Community Health Nursing

1. HOMEVISIT
- A FAMILY- NURSE CONTACT WHICH ALLOWS THE HEALTH WORKER TO
ASSESSTHE HOME AND FAMILY SITUATIONS IN ORDERTO PROVIDETHE
NECESSARY NURSING CARE AND HEALTH RELATED ACTIVITIES.

2. HOMEVISIT
➢ defined as the delivery of specialized nursing care services in the home health care setting
➢ Process of providing nursing care to patient or family at their DOORSTEP
➢ The services provided as an extension of the Health Service Agency ( Health Center)
❑ In performing home visits, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results
of desired outcomes.

3. CONCEPTS OF HOMEVISITING
✓Home visiting provides opportunity to make direct observation on home
environment, family structure, familial roles and relationships, life style,
cultural practices, group dynamics, etc. and make family health assessment.
✓In home visiting the members are relaxed, have more time and privacy and
feel free to raise questions, seek clarifications and sort out their problems
✓It provides opportunities to make direct observation of care given by family
members in planning and implementing family health care services
✓It provides opportunities to contact and interact with most of the family
members and establish rapport with the family as a whole
✓It also make possible to have active participation of family members in
planning and implementing family health care
✓It makes feasible to plan and provide comprehensive family health care with
major emphasis on promotive and preventive care

4. PURPOSE OF HOMEVISIT
1. To give nursing care to the sick, post partum mother and her new born
with the view to teach a responsible family member to give the
subsequent care.
2. To assess the living condition of the patient and his family and their health
practices in order to provide appropriate health teaching.
3. To give health teaching regarding the prevention and control of diseases.
4. To establish close relationship between the health agencies and public for
the promotion of health
5. To make use of the inter- referral system and to promote the utilization of
community services.

5. PRINCIPLES OF HOMEVISIT
• A home visit should be planned and must have a purpose or objective.
• The purpose of home visits should be clear and must meet the needs of the
patients.
• Planning for a home visit should make use of all available information about
the patient and his family through family records.
• In planning for a home visit, we should consider and give priority to the
essential needs of the individual and his family.
• Planning and delivery of care should involve the individual and family.
• Home visit should give excellent opportunities for nurse to demonstrate
hygienic principles
• Home visit should be convenient, acceptable and educative to the patients.
• The plan should be flexible and regular

6. PRINCIPLES OF HOMEVISIT
• The nurse should make an attempt to include each family member while using nursing
process
• The nurse and the family must develop positive interpersonal relationship in their work
to achieve the goal
• The nurse must respect the patient’s rights.
• Home visit should be recorded in the diary and family folder.

7. ADVANTAGES OF HOMEVISIT
• Home visit provides an excellent opportunity to implement the nursing process.
• Home visits provide an opportunity to study the home and family situation.
• Home visits provide an opportunity to render service to the family members at their
own surroundings.
• Prompt and proper home visit create a good understanding between nurse and family
and build good image of nurses.
• Home visits clarify the doubts raised by the family members.

8. ADVANTAGES OF HOMEVISIT
• Home visits help to observe family practices and progress of care given by nurse and
others.
• Home visits help to prevent and handling the problems
• Home visits help the nurse and family members to modify the ways of their care.
• Home visits facilitate patient control of the setting.
• Home visits are the best opinion for patients unwilling or unable to travel
• Home visits provide natural, environment for the discussion of concerns and needs

9. ROLES OF CHN IN HOMEVISITS
• Records the history of family to ascertain the cause and duration of illness
• Providing treatment and related care
• Demonstrating the nursing procedure to educate the family members
• Giving medicines as per the standing orders and providing essential nursing care
• Supervising the nursing procedure provided by family members
• Including the patient himself in taking care of chronic illness and giving them mental
support.

10. GUIDELINESTO CONSIDER REGARDING
THE FREQUENCY OF HOMEVISIT
• NO definite rule to be followed on the frequency of home visits
a. The physical needs, psychological needs and educational needs of the individual and family
b. The acceptance of the family for the services to be rendered
c. The policy of a specific agency and the emphasis given towards their health programs
d. Take into account other health agencies and the number of health personnel already involved in the
care of a specific family
e. Careful evaluation of past services given to a family and how the family avail of the nursing services
f. The ability of the patient and his family to recognize their own needs, their knowledge of available
resources and their ability to make use of their resources for their benefits

11. COMPOMENTS OF HOMEVISIT
1. INITIAL PHASE (Planning)
Activity: collect information from clinical and other records before planning for a visit
During home visit, she has to assess or observe and make a note in initial visit
2.ACTION PHASE
a. SOCIALIZATION PHASE- establish rapport with the client and family
b. WORKING/ PROFFESIONAL PHASE- apply problem solving techniques to situation
found in the home, plan with the family to resolve health problem situations, provides
nursing care
c. SUMMARY PHASE- documentation of significant findings
3.TERMINATION PHASE- nurse-patient goals are reached, health is restored and the
patient can function without actions.The nurse records the important events in the family
and reports the problems of the family.

12. FOR RET DEMO: STEPS IN CONDUCTING HOME
VISIT
1. Greet the patient and introduce yourself
2. State the purpose of the visit
3. Observe the patient and determine the health needs
4. Look for a place to put your PHN bag, in the table or chair six feet away
from bedside, or any convenient place as long as proper procedure can be
done in that area.
5. Put the bag in a convenient place then proceed to perform the bag
technique.
6. Perform physical assessment and nursing care needed. If more than one
member of the family is for health supervision and care, start with the well
member to avoid transfer of infection.
and give health teaching

13. FOR RET DEMO: STEPS IN
CONDUCTING HOMEVISIT
7. Give the necessary health teaching and advice based on the clients need and condition. If
the client is weak or too indisposed condition, you may teach the family member since they
are with client most of the time
8. Clean all the articles used.Wash hands, remove apron and fold place in the bag( you may
put in a plastic bag or above the bag flaps)
9.Record all important data, observation and care rendered
7. Make an appointment for a follow up home visit or clinic visit. Leave specific instructions
if necessary on how to ensure nursing care to the sick family member.

