Module Components

• Overview

Topics

• Definitions
• Why Do Home Visits
• How to Conduct Home Visits

Nurs 467 - Public Health Nursing

Module 7: Home Visiting

How to Conduct Home Visits

Phases of the home visit

The phases of the home visit include the planning that occurs before the visit, the initiation of the visit to break the ice and establish trust, the implementation of the visit, and the termination of the visit when goals are made and the next contact is scheduled. The cycle starts again with planning the next contact or visit.

Safety Concerns

A key concern for the community/public health nurse and the employer is how to assure the safety of the nurse while in route to and in the process of conducting home visits. Consider the safety guidance below when conducting home visits. This information is also included in the course Student Manual.

1. Dress appropriately
2. Visit with a partner
3. Stay alert and observe surroundings
4. Avoid secluded areas
5. Avoid areas where people loiter
6. If feel unsafe, don’t go
7. Map out route
8. Call family before leaving
9. Leave itinerary with agency
10. Report back to agency at end of day
11. Clarifying the nurse’s self-responsibility
12. Promoting safe travel
13. Handle threats during home visits – protect yourself first
14. Protecting safety of family members

Managing Time and Equipment

It is important to structure your time when conducting home visits, taking into consideration travel time, visit location and client priorities. Additional consideration must be given to clients with special needs or circumstances. For example, a visit may be scheduled to do a dressing change for an infected wound. In this case, the client should be scheduled after “clean” or immunosuppressed clients are seen. Most visits take about 1 hour, however initial visits could take upward of two hours because of documentation. It is helpful to be prepared with all necessary forms, and as much information completed beforehand as possible.

In the past, nurses often needed to modify medical equipment for client use. In this litigious environment modifying or “jerry rigging” equipment is not recommended. While obtaining an infant’s weight by first weighing mom with and without the baby is a harmless modification, other “creative” solutions may result in injury to the patient. Nurses should take the necessary steps to assist clients in securing the proper equipment. Nurses should also be sure to exercise universal precautions and maintain clean nursing tools. Nurses’ tools should always be secured in bags and kept in a safe place.

Promoting Asepsis in the Home

Practicing aseptic technique is as essential during home visits as it is in the inpatient setting. Nurses must wash hands before and after working with clients. All sinks in homes are considered dirty since the nurse has no idea what has touched the sink. In the event that proper supplies (liquid soap, towels and trash can) are not available the nurse should be prepared with soap, towels and bags for disposing of trash. Hand sanitizer is also an option for hand washings.

Determining Success of Visit

Visit success is determined by:

1. The degree of client satisfaction
2. Quality of the nurse-client relationship
3. Adoption of health behavior
4. Health status of client
5. Goals of the visit are accomplished