Home visit and Bag Technique

Home Visit, its introduction, definition, objectives, principles, purposes, types of home visit, components of home visit, steps in home visit, frequency fo home visit followed by Advantages and Role of coommnity health nurse.

1. Home visit and bag technique PRESENTED BY :- Kaushal Sharma B.Sc Nursing

2. INTRODUCTION A home visit is one of the essential parts of the community health services because most of the people are found in home. Home visit fulfills the needs of individual, family and community in general for nursing service and health counselling. A home visit is considered as the backbone of community health service.

3. CONTINUE…… A home visit is a family nurse contact which allow the health worker to assess the home and family situation in order to provide the necessary nursing care and health activities.

4. DEFINITION A home visit is defined as the process of providing the nursing care to the patients at their doorsteps. It requires technical skills, resourcefulness, judgment, relationship. It is defined as providing the services to family at their doorstep to maintain the health & reduce the mortality and morbidity in family. It refers to identification and prioritization of health needs of the individual and family at their doorsteps and provision of care using available resources.

5. CONTINUE…… Home visiting is defined as the delivery of specialized nursing care services in home care settings. Home Visit is a process of providing nursing care to patient or whole family at their doorstep.

6. OBJECTIVES OF HOME VISIT To obtain information for family assessment. To get acquainted with the family. To begin a relationship of continuing assistance in the family health and health related needs.

7. PRINCIPLES OF HOME VISIT Home visit should be planned according to priority . The purpose of home visit should be clear and must meet the needs of the patients. Home visit should be regular and flexible . Home visit should be educative .

8. CONTINUE…… Home visit should give excellent opportunities for nurses to demonstrate hygienic principles . Home visit should be convenient, acceptable and educative to the patients. The nurse should make a attempt to include each family member while using nursing process . The nurse and the family must develop positive interpersonal relationship in their work to achieve the goal.

9. CONTINUE….. Nurse must carefully listen the family and understand the other person’s view . The nurse must respect the rights of the patient . Home visit must be recorded in the diary and family folder . Health education, nursing care should be specific .

10. CONTINUE…… Use safe technical skills and scientific nursing procedures . Evaluate the work periodically . Make a note of important facts about the home visit in your diary . Thanks to the family members and individual for good response .

11. PURPOSES OF HOME VISIT Protection against diseases. Providing essential treatment. Providing comfort and relief from pain to the patient. Giving a support and empathy to the patient and the family. Using domestic equipment for the nursing.

12. CONTINUE…. Providing health education. Giving as mush respect as possible to the faiths and beliefs of the family during the procedures. To fulfill the planned or scheduled visit. To visit the antenatal or high risk mother who needs continuous support. To assess the postnatal mother and newborn to assess their health status.

13. CONTINUE….. To alert mother on immunization that is due for her or for her baby or child. To assess the nutritional status and conduct physical examination. As a follow-up measure. To screen the contacts of communicable diseases. To lead and supervise the other health workers.

14. TYPES OF HOME VISIT

15. CONTINUE…. Illness Home visit Emergency Acute illness Chronic illness Dying patient home visit Terminal care Pronouncement of death Grief support

16. CONTINUE…. Assessment Home visit Polypharmacy Immobility Social isolation Suspected abuse or neglect Recent catastrophic diagnosis.

17. CONTINUE….. Hospitalization Follow- up Home Visit Acute illness, injury or surgery. Parents with newborn infants.

18. C OMPONENTS OF HOME VISIT Initiation phase Pre-visit phase Activities during Home V isit Termination phase Post activities phase

19. STEPS IN HOME VISIT Home visit refers to meeting the health needs of the people at their doorstep. The steps of home visit are as follows :- Facts finding Data finding Planning for a visit Action and health education Closing the visit Recording the visit Evaluation of the visit

20. 1. FACTS FINDING Facts findings are the first step during the home visit. It helps to study the clinics and other record to get an understanding of what has to be done which is given below :- Prepare a map of the area to be visited i.e. location, house, road, temples etc, and prepare family folders. Collect information of the family members regarding number of family member, occupation, education, date of birth, religion, income, past history, present illness, use of family planning, immunization etc.

21. CONTINUE……. Use technical skills and nursing procedure. Establish an interpersonal relationship, be polite and courage, show the interest towards the family. Identify the needs of the individual and family members. Discuss the problem with the family members and find out the possible solutions to problems.

22. 2. DATA FINDING After completing the facts finding, the process of analysis begins. The data of the members should be honest and based on the facts and not on the opinions. The personal, emotional, spiritual aspects should be involved which are taken together constitute the usual health problems. The problem and facts should show exact problems and what he is expected to do.

23. CONTINUE…. Discuss the point step by step and examine the matter critically. Then only comes to the conclusions. Do not jump and do not make hasty conversations. After that, the nurse helps the family to plan and use local and outside resources.

24. 3. PLANNING FOR A VISIT Community health nurse should assess or consider many factors while making a visit to the family such as:- Make good and realistic objectives and plan how we are going to achieve those activities. First priority should be given to essential basic need such as hunger, then only for personal hygiene or safe drinking water or sanitation. Family’s cultural background. This helps the community health nurse to understand their attitudes, beliefs, practices regarding medical practice and diet.

25. CONTINUE…. Occupational and income of family to determine and assist in budgetary problems. Age of all the family members. Psychological factors – basically the family relationships. Educational level. Local resources available in a family in order to be practical.

26. CONTINUE… Planning should also be based upon short term or long term objectives of the family. Some alternatives plan or suggestions are also helpful. Do respect the individual’s idea, suggestions, or solutions. Good planning leads to doing a good actions and achieve objectives.

