Community Health Nursing

1. HOME VISITING
Meaning:
Home visit refers to meeting the health needs of people at their doorsteps. Health services
given at home for patient, families and the community in general for nursing service and health
counseling.
Concepts of Home visiting:
1. Home visiting provides opportunity to make direct observation on home environment family
structure, familial roles and relationships.
2. 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.
3. It provides opportunities to make direct observation of care given by family members.
4. It provides opportunities to contact and interact with most of the family members.
5. It also makes possible to have active participation of family members in planning and
implementing family health care.
6. It makes feasible to plan and provide comprehensive family health care with major emphasis
on promotive and preventive care.
Purposes of Home visiting:
a. It is a routine part of planned visiting programme by a community health personnel.
b. It helps to investigate the source of infectious diseases.
c. To do follow up on some problems identified in the health centres, schools, industry or
hospitals.
d. To assess the nutritional and immunization status, environmental hazards.
e. To give health education to the individual, family and community.
f. To supervise and guide other health workers.

2. Principles of Home visiting:
1. Need Based: Home visiting should be planned and conducted based on the identified needs
of the people.
2. Priority Based: The home visiting should be priority to the existing problem in the family. It
may be maternal and child health services or antenatal check up.
3. Regulatory: Plan for regular home visiting programme based on family needs. It should be
conducted at regular intervals.
4. Flexibility: The community health nurse should adopt a flexible approach based on
prevailing circumstances at home.
5. Scientific Based: Be sure of the scientific soundness of the subjects used for discussion, use
of technical skills includes handwashing and inspection.
6. Analysis Based: Collect facts about the home, the patient and the environment and make an
objective analysis of the facts as an initial step in visiting the home.
7. Developing Relationships: Work with the person and family and plan jointly. Home visiting
helps to establish good working relationship in the family.
8. Sensitivity: The community health nurse should be sensitive to the persons feeling and needs
at the time of the visit, listen to the family and understand the other persons point of view.
9. Educative: Evaluate your own work; remember the quality of care is more important than
the number of home visits. It is essential to evaluate home visits from time to time.
Steps in Home Visiting:
a. Initial phase: The community health nurse should collect information from clinical and
other records before planning for a visit. During the home visit, she has to assess or observe
and make a note in initial visit. The community health nurse should introduce and establish a
friendly relationship by using simple language, assess physical and environmental status,
family’s cultural background, occupation and income of the family, member age, educational
factors and psychological factors.

3. b. Action phase: The interpersonal relationship starts when nurse enters into the house. The
nurse should use their effective communication skills to implement the nursing process.
During action phase the community health nurse provides nursing care ex: taking
temperature, physical examination and dressing etc. Demonstrating and teaching ex: teaching
insulin self administration. She makes diagnosis and tentative nursing care plan based on
establishing priorities.
c. 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. Evaluation of home visit is a continuous process, though at the end of
every visit, community health nurse evaluate the self.
Advantages of Home Visit:
1. The nurse can directly observe home and family atmosphere.
2. The nurse can directly observe the care given to patient by the family members.
3. It is possible to discover new health problems.
4. The family members will be more relaxed in their own surroundings.
5. The family gains confidence and feels to clear their doubts.
6. This helps to apply the gained knowledge and skills in the homes assisting and solving
individuals and families health problems.
Qualities of Community Health Nurse:
1. A qualified community health nurse is one who has undergone basic general nursing,
midwifery training and post basic education in community health nursing.
2. A community health nurse must have interest in people and in understanding human
behavior.
3. Sincerity and ability to empathize are basic qualities required for a nurse.

4. 4. A well poised nurse has a friendly disposition, honest, charitable, resourceful and cooperative
and takes responsibilities with initiative.
5. Minimum essential skills of a nurse are observation, communication, interviewing and
bedsides supportive and technical skills.
6. She must have abilities to make interpretations, make judgements and take decisions.