14. THE BAG TECHNIQUE
The bag technique is a tool by which the nurse, during her visit will enable her to perform a nursing
procedure with :
• ease and deftness
• save times and effort
• the end view of rendering effective nursing care to clients.
❑ The public health bag is an essential and indispensable equipment of a public health nurse which she has
to carry along during her home visits. It contains basic medications and articles which are necessary for
giving care.

15. PRINCIPLES OF BAG TECHNIQUE
1. Performing the bag technique will minimize, if not prevent the spread of any infection.
2. It saves time and effort in the performance of nursing procedures.
3.The bag technique should show the effectiveness of total care given to an individual or family.
4.The bag technique can be performed in a variety of ways depending on the agency’s policy, the
home situation, or as long as principles of avoiding transfer of infection is always observed.

16. PRINCIPLES TO CONSIDER AND PROCEDURE IN THE USE OF
THE PHN BAG
1. The bag should contain all necessary articles, supplies and equipment which may be used to answer
emergency needs.
2. The bag and its contents should be cleaned as often as possible, supplies replaced and ready for use at any
time.
3. The bag and its contents should be well protected from contact with any articles in the home of patient.
4. The arrangement of the contents of the bag should be the one most convenient to the user to facilitate
efficiency and avoid confusion.
5. Hand washing is done as frequently as the situation calls for, minimizing or avoiding contamination of the
bag and its contents
6. The bag when used for a communicable case should be thoroughly cleansed and disinfected before keeping
and re- using

17. CONTENT AND ARRANGEMENT OF THE
PHN BAG

18. CONTENTS AND ARRANGEMENT OFTHE PHN BAG
On RIGHT REAR of the BAG
▪ 2 test tubes and 1 holder
▪ Medicine dropper
▪ Alcohol lamp
On LEFT REAR of BAG
▪ Medicine glass
▪ Baby scale
▪ Bandage scissors
▪ Rubber suction
Front of the Bag LEFTTO RIGHT
▪Thermometer (oral and rectal)
▪Tape measure
▪Adhesive plaster
▪Cotton applicator

19. CONTENTS AND ARRANGEMENT OFTHE PHN BAG
BACK of the Bag LEFTTO RIGHT
▪ 70% Alcohol
▪ Betadine Solution
▪ Hydrogen peroxide
▪ Terramycin ophthalmic ointment
▪ Zephiran solution
▪ Spirit of ammonia
▪ Acetic acid
▪ Benedicts solution
▪ Liquid soap
▪ Cotton in sterile water

20. CONTENTS AND ARRANGEMENT OFTHE PHN BAG
INTHE CENTER OFTHE BAG
▪ 2 pairs of forceps ( curved and straight)
▪ 1 surgical scissor
▪ Sterile dressing ( OS and cotton balls)
▪ Roller bandage
▪ Syringes ( 5ml and 2 ml)
▪ Hypodermic needles g19, 22, 23, 25
▪ Sterile cord clamp
▪ Kidney basin

21. CONTENTS AND ARRANGEMENT OFTHE PHN BAG
On theTOP PILE CENTER OFTHE BAG
▪ Hand towel
▪ Soap in soap dish
▪ apron
▪ Plastic /linen lining
POCKET OF BAG
▪ Surgical gloves
▪ Waste receptacle
❖ Folded paper lining inserted between the flaps and cover of the bag
❖ BP apparatus and stethoscope are carried separately

22. Steps in Performing the BagTechnique Actions Rationale
1. Upon arrival at the patient’s home, place the bag on the table lined with a clean
paper.The clean side must be out and the folded part, touching the table.
To protect the bag from getting contaminated.
2.Ask for a basin of water or a glass of drinking water if tap water is not available. To be used for handwashing
3. Open the bag, take the linen /plastic and spread over the work field area.
The paper lining clean side out. ( Folded part out)
4. Open the bag and take out the towel and soap ( soap dish) To prepare for handwashing
5.Do hand washing
Wash hands using soap and water.Wipe to dry with towel.
To prevent infection from the care provider to the client
6.Take out the apron from the bag and put it on with the right side out To protect the nurse’s uniform
7. Put out all the necessary articles needed for specific care. To have them readily accessible.
8. Place paper receptacle outside the working area.
9. Close the bag and put it in one corner of the working area. To prevent contamination.
10. Proceed in performing the necessary nursing care and treatment. To give comfort and security and hasten recovery.
11.After the giving the treatment, clean all things that were used and perform
handwashing.
To protect the caregiver and prevent infection.
12. Open the bag and return all things that were used in their proper places after
cleaning them.
13. Remove apron, folding it away from the person, the soiled side in and the clean
side out. Place it in the bag.
14. Clean and fold the paper /plastic lining, place it inside the bag and Close the
bag.
15.Take the record and have a talk with the Mother.Write down all necessary
data that were gathered, observations, nursing care and treatment rendered. Give
instructions for care of patients in the absence of the nurse.
For reference in the next visit.
16. Make appointment for the next visit (either home or clinic) taking note of the For follow-up care.