27. 4. ACTION AND HEALTH EDUCATION APPROACH TO FAMILY :- Locate the right house Knocking at the door and call out. Introduce yourself, your agency and the purpose of your visit. Establish good rapport – being courteous, polite, warm and friendly. Good observer of verbal and non-verbal response from family. Use the words – ‘HOW’, ‘WHAT’, ‘WHEN’, while questioning.

28. CONTINUE…. Be a good listener. Keep in mind agency’s policies during visit regarding fees and care. The talk should be informal, giving plenty of opportunities to ask a questions and provide a platform for discussion. Do not force information. Observe local customs e.g. Removing shoes or chappals before entering the house is necessary in I ndian Communities.

29. CONTINUE…. INTERVIEWING THE FAMILIES :- Interview is defined as a conversation with a purpose, an exchange of ideas between two people, process of giving and receiving information. The nurse should be sensitive to the other person’s point of view. PRINCIPLES OF INTERVIEW TECHNIQUE :- Provide privacy. Establish a good rapport. Be a good listener .

30. CONTINUE…. Must maintain an intellectual alert attitude. Understand the client’s and family's problem and their socio-cultural background. Relieve anxieties and fears by providing a conductive environment. Speak the language of the client and use simple terms which can be understandable. Follow through on the interview. Record the interview. Evaluate the interview.

31. CONTINUE…. ACTIVITIES DURING HOME VISIT :- Providing nursing care with comfort e.g. Taking temperature, for giving bath. Observing and assessing patient’s condition. Assist and guide them in making plans for solving their health problems. Demonstrating and teaching e.g. giving insulin injections. Making nursing diagnosis and tentative nursing care plan. Establishing priorities. Giving assurance to the individual and family appropriately.

32. CONTINUE….. The major objective of health care services in the home is to help people with their health problems and work with them towards keeping the family healthy. The purpose of the bag is to carry out necessary equipment to perform nursing care in the home. E.g. performing minor dressing, conducting delivery etc. It saves time and effort in the performance of a nursing procedure.

33. CONTINUE…. HEALTH EDUCATION :- The action and health education should be as per family time schedule. Find out what is the best time for teaching them.

34. CONTINUE…. This help to provide effective teaching as you are helping them. It also builds good interpersonal relationships. Emphasis should be given on practical more often than theoretical.

35. 5. CLOSING THE VISIT The nurse should summarize the contents of her visit and plans for next visit. For example, say that you’ll visit next day or next week. Its basically a termination phase.

36. 6. RECORDING THE VISIT Record the activity carried out and the services given specifically. For example, record what food were advised regarding disease instead of recording ‘discussed well balanced diet’. Describe what was done and reason for doing the specific procedure.

37. CONTINUE….. For example, what demonstrations were carried out, what was discussed, explained, explored, suggested or reviewed. A clear, concise and skillfully written records helps in better patient care.

38. 7 . EVALUATION OF THE VISIT T his is necessary in terms of :- Was good relationship established ? Was the point of view of community health nurse understood ? What was the immediate problem/need ? What was the total problem ? List the difficulties and hindering factors in the situations ? What plans were being made and what actions were taken to deal with the underlying cause of the problem? How did the personal respond to your visit ? What changes took place ?

39. CONTINUE….. Have you made effective use of man, material, and measures ? How effective was the teaching ? How far the visit has been useful ? What was the attitude of individual, family, and community? Do you need guidance, counseling, and discussion with your superior ? The results of community health services is not always seen immediately. It takes time. Knowledge is changed but attitude.

40. CONTINUE……. habit, and behavior change is difficult, but once changed, it has a permanent effect. (These questions should be raised and answered at the end of each visit.)

41. FREQUENCY OF HOME VISIT Making decision regarding frequency of visit is a matter of judgment. It depends upon the extent of health problem of the family Priorities are established on the following guidelines :- Visit in response to the need felt by the family such a mother in labor, acute and serious illness etc. Visit to premature infants and infants with defects. Regular visit to post natal mother and antenatal mother.

42. CONTINUE….. Visits to chronically ill patients. Supervisory visit to infants, toddler, eligible couples. Collection of family information and investigations. Information, education, counseling and guidance purposes.

43. ADVANTAGES Home visit provides an excellent opportunity to implement the nursing process. Home visit provide an opportunity to study the house and family situation. Home visit provides an opportunity to render service to the family members at their own surroundings. Prompt and proper home visit create a good understanding between nurse and family and builds good image of nurses. Home visit clarify the doubts raised by the family members.

44. CONTINUE….. Home visit helps to observe family practices and progress of care given by nurses and others. Home visit help to prevent and handling the problems. Home visit helps the nurses and family members to modify the way of their care. Home visit are convenient for the patients. Home visit facilitate the patient control of the setting. Home visit are the best option for patients unwilling or unable to travel.

45. CONTINUE…… Home visits provide natural environment for the discussion of concerns and needs. It helps in prevention of disease, promotion of health and maintenance of health, early detection of disease, surveillance & follow-up. Helps in referring the people who are in need for higher level care. Home visit help Community H ealth Nurse to learn the culture of the family and to provide culturally sensitive care. Home visit helps in identifying the new problems & plan needed care accordingly.

46. Role of community health nurse in home visit

47. ROLE OF COMMUNITY HEALTH NURSE :- Recording the history of the family to ascertain the cause and duration of illness. Providing treatment and related care. Demonstrating the nursing procedure to educate the family members. Giving medicine as per the standing orders and providing essential nursing care in the grave situations.

48. CONTINUE…… Supervising the nursing procedures provides by family members. Including the patient himself in taking care of chronic illness (heart, arthritis, cancer, diabetic patients, etc.) and giving them mental support.

49. THANKS