Home Visits in Community Health Nursing

Flashcards covering key vocabulary and concepts related to home visits in community health nursing, based on lecture notes from NSCH 111 Study Unit 7.

Nursing Process

A systematic, problem-solving approach used to identify, diagnose, and treat health issues. In a home visit context, it provides a framework for focused, purposeful, and planned events with specific goals and objectives.

Dimensions Model of Community Health Nursing

A model that encompasses cognitive, interpersonal, ethical, skills, process, and reflective dimensions of nursing, integrated with biophysical, psychological, physical environmental, sociocultural, behavioral, and health system dimensions of health to understand and address client needs during home visits.

Initiating the Home Visit

The first step in the home visit process, involving requests from healthcare providers, clients, friends, or the CHN, focusing on communication, expectation setting, overcoming fear, building rapport, obtaining consent, ensuring safety, and confirming the visit is welcome.

Preliminary Health Assessment

An assessment conducted before the home visit, reviewing existing information for current clients, and assessing available data for general cues on strengths and potential problems for new clients, considering the six Dimensions of Health to review factors influencing health status.

Biophysical Considerations

Assessment of needs related to the ages of individuals in the home, specific health needs relevant to their age and developmental stage, existing health problems, difficulties in performing daily activities, disabilities, and physiological states necessitating health care.

Psychological Considerations

Assessment of needs related to the emotional status, coping strategies, need for relief for family caregivers, history of mental illness, interpersonal interactions, and potential for domestic violence within the home.

Physical Environmental Considerations

Assessment of needs related to the home environment, with emphasis on safety, including the location of the home, neighborhood safety, environmental conditions, safety hazards, age-related safety needs, availability of comforts, and potential infection risks.

Socio-cultural Considerations

Assessment of needs related to the educational and economic levels, social support, employment status, religious or cultural practices, personal privacy, and family interactions within the home.

Behavioral Considerations

Assessment of needs related to consumption patterns, nutritional needs, substance use or abuse, special dietary needs, smoking habits, and medication use within the home.

Health System Considerations

Assessment of needs related to the correct use of health care, difficulties in accessing health care services, payment sources for home care, and access to other health promotion and restoration services.

Nursing Diagnoses

The identification of health conditions to be addressed during the home visit, based on preliminary assessment data, including positive, problem-focused, and health-promotive diagnoses.

Positive Nursing Diagnoses

Nursing diagnoses that reflect the client's strengths demonstrated in the preliminary assessment, such as effective coping supported by a strong family system.

Problem-focused Diagnoses

Nursing diagnoses that identify actual or potential problems revealed by preliminary assessment data, such as ineffective contraceptive use due to inadequate knowledge.

Health Promotive Nursing Diagnoses

Nursing diagnoses that reflect the need for health-promotive services, such as the need for routine immunizations for a new baby.

Planning the Home Visit

The process of preparing for the home visit to address the health needs most likely to be present, including reviewing previous interventions, prioritizing client needs, developing goals and objectives, considering acceptance and timing, identifying appropriate nursing interventions, obtaining necessary materials, and planning for evaluation.

Reviewing Previous Interventions

Examining all previous interventions related to the client’s health needs to determine their effectiveness and identify successful strategies to continue.

Prioritizing Client Needs

Ranking identified client needs based on their potential to endanger health, the extent to which they worry the client, and how easy they are to solve.

Developing Goals and Objectives

Creating general expectations (goals) and specific, measurable actions (objectives) for addressing the most important identified client needs.

Considering Acceptance and Timing

Taking into account the client's readiness to accept the intervention, the appropriate timing of the visit, and introduction of interventions in a way that builds rapport and trust.

Identifying Appropriate Nursing Interventions

Planning specific nursing activities for each nursing diagnosis based on evidence of effectiveness, practice guidelines, agency procedures, and clinical pathways.

Obtaining Necessary Materials

Gathering all materials and supplies needed to implement planned interventions during the home visit, considering that the client's home may not have everything required.

Planning for Evaluation

Establishing criteria for evaluating the success of interventions, using both short-term and long-term measures.

Implementing the Planned Visit

Conducting the home visit, which includes validating assessment of health needs, identifying additional needs, mutual goal setting, modifying the intervention plan as needed, performing nursing interventions, and dealing with distractions.

Validating Assessment and Diagnosis

Confirming the accuracy of the preliminary assessment by reassessing needs and modifying the plan of care in agreement with the client.

Identifying Additional Needs

Collecting further data on the Biophysical, Psychological, Physical environmental, Sociocultural, Behavioural and Health system dimensions to identify additional health care needs.

Mutual Goal Setting

Collaborating with the client to re-examine and revise tentative goals and objectives, ensuring they agree with and are committed to achieving them.

Modifying the Plan of Care

Adjusting the initial plan of care based on findings during the home visit and input from the client or family, restructuring priorities as needed.

Performing Nursing Interventions

Implementing nursing activities, whether primary, secondary, or tertiary prevention, based on the modified care plan.

Dealing with Distractions

Managing environmental, behavioral, and nurse-initiated distractions to maintain focus and effective communication during the home visit, including strategies to minimize negative impacts and build trust.

Environmental Distractions

Distractions arising from physical and social environments, such as background noise, crowded environments, or interruptions by family members.

Behavioral Distractions

Distractions caused by client behaviors, potentially indicating discomfort or lack of trust, which nurses can address by exploring the reasons behind the behaviors and establishing trust.

Nurse-Initiated Distractions

Distractions originating from the nurse's own fears, role preoccupations, or personal reactions to different lifestyles, which can create barriers to relationships and hinder the purpose of the home visit.

Evaluating the Home Visit

Assessing the effectiveness of interventions based on the evaluation criteria established during planning, considering both short-term and long-term outcomes.

Documenting Home Visits

Recording the actual assessment of client health status, identified health needs, goals, interventions, client responses, outcomes, and future plans of care.

Termination

The planned conclusion of home visit services, involving a review of achieved goals, referral for continued care if needed, and clear communication about the time-limited nature of the services.