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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

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.

Purpose

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.  

Objectives

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.

 

Advantages

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

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

Establish rapport

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.

 

Data analysis

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.

 

Health education

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.

 

Actions

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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