Home visiting evaluation Primary Health Care Nursing (NUR 473) Home visiting evaluation (chronic cases) Lecture 8

After completion the lecture the students enable to: define the home visit describe objectives of the home visit know the purpose of home visit know phases of home visit know the Advantages and disadvantage of home visits

Introduction The home visit is a family-nurse contact which allows the health worker to assess the home and family situations in order to provide the necessary nursing care and health related activities. In performing this activity, it is essential to prepare a plan of visit to meet the needs of the client and achieve the best results of desired outcomes.

Introduction Is a professional contact between the community health nurse and the family The services provided is an extension of the health services agency ( Health center) The community health nurse doing home visits usually works as part of a home health care team that can includes social workers, rehabilitation specialists, and home health nurses or aides. Cooperation and communication with other care providers are essential.

Objectives of the home visit: Assessment Nursing care Treatment Health education Referral (if care fails)

Purpose of home visit To give care to the sick, to a postpartum mother and her newborn with the view teach a responsible family member to give the subsequent care. To assess the living condition of the patient and his family and their health  practices in order to provide the appropriate health teaching. To give health teachings regarding the prevention and control of diseases. To establish close relationship between the health agencies and the public for the promotion of health. To make use of the inter-referral system and to promote the utilization of community services

Visiting nurse association Hospice Public health departments The goals of primary health nursing are often met through providing health care to families in their home. It can be provided by: Visiting nurse association Hospice Public health departments Home health agencies School districts

Principles involved in preparing for a home visit A home visit must have a purpose or objective. Planning for a home visit should make use of all available information about the patient and his family through family records. In planning for a home visit, we should consider and give priority to the essential needs if the individual and his family. Planning and delivery of care should involve the individual and family. The plan should be flexible.

Guidelines to consider regarding the frequency of home visits The physical needs, psychological needs, and educational needs of the individual and family. The acceptance of the family for the services to be rendered, their interest and the willingness to cooperate. Take into account other health agencies and the number of health personnel already involved in the care of a specific family. Careful evaluation of past services given to the family and how the family avails of the nursing services. The ability of the patient and his family to recognize their own needs, their knowledge of available resources and their ability to make use of their resources for their benefits.

Steps in conducting home visits Greet the patient and introduce yourself. State the purpose of the visit Observe the patient and determine the health needs. Put the bag in a convenient place. Perform the nursing care needed and give health teachings. Record all important date, observation and care rendered. Make appointment for a return visit.

Advantages of home visits: These visits cost less than hospital care, with better outcomes, especially when chronic health issues are involved. Clients have greater control over their health and lives. The community health nurse gains access to families to provide health education and other prevention strategies. The nurse can observe family and environment factors that influence health. Home visits allow for primary intervention, to prevent disease or injury from occurring. Home visits facilitate family participation and promote family focus.

Disadvantages of home visits: Home visits are time consuming; travel time is required to get to the persons needing care. There is no easy access to emergency equipment or consultation with other health professionals if needed. Home visits may present issues regarding the nurse personal safety in some community or family settings. The nurse has less control over the care setting (for example, cleanliness, noise, privacy, or distractions).

Community health nurse bag   Requirements include equipment for basic assessment, medical asepsis, and waste disposal. These precautions must be followed to avoid contamination from blood, body secretions, excretions, or contaminated items. - Wash hands - Use gloves. - Wear eye and face protection - Wear gown - Handle client care equipment carefully. - Clean environmental surfaces. - Use proper sharps disposal container.

The three most common intervention in home health care include: Helping families deal with stress created by health problems. Making referrals for community services. Teaching and educating clients, with the focus on strengths rather than weakness.

Evaluation is the ongoing process that continually assesses clients progress toward expected outcome. Termination of home visits occurs when both client and nurse are satisfied that goals have been met or that appropriate referrals have made. Telemedicine: which use phone and computer technologies to monitor clients and provide care without the nurse making a home visit.