Introduction to Home Visiting
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 a 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.
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.
Home Visiting cont…
It is the most important aspect or backbone of community health nursing
Vast majority of sick people are in home
People are in need of simple services by the health nurse
Home visiting has been shown to be effective at helping families because it:
improve health status
achieve economic self-sufficiency
improve positive parenting
reduce child maltreatment
achieve goals such as child spacing, education etc
establish links to community resources.
Home visits are an effective means of confirming household circumstances such as residence and household composition. They are also an excellent opportunity to review family self-sufficiency plans, assess supportive service needs, and discuss other client rights and responsibilities.
Home visits can be conducted statewide, in rural as well as urban areas.
To enhance the mental and physical health of individuals and their families.
To enhance the cognitive, social and emotional wellbeing of children and their families.
To assist families to provide a safe and supportive environment for their children.
To better link families to available resources and networks within the community.
To offer an evidence-based, acceptable and culturally appropriate home visiting service.
Cost less than hospitalization
Affords client greater control on interaction
Family more willing to health education
CH Nurse can observe factors that influence family health
CH Nurse can observe family interaction
Allows for early intervention
Allows for identification of environmental resources and hazards
Allows for assessment of family over longer period of time than is possible during hospitalization
Facilitates family participation in health care
Facilitates family focus and individualized care
Steps of Home Visiting
Approach to a family as per plan
Knock the door
Leave the shoes outside (Depend on housing standard)
Introduce yourself and the purpose of the visit
Remove your anxiety and fear
Be polite and friendly
Collect the data you need
Steps of Home Visiting
Understand the social background
Do physical assessment
Assess their felt need
Plan and provide your care
Inform the procedure
Wash hands before the procedure
Use your bag scientifically
Steps of Home Visiting
Give health teaching
Replace the articles inside the bag
Record your service and plan for follow-up
Write a clean report about your service
Evaluate your service
Primary data or Subjective data
Data which is reported by family and community members and recorded by nurse in log diary is as under:
These are intangible facts and based on other’s reports.
Inquire about immunization and family planning.
Inquire about illnesses-previous and present.
Inquire about history of major diseases in any member of family.
Inquire about usage of long term medication, e.g. for anti-hypertensive, antipsychotic, hypoglycemic for diabetes.
Inquire about methods of disposal of waste.
Inquire about ways of cooking, they use to cook.
Take diet history of week.
Ask about physical and mental symptoms.
Inquire about heating or cooling system in house.
Secondary Data or Objective Data
Facts (data) which CHN can see, observe, feel and measure evidently. These are as under:
To observe the sanitary conditions of home and community.
To observe the sanitary conditions of kitchen.
To observes the methods of cooking in home.
To observe the food stuffs its physical condition , which is being consumed. Whether it is fresh or not? It is balanced or not?
To check the water for quantity and quality.
To observe the personal hygiene of members of family.
To observe the constructions of houses, whether these are ventilated and according to principles of health or not?
To observe the life style of family.
To observe the customary practices, related to health.
To observe the cultural practices related to health.
To see the diseased members of family or community.
To observe the signs of diseases or illnesses, if reported.
Observes the drugs, which are being taken by the members of family.
Check Immunization cards.
See the scar of vaccine injected on arm.
Separate all data category wise e.g. sanitary problems in one column and Nutritional problems in another column of table.
Analyze the data or facts by keeping into tables, frequencies, percentage and mean.
Through analysis, we can know the causes of problems, prevalence of problems.
Prioritize the problems on the base of needs and dangers.
Planning action with family
Plan the day, time, and topic or type of interventions.
Arrange material resources for interventions.
Intimate the family about your visit and interventions (E.g. Health Education etc).
Before interventions, tell the advantages of the interventions.
After prioritizing the problems and select one problem for health education or for other action at one time.
If you give the health education, then should:
Use simple language.
Avoid usage of terms in speaking.
Speak short sentences.
Use demonstration method of teaching. (E.g. Demonstration of healthy cooking).
Use Pictorial Posters, Use Video aids rather than audiotapes.
Physical actions are depending upon the type of problem. But some points given below should be kept in mind for actions, formulated for any type of problem:
Actions should be culturally accepted.
Cost of actions should be affordable by the family and community.
Write daily log book
It is a diary or note book, in which each and every action or activity or observation and incidences are recorded.
Write Observation visit reports
During home visits, whatever you observe in home, in streets, in community which may healthy or un-healthy, you have to write that observation report.
After Analysis of that observation, CHN can conclude the problems and plans and formulates actions.
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