HOME VISITING IN COMMUNITY HEALTH

Home visiting is very essential to the community health services, because majority of the
patients are found in the home.

Home visiting is the process of providing nursing care to patients at their homes.
Objectives of home visiting.
 To create close relationships with community and families
 To discover the condition in which the family lives and to identify how these conditions
affect their health.
 To promote family health by providing family members with health education adapted to
their level of growth and development.
 To monitor the skills learned in the health education
 To demonstrate to the family on how to administer health care needed by other family
members.
 To refer to appropriate specialized services.
Factors influencing the growth of home visiting services.
 Increasing elderly population because of chronic illnesses related to
 Increased prevalence in HIV/AIDS
 Advanced technology that allows health services at home/family level
 Raise in the cost of health care
 Demand for consumers satisfaction.
Principles of home visiting

When carrying the home visits the community nurse should follow basic principles given below.

 Home visits should be planned with a purpose and should be beneficial to the patients
 The purpose of home visits should be clear and must meet the needs of the patients.
It shouldn’t only include surveys, statistics and health teachings
 Home visits should be regular and flexible according to the needs of the patients
 Home visits should be educative. i.e. it gives excellent opportunities for health
education.
 Home visits should be convenient, acceptable and educative to the patients.
 Home visits should give opportunities for health workers to demonstrate hygienic
principles.
  The nurse should make an attempt to include each family member while using
nursing process.
 The nurse and the family must develop positive interpersonal relationships in their
work to achieve the goal.
 The nurse must be flexible and must respect the patients’ rights to accept or reject
care and to participate in the goal setting and goal achievement.
 Home visits should be recorded in the dairy and family folder.

Advantages of home visits

 Provides the excellent opportunity to implement the nursing process

 Provides an opportunity to study the home and family situation
 Provides an opportunity to render service to the family members at their own
surroundings
 Prompt and proper home visits create a good understanding between nurse and
family and builds good image for nurses
 Clarify the doubts raised by the family members
 Helps to observe family practices and progress of care given by nurses and others
 Help the nurses and the family members to modify the ways of their care
 Home visits are best option for patients unwilling or unable to travel
 Home visits provide natural environment for the discussion of concerns and needs

COMPONENTS OF HOME VISITING:

The components of home visits are;

Initiation phase: In this phase, the community health nurse clarifies the source of referral for
visit and purposes of visit and also share information, reason and purposes for home visits with
family

Pre-visit activities: When the nurses are assigned to home visit, they must know certain prior
information regarding the home and the family which includes location of the house and its
distance and address and some information on the need for the visit. Pre-visit is the part of
assessment phase as the nurse gather information about the patient, investigates community
resources, assembles supplies.The information may be obtained from the family folders or other
nurse or family members or health agencies regarding age, sex, family, culture and values,
problems, care given etc. This helps the nurses to take appropriate steps during the visit to meet
the needs of the patient and also helps to make initial planning.

Activities during home visits: The community health nurses have to use their talents to ensure
good family reception family for their visit, for which they have to begin to develop trust and
rapport which are the basis for positive interpersonal relationship. The nurse-patient relationship
is the basis for providing possible health services to the community. Here, the nurse introduces
herself to family, shows professional identity and establishes nurse-patient relationship.

Nurse-patient relationship should have the following characteristics;

- One person must have knowledge and skill from which another can benefit.
- The needs or requirements of the person to be assisted must take priority over those
of helping person
- The relationship is self limiting by virtue of the goals to be achieved.
- The person to be helped must be in need and utilize the assistance.
- The assistance must be given competently.

During home visits, the nurse assesses the family needs and plans the nursing care according to
the needs of the family.

Termination phase of visit:

Termination of visits occurs when;

 Nurse-patient goals are received, health is restored and the patient can function without
nursing actions.
 A patient changes his residence or leaves the home to go to another home
 The nurse transfers the patients’ care to another nurse or other members to provide health
care.

Post visit activities: post-visit activities include recording and reporting. The nurse records
important events in the family and reports the necessary materials to the higher authorities and
discusses the problems of the family with colleagues and other members of health team and
make plans accurately to meet the needs of the family.
Areas[points] to be associated with home visiting.

 General cleanliness
 Solid waste disposal
 Latrine
 Personal hygiene
 Vaccination of less than 1yr infants
 Vaccination of women
 Anti-natal care, presence of insects/ radiant in the house
 Feeding of children above 2yrs
 Family planning
 Presence of sick person in the house and action taken.

Limitations of home visiting.

 Time consuming
 Limited equipment can only be carried to homes
 Appointment might not be kept
 Un co-operative family members, violent etc
 Certain homes may be geographically not reachable
 Language barrier.

Problems of home visits

 Consumes a lot of time and energy. Community health nurses have to make a trip from
their place or agency to home which consume more time than required to serve actual
purpose of visit or providing care.
 Non acceptance. The family may not accept the nurse due to various factors. The causes
may be due to cultural differences between the nurse and the family personal
characteristics of the nurse and the patients and also socio-economic status to some
extent.
 Problem of local language. The language of the region may also play an important role as
the nurse may not be fully acquainted with the local/community language
 Role confusion. A confusion may prevail vis-à-vis the role of a nurse in the community
where due to lack of knowledge, individuals or families may fail to understand the role of
a nurse in home visiting.