communication Skills
• The nurse's ability to be with family members determines the success of the nurse-family relationship.
• A nurse can employ techniques of speaking & listening appropriately & still not have a working
relationship because caring is not there.
Promoting Nurse Safety

5.  Promote safety of CHN is critical. The purpose of the home visit is to offer or provide nursing services that
make contribution to the family's health and to do so while maintaining the nurse's safety. The purpose of
a home visit is to provide care at all costs.
 Assertiveness, not abandonment of one's own needs, is required, which is especially true when you are
learning to be a CHN and the boundaries of your professional role.
Promoting Safe Travel
• All CHN can benefit from basic crime prevention courses that local or state police provide regarding safety
on the street and in automobiles.
• Knowing that shehe is incorporating basic self-protection behaviors is especially helpful for a CHN.
Promoting the Safety of Family Members
• lf you believe that someone is in imminent physical danger or is being injured you need to call the policing
authority that responds to domestic violence.
• If someone has been injured you should call for both police and rescue workers, If you believe that
dependent children or adults are being neglected or abused you need to contact your faculty or
supervisor & follow your school or agency's policies & procedures. Short of these priorities the CHN is not
legally bound to respond.
Managing Time & Equipment
 The community health nurse's effectiveness depends on the planning the day for the efficient use of time
and other resources.
 Physical resources are often limited to equipment carried by the nurse, or provided by the family at the
home, or both.
 Consequently, making do with what is at hand and doing this consistent with basic principles of safety and
infection control are the hallmarks of a skilled CHN, although more specialized equipment is being used in
the home to care for sicker individuals
What can I expect during a home visit?
1. Parenting education and support
2. Information regarding their child’s health.
3. Safety information.
4. Developmental information.
5. Nutrition education.
6. Community resources.
7. Assistance with appropriate referrals as needed

6. What kind of help can if get with my children?
The Public Health Nurse provides appropriate interventions & uses a strengths-based approach to:
J Help promote healthy attachment and bonding between parents and their babies.
J Provide parents with information needed to promote healthy brain, physical & social/ emotional
development in their babies.
J Teach parents the importance & life long impact of responsive care giving.
Why does Community Health District want to help families?
© Decrease the stress on families.
© Increase a family’s stability & self-sufficiency.
© Provide timely, individualized parent education.
© Provide community resources and referrals as needed.
Need Assessment
• Despite the utility of the home visit intervention, health department/agency retrenchment has reduced
home visit funding and utilization.
• Absolute reductions in resources and the dilemmas of resource distribution have played a part. Less
visible is the enduring policy legacy of nineteenth-century social welfare opposition to non-institutional
service delivery
Assessing Your Home-Care Needs
• A number of options are available for finding help at home. It is often best to start by assessing both your
It is also important to evaluate the values and preferences of the person receiving care.
He or she may be more comfortable with a home care worker who shares his or her cultural background
and/or language.
Assessing Your Home-Care Needs
• The care recipient may also have a preference between male and female caregivers, particularly if the
worker will be helping with personal care.
• This assessment may also enable you to include alternative (and possibly less expensive) approaches to
care such as adult day care, friendly visiting services, home grocery delivery, pharmacy delivery services
and meals-on-wheels programs
• The purpose of needs assessment is to gather the information required to bring about change beneficial
to the health of the population.

7. • "Health gain" can therefore be achieved by reallocating resources as a result of identifying four factors:
1. Non-recipients of beneficial healthcare interventions (that is, unmet need);
2. Recipients of ineffective health care (and releasing the resources for unmet need);
3. Recipients of inefficient health care (and releasing resources for unmet need); and
4. Recipients of inappropriate health care (for whom the outcomes could be improved).
• There are a variety of checklists to help you evaluate what types of help are needed. In general, consider
the following areas:
1. Personal Care: bathing, eating, dressing, toileting
2. Household Care: cooking, cleaning, laundry, shopping
3. Health Care: medication management, physician's appointments, physical therapy
4. Emotional Care: companionship, meaningful activities, conversation
• Once a family member has moved to a nursing home, it is important to visit as often as time allows.
Residents of nursing facilities need to be reassured on a regular basis that they are still an important
List of ideas help to provide care & support to loved one during your visits.
• When you visit, be supportive & affectionate. Personal contact with others is extremely important and
many times the only touch older adults living in a facility experience is when they are dressed or bathed.
• Residents in nursing homes need to know they are loved and not forgotten. If they are receptive, hold
their hand, give them hugs when you arrive and leave, and give them eye contact when they are talking to
you. It is important to try to ignore any distracting smells or noises so as not to upset your loved one.
List of ideas help to provide care & support to loved one during your visits.
• Ask permission to visit and then plan your visits in advance. First, it is important to enable your family
member to retain as much control in his or her life as possible.
• By asking their permission to visit, you are enabling your loved one to have control over at least one
aspect of their schedule.
• Because there are two parts to a visit (looking forward to the visit, and the visit itself), plan your visits
ahead of time rather than just dropping by. Planning ahead allows a resident the enjoyment of
anticipating your visit.
• When you visit, share news about your life and your family and don’t forget the photo album!
• Do not spend the entire visit asking them questions about how they feel or if they have eaten. Instead,
share funny stories or talk about a big decision you have made. Make sure to tell your loved one

8. • Make sure the nursing home staff know about your visit ahead of time, will have the time to meet with
you, and have the opportunity to gather all relevant data (e.g., lab results) and any ancillary staff you wish
to see, in advance of the visit.
• Ask them to be sure that the medical record is complete & will be available. Ask them to let the family
know about your visit, so that they can be present if they wish.
• The initial assessment visit is very important. The history and physical examination, which lead to the
formulation of the patient’s care plan
Home health care, broadly denied, refers to all of the services and products provided to clients in their
homes to maintain, restore, or promote their physical, mental, and emotional health.
• Its purpose is to maximize the client’s level of independence and to minimize the effects of existing
disabilities through non-institutional services.
• Its primary goal is to use these supportive services to decrease rehospitalization and prevent or delay
institutionalization