Family health care setting CHN

Compiled By: Mr.Ashish Roy

1. FAMILY HEALTH CARE
SETTINGS
COMPLIED BY-
MR. ASHISH ROY
(NURSING TUTOR)

2. FAMILY HEALTH CARE SETTINGS
Family care provided by health professionals and self-care by the individual in the home
account for the greatest portion of health care in the community health services.
A variety of health care setting can be used for providing family health nursing care.
* HOME VISITS
* HOME NURSING
* HEALTH CENTRES AND CLINICS

HOME VISITS:
Home visit is an important activity of community health services community itself. It is not
able to take advantages of institutional health services due to illiteracy, unemployment and
unavailability of resources. Here is a description of the advantages principles and aims of
home visit.
AIMS OF HOME VIS IT
I. Protection against diseases.
ii. Providing best possible nursing in homely conditions.
iii. Improving the health standard of family
iv. Monitoring the health problems and diseases identified in health problems
v. Assessing the health immunization, nutrition level and environment hazards
to a family
vi. Reducing the MMR and IMR p roviding maternal and child health services.

PRINCIPLES OF HOME VISIT: {RPF VD SEE }

1. Regularity: Home visit should be conducted intervals. So, that maximum
cooperation of the selected unit or family can be increased as per the requirement.
2. Planned and Purposeful :
Home visit should be planned and conducted as per the requirements of the
community. One should categories her area then visit the selected units.
Similarly is necessary to have a definite aim of home visit when can be anything like
survey statics collection, maternal and child health services nursing at home etc.
3. Flexibility :
There is always a possibility that owing to the preceding circumstances at home, the
aim of home visits has to be changed or the visits need to be cancelled. So the
community health nurse should adopt a flexible approach while handling these
changes and conditions.
4. Voluntary and convenient :

3. Home visit should be voluntary and convenient for the family members. During
home visits people should be motivated health to accept voluntarily, instead of
forcefully imposing one’s concepts on them.
5. Developing Relationship :
Home Visit Help in establishing Good relationship between nurses and family
members in understanding the problems and collecting the facts.
6. Scientific and up-to-date technique :
Home visit will be able to remove the misguided beliefs and superstitions science.
Similarly, the services provided during home visits should be latest and complete and
complete with technical expertise. It is essential to inform the family members about
the benefits of home visits and the up dated knowledge.

7. Educative :
Home visit is an excellent opportunity for providing health education. Therefore
during home visits people should be educated about personal health nutrition, family
planning immunization, mother welfare, reproductive and child health and health
problems of community.

8. Evaluative :
It is essential to evaluate home visit from time to time. Therefore it is necessary that
information is properly filled in daily dairy, family card, etc. Similarly the results of
home health indicators or some other technique.
HOME VISITING PLANNING, TCHNIQUE AND EVALUATION: -
The home visit should be conducted in a planned manner, on the basis of its aim and the
availability of resources. Home Visits have three main steps:-
 Preliminary Planning and preparations:
Preparing a map of the area after its survey.
 Preparing family folder and individual card after collecting maximum possible
information about the background of the family.
a. Age and Sex of the head of the family.
b. Total income of the family
c. Education level of the family.
d. Educational level of each family member.
e. Health problems of the family member.
 Preparing home visit bag (nursing bag, delivery kit, family folder, entry card and
educational material for home visit.
TECHNIQUES OF HOME VISITING: -
 In the first meeting introduce yourself and state the cause of your visit.
 Develop good relations through information, friendly and try to win the confidence of
family.
 Motivate the individual to share his/her problems. Maintain the privacy and secrecy.
 Neither make fun of the habits culture and traditions of the family.
 Do not scold the family members for not following the advice rather explain again
politely.
 Make the changes in the home visit plan as per the domestic condition.
 Collect all relatable treatment.
 Provide service of help, instead of lips service .It should be most important.
 Health Education should be continue provided nursing care during interaction.

