Home visit-1.ppt

Rukhsana.M.Haroon
Lecturer ION,DUHS

• 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
11/18/2023 RUKHSANA.M.HAROON 2

• 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

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
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.
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
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

What kind of help can if get with my children?
The Public Health Nurse provides appropriate
interventions & uses a strengths-based approach to:
Help promote healthy attachment and
bonding between parents and their babies.
Provide parents with information needed to
promote healthy brain, physical & social/
emotional development in their babies.
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.

11/18/2023 Najwa Subuh Community Health
Nursing
31
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.
• "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.

11/18/2023 Najwa Subuh Community Health
Nursing
35
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

• 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

Home visit-1.ppt

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