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HOME VISITING & URINE TESTING
PRAMOD KUMAR
HOME VISIT
• It is an evidenced based program, implemented in response to findings from a needs assessment, that includes home visiting and is offered on a voluntary basis to pregnant women and children.
Principles:-Plan the work so
that visits are made on the basis of
need.Be sensitive to the
person’s feeling and needs at the time of the visit.
Understand the other person’s point of view.
Be sure of the scientific soundness of the subject you
discuss.
Use safe technical skills, including hand washing.
Attain a working knowledge of the
community resources and use
them wisely.
cont.…
Collect facts about home, the patient and environment and make an objective analysis of the facts as an initial step in visiting the home.
Work and plan with person and family.
Your work should be qualitative not quantitative.
On return, record facts in the family folder/ individual health care record.
Purposes of home visitA visit to the home
may be….
In response to a need felt by an individual in the family.
As a part of a planned visiting program e.g. pre
natal visit.
To investigate the source of an infectious disease.
cont.…..
To follow through on some problem identified.
To assess nutritional and immunization status, environmental hazards and give health education.
To follow treatment and care given by family members
To supervise and guide other health workers.
STEPS OF HOME VISIT:
A. Fact finding:-– The first step during a home
visit is to study the clinical and other records to get an understanding of what has been done. This should give a lead to present needs and the community health nurse will be able to build on what has been done.
cont.….
cont.….
•Conditions pertaining to the environment.•Maternal and child health.•Recent deaths and births.•Recent marriages.•Any illness in the family.•Assessment of malnutrition.
Observe and
ask about
…
B. Examination and analysis:• After the collection of facts, the process of examining
and analyzing begins. The personal, environmental and economic factors, the emotional involvements and spiritual aspects are taken together that constitute usual health problem.
• The community health nurse should be able to combine the facts about home condition, signs and symptoms, attitudes and relationships to identify needs and problems which will become the starting point of action.
• She should also assess the coping ability of the family.
C. Planning with the individual & the family:
Planning action with the person and gamily is one of the greatest importance.
Alternative plans and suggestions are helpful.
Respect for individual rights is important.
D. Action:-– Action depends upon the first three steps.
E. Follow-up:-– Follow up is one of the most important steps in the
home visit.– Always plan follow up according to need and time.– It helps a community health nurse to evaluate the work.– Follow up of persons undergoing treatment in chronic
illness is very important.
E. Evaluation of services:-– Review each family records periodically and answer
the questions:– What is the immediate problem?– What is total problem?– List the difficulties and unhelpful factors?– List the coping abilities?– What has been done about immediate problem?– What plans are being made and what action is being
taken to deal with the underlying cause of the problem?
– How can you make effective use of man and material present?
Advantages:• It permits the nurse to see the home and family situation.
• Develops feeling of trust and believe among community members.
• It permits more realistic teaching in the actual situation.
• Family practices can observe by community health nurse.
• Other members of the family can be contacted who may have greater influence and control on the members.
• It also provides opportunity to look for new health problems.
Disadvantages:• Visits are expensive in terms of time and transport facilities are
required
• Important point to be taken care is that such visits can only be made at times convenient to the client
• The number of people who can be contacted within a given period is limited
• Avoid bias: A tendency may develop to visit some families, with whom good relations have been established, more frequently, at the expense of trying to establish better relations with others and, this situation may result in loss of contact with the community as a whole and cause jealousy and resentment amongst some members of it.
URINE ANALYSIS
Urine analysis : -
•Urine analysis is the analysis of urine in order to find out the presence of sugar, albumin and microorganism.
Purpose : -
To test the evidence of sugar in the urine.
To test the evidence of albumin in the urine.
To test reaction. To test the specific gravity.
Articles required:-• Container for specimen• Benedict solution• Acetic acid• Test tubes & holder.• Kidney tray• Paper bag• Spirit lamp with spirit• Newspaper• Matchbox• Cotton balls in bowl
Procedure : -
• Select a proper place.• Spread the newspaper.• Unbutton the bag.• Take out the kidney tray and specimen bottle• Give the specimen bottle to the client for
collecting urine.• Take out hand washing articles and wash the
hands• Take the articles required for the test.
Test for sugar : -
• Pour 5 ml of benedict’s solution in the test tube.• Boil it to find out the color change, if no change that
shows the purity of benedict’s solution.• Add 8 drops of urine into the solution and reheat it;
allow it to cool.• Observe the color change which indicates the sugar level.– Blue : 0%– Green : 1%– Yellow : 2 %– Orange : 3 %– Brick red : 5%
Test for albumin:-
• Fill the test tube 3/4th with urine, check the reaction, if it is alkaline make it acidic.
• Boil the top portion.• If there is cloudy appearance it indicates
albumin/phosphate.• Add 5 drops of acetic acid & reheat.• If cloud still presents it indicates albumin
presence and if it disappears it shoes phosphate presence.
Termination of articles:-• After the procedure it is essential to terminate
the articles in a proper manner.• After the result, recording & reporting, dispose
the urine sample, as well as the liquid from the used test tube.
• Take the articles to the hand washing area.• Wash each article clearly.• Put the articles on newspaper for drying up.• Wash your hands.
Give health education
Wipe all the articles
with spirit swab
before placing
them in to bag.
After wiping
replace all the articles in to bag.
Close the chain & Pick up the bag.
Fold the newspaper and place it in the out
pocket.