4.  If there is patient in the family or there is a need of some other kind of nursing care,
provide nursing care first before starting the health education and further talks.
 Observe the physical environment of home health level of pregnant mother, health
level of child below five years of age, signs of mal nutrition, way of living, cleanliness
Condition of personal hygiene.
ESSENTIAL EQUIPMENT REQUIRED FOR HOME VISIT AND THEIR USE:-
a) Nursing Bag (Community Health kit/bag or Home visit bag)
b) Family folders, individual folders, individual cards, paper pen, pencil, scale.
c) Health Education Materials with proper Av-aids (audio visual aids) i.e., Charts, Flash
card, Flip Charts, Fannel Board, etc.
 1 Original Home Health Shoulder Bag
 Digital Thermometer
 6 disposable bag barriers
 Sphygmomanometer
 Dual-head stethoscope
 Pen light
 Tape measure
 Liquid soap
 Waterless cleaner
 Thermometer
 Water-soluble lubricant
 Latex gloves
 Paper towels, alcohol wipes, antiseptic, and Povidone-Iodine wipes
 Bandage scissors
 Personal protective equipment
 CPR barrier
 6 red biohazard bags
 Hard-surface disinfectant
 Spill cleanup set
o Other Equipment as per the requirements i.e., Blood Pressure Instrument,
Stethoscope, delivery kit, immunization kit, antenatal kit, postnatal care kit,
sugar testing kit and instruments test tubes test tube holder, benedict
solution, spirit lamp, isopropyl alcohol (spirit), providine iodine ( betadine ),
savlon , gauze pieces, gloves , plastic aprons, hand washing essentials , kidney
tray ,newspaper ,paper bag for collecting waste etc.

NORMAL TECHNIQUE OF US ING NURSING BAG/ HOME VISIT BAG :
Spread the plastic sheet on the neat on a neat and clean place and keep the bag
on it.
Take out the hand washing articles from the side pockets and wash your hands
Open the bag, take out essential items and close the bag.
Complete the task/procedure, place the dirty or used articles separately with
proper methods.
A separate bag can be used to carry the dirty or used instruments to the health
centre for sterilization.

5. Wash your hands at the end of the procedure. Keep the clean articles in the bag
and close it properly.
Things taken out from the outside pockets should be placed at the appropriate
places.
SOME OTHER PRECAUTIONS :
CHECK THE BAG BEFORE LEAVING FOR HOME VISIT.
BAG SHOULD BE KEPT AT THE PROPER PLACE, OUT OF REACH OF CHILDREN.
BAG SHOULD BE THROUGHLY CLEAN DUST FREE AND DISINFECTED.
THINGS WHICH CAN BE STERILIZED SHOULD BE KEPT STERILIZED
PERSONAL ITEMS LIKE PEN PAPER PENCIL RUBBER SCALE SHOULD NOT BE KEPT
INSIDE THE BAG THESE ITEMS SHOULD BE KEPT IN POCKET ARTICLE POUCH.
IT IS ESSENTIAL TO CHANGE THE BAG FROM TIME TO TIME

HEALTH CARE BAG TECHNIQUE
Prevent Cross-Contamination, Protect Patients, and Demonstrate Compliance
As a trusted source for high-quality, unique healthcare bags, Hopkins Medical
Products recognizes the importance of promoting proper Healthcare Bag
Technique.
A healthcare bag – also referred to as a nurse bag, medical bag, public health
bag, or visiting bag – is a home healthcare essential. Its omnipresence in
patient care demands consistent efforts to prevent cross-contamination,
protect patients and their loved ones, and remain fully compliant.
Objectives
Prevent contamination of the healthcare bag.
Protect patients, family members, and healthcare workers from the spread of
infection.
Demonstrate compliance with federal, state, and local laws and regulations,
accreditation standards, infection control principles, and standard
precautions.
Bag Technique Procedure
Select a healthcare bag that has at least three separate compartments, at least
one of which should be lockable to secure patient records.
Designate two “clean” compartments, one for clean disposables and the other
for patient records.
Pack the bag with necessary supplies before leaving for visits. Pack hand
washing supplies near the top or in a side pocket where they are easily
accessible.

6. Store the healthcare bag in a clean storage container or other separate
compartment in your car.
Do not take the healthcare bag into infested homes or homes of patients with
antibiotic resistant infections such as MRSA or VRE (Methicillin-resistant
Staphylococcus aureus (MRSA) and vancomycin -resistant enterococci (VRE)
cause nosocomial infections and are associated with increased rates of illness
and death. Both organisms are now endemic (native and restricted to a certain
place.) in many healthcare institutions, particularly in intensive care units
(ICUs)).
In the home, identify a clean and safe area for the healthcare bag. Never set the
healthcare bag on the floor. Always choose a place to set the bag that gives you
enough work space, is close to the patient, has a source of water, and is away
from children and pets.
Plan where you will discard disposable items and sharps ahead of time.
Spread an impervious barrier on the surface before setting the bag down.
Remove hand washing supplies first. Wash and dry hands thoroughly, following
proper hand washing technique.
Remove any items needed for patient care, including any necessary personal
protective equipment.
Close the bag before performing patient care.
Wash your hands again if you need to re-enter the bag for additional supplies
during patient care.
Only dispose of sharps in an approved sharps disposal container. The sharps
container must be kept in a separate “dirty” compartment or a designated
sharps container pouch. Never put used sharps directly in the bag.
Discard disposables in a sealed trash bag or biohazard bag. Follow local and
state regulations for infectious waste disposal.
Bag soiled reusable items that cannot be cleaned in the patient’s home and
transport them according to agency policy. Do not put these soiled items back
into the healthcare bag.
Wash your hands, then repack and close the healthcare bag.
Clean and disinfect the healthcare bag weekly by hand washing in mild soap and
warm water and air drying. Then spray both inside and outside with Sanitizers ,
and air dry again.

