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HOME VISITING

The home visit:

A home visit is conducted to visit clients
where they live in order to assist them in
their efforts to achieve a high level of
wellness as possible (Empower).

Home visit cont.

-To visit families in their home is a privilege.

-Home is a private space. (you are a

stranger).

-You are the guest and they are the experts.

Home visiting cont.

-Work with families where they live,
(streets, homeless shelter, with
relatives).

- Use of expert nursing skills.

- Use of non judgmental approach.

Therapeutic Relationship With

the Client / Family.
-Gibbs trust model.
-Initiation of relationship
-Acceptance and trust
-Data flow.
-Goal setting and decision
making
-Self control.

The aim of Home Visit:

To improve health and the quality
of life (health promotion).

-Initiate and maintain relationship.

-Assessment of family
(environment).

Aims cont.
-Source for data.
-Follow-up care.
(Implementation Of Nursing Process In
The Home).

Advantages of home
visiting.
Costs less than hospitalization.
Clients are able to have a greater
control over interaction.

Family accepts change (more

amenable) to health education.

Advantages cont.
Able to observe factors that influence
family health.

Able to observe family interaction.

Allows for early intervention.

Advantages cont.
Able to identify environmental
resources and hazards.

Allows for assessment of family

over longer period of time than
hospitalization.

Advantages cont.
Facilitates family participation in
health care.

Facilitates family focus and

individualized care

Disadvantages of home
visiting.
Change in value system and style of practice.
(not compatible with providing services at
home).

Less coverage in proportion to time spent.

No easy access to emergency equipment or
consultation.

Personal safety concerns.

Disadvantages cont.
Work individually, (cannot work with groups).
Distraction difficult to control.
Family resents intrusion into home and/or
prefers health care setting.

Can be exhausting to the care giver.

Previsit Preparation.
(Planning)
Factors to be considered in planning a
home visit:

- Geographic lay-out of the area.

- Number of houses to be visited.
- Number of families needing close

supervision-reason for visit (referral).

Pre-visit Preparation
cont.
- Yearly plan schedule for a visit in a year.
- Distance (further the home, lesser the no. of
home visited).

- Transport.
- Time spent in a home.

Factors to be considered in
the suitability of the home
visit.
Acceptance of the visit.

Working time of the family.

Special functions in the family.
Safety.

Activities performed- H/V

Assessment of home environmental conditions.
-reveals important assessment & information.
(guide planning and intervention with families).
-gather information about resources/difficulties
encountered by families.

Assessment of household members.

Planning to meet the health

needs of families during
home visit.
Lack of planning & preparation
greatest barrier to successful family
health visit.

Successful family visit Good

planning & preparation, accurate

documentation & follow-up.

Phases of home visit.

Contacting Phase:
When the nurse becomes aware of an
individual/family who is desiring or
needing a visit.

Referral- self / agency (e.g. social welfare).

Clarify reason for referral.

Contacting phase cont.

Clarify purpose of h/visit, who ref.
family & why.

Know where to go.

Determine whether any special equip.
is needed or is available in the home.

Entry Phase.
From going to see phase to the seeing
phase.

Observe and interact with families.

Learn about them and their life situation .
Provide health education.

Entry phase cont.

Complete treatment if required.
Reviewing plans of care with the family.
Identifying health needs of all household
members.

Referring family members to app. Resources.

Conduct all visits in a caring way, providing comfort, support,
information, and counseling, as indicated.

Termination Phase.
Summarize accomplishments of the
visit, and with the family.

Discuss plans for the next home visit.

Termination phase cont.

Discuss referrals with the family if any.
Reinforce family strengths.
Documentation
Clean up.
Thank the family for their time.

Implementation of the
nursing process in the
home.
Assessment involves all family

members both as individual and family

as a unit.

Family nursing diagnosis is important in

developing appropriate plans &
intervention, in collaboration with the
family.

Assessment.

Use of acute observation skill.

Purpose of the 1st. H/visit begin to

identify family strengths & health needs,

coping abilities, home environment.

Assessment cont.
Use of assessment tools, (interviewing,

observation, questionares, or checklist).

**(assessment tools - remind the nurse about
areas to explore with the family).

assessment -- health education (same

time). **(teaching h/promotion activities to

the family may begin only after members
express an interest & recognize a need).

Nursing diagnosis &

planning care.
On the basis of assessment establish the
nursing diagnosis.

: for the entire family/ individuals within the

family.
: long term/short term goals established within
the family strengths/weakness.
: expected outcomes, including measurable
results within a specific time frame are
established.

Cultural health practices.

Influence all aspects of nursing process.
Understand them understand client
behavior.

Plan interventions that are consistent

with client health beliefs.

Intervention.
Begins with the first visit.
Decisions are made in the planning process.
Prioritize health needs- deal with important
ones first.

(this is the responsibility of both the client

and the nurse).

Intervention cont.
Family members can absorb limited
information only.

Arrange for second visit,(cont.

assessment).

Include family members in the care of

the client.

Intervention cont.
Common interventions are teaching about
various health considerations e.g.
- Family stress.

- Referrals.
- Promoting family strengths.

Evaluation.
Ongoing process.
The nurse & the family must continually

assess the progress of the family towards

achievement of expected outcomes.

Consider modifications to the plans.

Reference.
Allender J.A. & Spradley, B.W.2005,

Community Health Nursing, Promoting &

Protecting the Publics
Health.2005,Lippincott, W & Wilkins.

Thank you!
Any Questions?

Enjoy your home visiting

Sr. T. Naisau. 05/11/2008.