key Nursing Steps During the Home Visit

1. Identify the key nursing steps during the Home Visit.
2. Describe the five (5)  challenges you may encounter as a Community/Public Health Nurse assisting caregivers (family/significant others) with their additional responsibilities and burdens of caring for a loved one.
3. Select two (2) of the challenges in number 2 above and provide evidence-based interventions the Community/Public Health Nurses will use to assist caregivers with these issues/challenges

Key Nursing Steps During the Home Visit

1. Preparation and Planning:
   • Review patient records and care plan.
   • Gather necessary supplies and equipment.
   • Communicate with the patient and family to schedule the visit.
2. Assessment:
   • Conduct a comprehensive health assessment of the patient, including physical, mental, and emotional health.
   • Evaluate the home environment for safety and accessibility.
   • Assess the caregiver’s ability and resources to provide care.
3. Education and Training:
   • Provide education on disease management, medication administration, and symptom monitoring.
   • Teach proper use of medical equipment and assistive devices.
   • Demonstrate and supervise caregiving techniques and procedures.
4. Care Coordination:
   • Develop and update the care plan in collaboration with the patient, family, and other healthcare providers.
   • Coordinate services such as physical therapy, occupational therapy, and social services.
   • Facilitate communication between the patient, family, and healthcare team.
5. Support and Counseling:
   • Offer emotional support and counseling to the patient and caregivers.
   • Address concerns and answer questions related to the patient’s condition and care.
   • Provide resources for respite care and support groups.
6. Evaluation and Follow-Up:
   • Monitor the patient’s progress and adjust the care plan as needed.
   • Conduct regular follow-up visits and assessments.
   • Ensure continuity of care by maintaining accurate and up-to-date documentation.

Five Challenges Community/Public Health Nurses May Encounter

1. Caregiver Stress and Burnout:
   • Caregivers often experience physical and emotional exhaustion due to the demands of caregiving.
2. Lack of Knowledge and Skills:
   • Caregivers may feel unprepared or lack the necessary skills to provide adequate care.
3. Financial Burden:
   • The cost of medical care, medications, and adaptive equipment can be overwhelming for families.
4. Social Isolation:
   • Caregivers may become socially isolated due to the time and energy required for caregiving, leading to feelings of loneliness and depression.
5. Navigating Healthcare Systems:
   • Understanding and accessing healthcare resources, insurance benefits, and community services can be challenging for caregivers.

Evidence-Based Interventions for Two Challenges

1. Caregiver Stress and Burnout

Interventions:

• Respite Care Services:
  • Providing temporary relief for caregivers through respite care services can help prevent burnout. These services offer short-term care for the patient, allowing caregivers to rest and recharge. Research shows that respite care can significantly reduce caregiver stress and improve their quality of life (Thomas et al., 2017).
• Support Groups and Counseling:
  • Facilitating access to support groups and counseling can provide emotional support and practical advice for caregivers. Evidence suggests that participation in support groups can improve caregivers’ mental health and coping abilities (Wilz et al., 2018).

2. Lack of Knowledge and Skills

Interventions:

• Educational Programs:
  • Implementing structured educational programs tailored to the specific needs of caregivers can enhance their skills and confidence in providing care. These programs can include hands-on training, workshops, and instructional materials. Studies indicate that caregiver training programs improve caregiving competence and patient outcomes (Gitlin et al., 2016).
• Telehealth Support:
  • Utilizing telehealth to offer real-time guidance and support can help caregivers address immediate concerns and questions. Telehealth services provide caregivers with access to healthcare professionals for advice and instruction, which can improve their ability to manage complex care situations (Dang et al., 2019).

References

• Dang, S., Olsan, T., Karuza, J., Cai, X., Gao, S., & Mendoza, T. (2019). Telehealth interventions for vulnerable populations. Annual Review of Nursing Research, 37(1), 223-244. https://doi.org/10.1891/0739-6686.37.223
• Gitlin, L. N., Marx, K., Stanley, I. H., & Hodgson, N. (2016). Translating evidence-based dementia caregiving interventions into practice: State-of-the-science and next steps. The Gerontologist, 55(2), 210-226. https://doi.org/10.1093/geront/gnv023
• Thomas, K. S., Akobundu, U., & Dosa, D. (2017). More than a meal? A randomized control trial comparing the effects of home-delivered meals programs on participants’ feelings of loneliness. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 71(6), 1049-1058. https://doi.org/10.1093/geronb/gbv111
• Wilz, G., Reder, M., Meichsner, F., & Soellner, R. (2018). The Telephone-based Cognitive Behavioral Therapy for Caregivers (T-Care) Program: Efficacy and Moderators of Outcome. The Gerontologist, 58(6), 1033-1044. https://doi.org/10.1093/geront/gnx062