1. 6/11/2016 Presented by DR/ Amira Yahia 1

2. Learning outcomes To define home visit To identify the purpose of home visit To discuss the advantage and disadvantage Discuss how can nurse apply safety

3. 6/11/20163 A home visit 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 tile health professional goes to the client rather than the client coming to the health professional

4. 6/11/20164 Home visiting involves a process of initiating relationships with family members, negotiating & implementing a family-focused plan of care, & evaluating health outcomes & family satisfaction

5. 6/11/20165 PURPOSE Basic goals of home visit:  Promoting support systems that are adequate and effective & encouraging use of health-related resources.  Promoting adequate, effective care of a family member who has a specific problem related to illness or disability.  Encouraging normal growth and development of family members and the family and educating the family about health promotion and illness prevention  Strengthens family functioning and relatedness  Promoting a healthful environment

6. 6/11/20166

7. 7 Advantages 1)Home setting provides more opportunities for individualized care 2)most people prefer to be cared for at home 3)environmental factors impinging on health, such as housing condition & finances, may be observed and considered more readily 4)Information collection and understanding lifestyle values are easier in families' own environment

8. 6/11/20168 5)Participation of family members is facilitated 6)Individuals and family members may be more receptive to learning because they are less anxious in their own environment and because the immediacy of needing to know a particular fact or skill becomes more apparent 7)Care to ill members in the home can reduce overall costs by preventing hospitalizations & shortening the length of time spent in hospitals or other institutions 8)A family focus is facilitated

9. 6/11/20169 Disadvantages 1.Travel time is costly 2.Less efficient for nurse than working with groups or seeing many clients in an ambulatory site 3.Distraction such as TV and noisy children may be more difficult to control 4.Clients may be resistance or fearful of the intimacy of home visits 5.Nurses safety can be an issue

10. What does the Public Health Nurse do? 1.Get needed medical appointments 2.Have a healthy pregnancy 3.Breastfeed successfully 4.Raise healthy children 5.Keep children safe 6.Plan the size of the family 7.Make healthy food choices 8.Evaluate children’s health & development 9.Get accurate immunization information 10.Get treatment for/prevent lead poisoning 11.Obtain Medical & community resources 12.Deal with loss 13.Develop a crisis plan of action

11. 6/11/201611 Families Retain much Control  The family can control the nurse's entry into the home by explicitly refusing assistance, establishing the time of the visit, or deciding whether to answer the door.  The nurse if there to offer services & engage the family in a dialogue about health concerns, barriers & goals.  As with all nurse-client relationships, the nurse's commitment, authenticity, and caring constitute the art of nursing practice that can make a difference in the lives of families

12. 6/11/201612 Nursing Care Is More Interdependent with Families Because families have more control over their health in their own homes, & because change is usually gradual, greater emphasis must be placed on mutual goals if the nurse & family are to achieve long-term success. Except in emergency situations, the client determines the priority of issues with which to be dealt Families are sometimes unaware of what they do not know. The nurse must suggest health related topics that are appropriate for the family situations

13. 6/11/201613 Creating Agreements for Relatedness  Nurses are expert in caring for the ill; in knowing about ways to cope with illness, to promote health, and to protect against specific diseases; & in teaching & supporting family members.  Family members are experts in their own health. They know the family health history, they experience their health states, & they are aware of their health-related concerns.

14. 6/11/201614  Contract is legally binding agreements. This is not true of nurse-client contracts.  Nurses are legally & ethically bound to keep their word in relation to nursing care; clients aren’t legally bound to keep their agreements.  However, establishing a mutual agreement for relating increases the clarity of who will do what, when, where, for what purposes, and under what conditions.  Because of some people's negative response to the word contract agreement may be better.

15. 15 Increasing Understanding through Communication Skills The nurse's ability to be with family members determines the success of the nurse-family relationship. A nurse can employ techniques of speaking & listening appropriately & still not have a working relationship because caring is not there.

16. 6/11/201616 Promoting Nurse Safety  Promote safety of CHN is critical. The purpose of the home visit is to offer or provide nursing services that make contribution to the family's health and to do so while maintaining the nurse's safety. The purpose of a home visit is to provide care at all costs.  Assertiveness, not abandonment of one's own needs, is required, which is especially true when you are learning to be a CHN and the boundaries of your professional role.

17. 6/11/201617 Promoting the Safety of Family Members lf you believe that someone is in imminent physical danger or is being injured you need to call the policing authority that responds to domestic violence. If someone has been injured you should call for both police and rescue workers, If you believe that dependent children or adults are being neglected or abused you need to contact your faculty or supervisor & follow your school or agency's policies & procedures. Short of these priorities the CHN is not legally bound to respond.

18. 6/11/201618 Managing Time & Equipment  The community health nurse's effectiveness depends on the planning the day for the efficient use of time and other resources.  Physical resources are often limited to equipment carried by the nurse, or provided by the family at the home, or both.  Consequently, making do with what is at hand and doing this consistent with basic principles of safety and infection control are the hallmarks of a skilled CHN, although more specialized equipment is being used in the home to care for sicker individuals

19. 6/11/201619 What can I expect during a home visit? 1.Parenting education and support 2.Information regarding their child’s health. 3.Safety information. 4.Developmental information. 5.Nutrition education. 6.Community resources. 7.Assistance with appropriate referrals as needed

20. 6/11/201620 What kind of help can if get with my children ? The Public Health Nurse provides appropriate interventions & uses a strengths-based approach to: JHelp promote healthy attachment and bonding between parents and their babies. JProvide parents with information needed to promote healthy brain, physical & social/ emotional development in their babies. JTeach parents the importance & life long impact of responsive care giving.

21.  Carry a cellular phone  Be sure the agency knows your visit  Call to schedule the visit and do not go into the home without invitation  Dress simply without expensive jewelry.do not carry large amount of cash  Wear agency badges  Clarify direction before travel.Carry a map

22. Thanks Any question