Class 10_HomeVisits_cvv_Studentv2025.pptx (1)

HOME VISITING

• N3000 Class 10

THE HOME VISIT

• Key points to remember:

  • Clients and/or families allow healthcare professionals into their homes during vulnerable moments.

  • Always empathize; put yourself in the clients' or families' shoes and consider their feelings.

PURPOSE OF HOME VISITING

• Objectives of home visits:

  • To enter a client's home and understand their health needs from their perspective.

  • Develop a relationship with the client and possibly their family.

  • The nurse acts as a guest, working collaboratively to identify and meet health care needs.

  • Consider the necessity of the home visit for the client.

  • Understand the advantages (personalized care, direct observation) and disadvantages (client privacy, safety concerns) of home visiting.

PREPARING FOR THE VISIT

• Essential steps before a visit:

  • Call and introduce yourself.

  • Schedule a convenient place and time for the visit.

  • Discuss the referral and the visit's initial reason.

  • Obtain detailed directions to the client's home.

  • Prepare for potential refusal of meeting by hypothesizing possible outcomes.

PLANNING YOUR VISIT: PRACTICAL TIPS

• Prior preparations include:

  • Pack necessary items based on the type of visit (e.g., for a new mom or an elderly adult with complex care needs).

  • Have a reliable GPS system available.

  • Carry a cell phone for emergencies.

  • Check the weather to dress appropriately.

  • Ensure your vehicle is in good condition with a full tank of gas.

  • Bring hand sanitizer and prioritize personal safety.

RISK ASSESSMENT

• Assessment of potential risks before visiting:

  • Determine if the neighborhood poses a high risk.

  • Assess for pets, history of violence, and substance misuse.

  • Evaluate client or family receptiveness and awareness of surroundings.

  • Safety practices include backing the car into the driveway and locking doors.

  • Be prepared to cancel the visit if personal safety is compromised.

STAGES AND ACTIVITIES OF A HOME VISIT

1. Engagement

2. Assessment

3. Intervention

4. Termination and Evaluation

5. Post-Visit Documentation

• Reference: Chapter 12, Pages 291-295

1. ENGAGEMENT

• Key activities for engagement:

  • Introduce yourself and your professional identity.

  • Clarify the source of referral and the purpose of the visit.

  • Establish a shared understanding of the visit's purpose with the family.

  • Build the nurse-client relationship.

2. ASSESSMENT

• Steps in the assessment phase:

  • Conduct assessments of the client or family.

  • Engage in the "seeing phase" to understand their needs.

  • Apply the Calgary Family Assessment Model (CFAM) to pinpoint family health concerns.

  • Set mutually acceptable goals and solutions.

  • Assess the home environment, understanding what to look for.

POTENTIAL RISKS FOR INJURY

• Consider risk factors based on the environment:

  • Differences in risks between seniors and children/infants.

  • Specific hazards in the kitchen, bedroom, living room, bathroom, and stairs/entrances.

3. INTERVENTION

• Intervention phase entails:

  • Implementing interventions with the CFIM framework.

  • Planning and prioritizing care in collaboration with the client/family.

  • Continuing to strengthen the nurse-client relationship.

4. TERMINATION AND EVALUATION

• Finalizing the visit:

  • Review the visit with the family.

  • Assess whether the established goals were met.

  • Provide referrals to other community resources as necessary.

  • Plan for future visits based on ongoing needs.

5. POST-VISIT DOCUMENTATION

• Follow agency policy when documenting the visit.

DEBRIEFING

• Objectives of effective debriefing:

  • Recognize and release emotions experienced during visits.

  • Reinforce the objectives of care delivered.

  • Clarify information and enhance critical thinking and problem-solving skills.

  • Foster reflective thinking and link practical events with theory.

  • Relieve stress associated with home visits.

CONTRACTING WITH FAMILY

• Contracting strategy involves:

  • Formally involving family in the nursing process.

  • Jointly defining roles of family members and the nurse.

  • Recognizing the advantages and disadvantages of this approach.

POTENTIAL OUTCOMES

• Expected outcomes from home visiting in various contexts:

  • Public Health Nursing:

    • Increased rapport, parenting skills, health knowledge.

    • Decreased child abuse/neglect, maternal depression, hospital visits.

    • Better-adjusted children and enhanced social supports.

  • Continuing Care Nursing:

    • Improved rapport, understanding of illnesses, coping capacities.

    • Reduced unnecessary medical visits, length of stay in hospitals.

    • Enhanced client health and knowledge of available resources.

BUILDING EXPERTISE IN HOME VISITING

• Strategies for enhancing home visiting skills:

  • Observe and learn from experienced nurses during joint visits.

  • Review and reflect upon communication and assessment skills.

  • Evaluate past home visits for accomplishments and areas of improvement.

  • Self-reflect on personal values and approaches.

  • Accept realities, seek common ground, and respect families' capabilities.