Home visiting - public health nursing

Home visiting:

Home visiting is the backbone of public health nursing. The purpose of home visiting is

to carry out simple nursing care in the home

for the prevention of disease

promotion of health of the members of the family.

Principles of home visiting:

1.     Home visiting should be made according to the needs of the people

2.     It should be part of a planned visiting programme

3.     Collect background Information: regarding the family In particular an community in general - that is Information regarding the family size occupation, Income, religion resources, customs and cultures.

4.     Identify the health problems of the family

5.     Use safe technical skills, and nursing procedures

6.     In health teaching; be sure of what you discuss, i.e., scientific soundness

7.     The approach to the family should be kind and courteous with a view to gain their confidence

Planning and evaluation:

Planning is an art and science. The purpose of planning is to achieve definite objectives within a specified time and within the available resources.

First make survey and prepare a map of the area with details of topography location of villages, population, road etc. Collect all the background information of the community. Prepare family folders and Individual cards.

Identify the families or individuals in need of home visiting. These are usually the antenatal and postnatal cases, infants, toddlers, chronically sick and those who are unable to attend a treatment centre.

On the first visit, the public health nurse should introduce herself to the family and explain the purpose of the visit. The talk should be informal giving plenty of opportunity to ask questions and raise discussion.

Take the nursing bag. Treat minor illnesses. Advise hospitalization where necessary. Undertake immunization

where necessary. Give health instruction on personal and environmental hygiene.

Follow up : This is' the most important part of home visiting, to find out how far the instructions given were followed; and to give credit for what they have done.

Evaluation Try to evaluate what has been achieved against the goals. The questions to be raised are :

How far the visit has been useful ?

What have been the difficulties ?

What more needs to be done?

Bag technique: The Bag:

Bag technique: The Bag:

The bag should be made of canvas, leather or light metal.

It should be such that it can be carried by the hand or on the shoulder.

The bag should have outside pockets for keeping a note-book, tape measure, newspaper or plastic sheet, towel, soap in a soap dish, and a nail brush.

Bag Technique:

As the same bag may have to be used in several homes, every effort should be made to keep the bag as clean as possible.

First spread the newspaper or plastic sheet on a flat surface in a clean area and place the bag on it. It should be kept away from children and animals.

Wash hands with soap and water each time before opening the bag.

Remove only what is needed.

Carry out the nursing procedure.

Wash and boil all the Instruments after finishing the work; wash hands, open the bag and replace them in the bag. When this is not possible, place them in a separate bag.

Bum the soiled dressings.

Fold the used newspaper with used side inside, and keep it in the outer pocket.

Equipment:

No home visit should be made without bag or kit. There are two separate kits - one for deliveries (Delivery Kit) and the other for general nursing and for prenatal and postnatal visits.

Delivery Kit: The, UNICEF kit is widely used for deliveries and is most suitable. The equipment is contained in an aluminium box.

Nursing Bag: If no separate bag is supplied, the nurse should Improvise, using a tin with an air-tight lid, or a plastic bag. As the equipment may have to be carried by hand for long distances and for long periods, the tin or bag should be as light as possible and should contain only essential articles. Unless the whole container can be completely disinfected, a separate cotton lining should be used. The nurse must also carry separately (not in her kit) a pen or pencil, a notebook or diary in which to note down observations and enter records before leaving the patient's home. Some clean

Nutritional problems

Malnutrition is widely prevalent in India. The specific nutritional problems are :

Protein-calorie malnutrition:

This is due to deficiency of calories and proteins in the diet. A large number of children are victims of kwashiorkor and marasmus in 'India

Endemic goitre :

About 71 million people are estimated to be affected by endemic goitre (i.e., swelling of the thyroid gland in the neck) and other iodine deficiency disorders. This condition is due to iodine deficiency.

Vitamin deficiencies :

Deficiency of vitamin A is an important public health problem in India especially in the age group, 3 to 5 years. About 12.000 to 14,000 children are estimated to go blind every year.