Essential Supplies Checklist
Medium Alcohol Gauze Pads
Powder-Free Latex Gloves (non-sterile)
Adhesive Tape Remover Pads
Disposable Water Repellent Bag Barriers or Antimicrobial Soap
Reusable Antimicrobial Bag Barrier
3/4” x 3” Adhesive Bandages
4” x 4” Non-Sterile Gauze Sponges
4oz Waterless Hand Cleaner

7. Micropore Tape with Dispenser
C-Fold Paper Towels
Hopkins Antimicrobial Hand Wipes
1 Qt Sharps Container
Latex Free Nylon Sphygmomanometer
Dual Head Economy Stethoscope
Red Biohazard Bags
Clinic or Flex Temp. Thermometer
SaniZide Plus 4oz Spray, SaniZide Pro 1,or Wipes Disinfectant Wipes Flat Pack
E-Z Lubricating Jelly*
Premium Spill Kit Polybag
Micro shield CPR Mask
Hopkins Reusable Pen Light with Pupil Guide
Personal Protection Kit

MORE WAYS TO PROTECT AND PREVENT CROSS -CONTAMINATION
You never can take too many precautions when it comes to safeguarding yourself, your
colleagues, and visitors.
Once you have mastered the basic principles of our recommended Healthcare Bag
Technique, we encourage you to explore more opportunities to limit cross-contamination
and remain compliant with ever-evolving regulations, privacy laws, and standards.

Antimicrobial Protection in the Bag
Hopkins Medical Products revolutionized the healthcare and medical bag industry in 2018
by launching the first-ever antimicrobial home healthcare bag line, by incorporating
Microban, which helps prevent organisms from growing and colonizing on materials, we
added an extra layer of protection to the Hopkins bags used and loved by healthcare
professionals around the world.

CLINICS
The word ‘clinic’ was used for a place where a group of physicians would sit to treat and
study patients requiring medical and surgical treatment.
According to another concept clinic is the place where the patient who can move about or
are not institutional come for check-up or treatment.
Features of Good Clinics –
Planned and follows the time table.
As far as possible liberating the patients from the compulsion of pre-registration.
Physicians and members of health team should be specialist one and skilled in their work
and sufficient in number
Proper arrangement of place, equipment furniture, medicine toilet drinking water,
stationery, etc.
Working hours of clinic should be more than the routine timing of health centres.
Behaviour of medical staff should be more satisfactory while giving the diagnosis, treatment
and answers to the questions to the patients.
Arrangement should be made for effective health educations.

8. Types of Clinics:
1. General Clinics:
These are arranged for the examination, diagnosis and treatment of minor aliments

2. Maternal and child health clinics:
Maternal and child health are mostly provided through these clinics.
ANTENATAL CLINICS
POST-NATAL CLINCS
FAMILY PLANNING CLINIC
UNDER FIVE CLINIC
REPRODUCTIVE & CHILD HEALTH CLINIC

3. Speciality Clinics:
Medical counselling services for certain specific disorder are provided through these clinics:
Diabetic clinic
Nutrition clinic
Tuberculosis clinic
Cardiac Clinic

ROLE OF COMMUNITY HE ALTH NURSE IN CONDUCTING CLINICS :
Clinic are conducted on the basis of clinic spirit in which doctors, community health nurse
female and male health workers voluntary organization and community make valuable
contribution.
 Assessing the health status of patients.
 Providing the nursing services to the patients.
 Educating the patient for improving the health and skilful adjustment.
 Providing special knowledge and skill and technique as per the health needs of the
patient
 Assisting the doctors.
 Selecting the place of the clinic.
 Monitoring the records which are preserved at the clinic.
 Supervising other health and nursing staff working at the clinic.
 Providing health education to the patient and his family.
 Hand over the responsibilities to the health worker (ANM/FHM), health guide and
other health workers for conducting the clinic.
 Other General responsibilities are :-
-Making arrangement to keep clinic peace and cleanliness
- Making arrangement for clean drinking water
- Maintaining a healthy atmosphere to the clinic

9. REFERENCES


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