class 10 Flashcards

1
Q

home visit

A

provision of CHN care where the individual/family reside

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2
Q

home visit referral process

A

-referral from social or health agency (may be mandatory)
-request from family members/self referral

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3
Q

3 types of home visits

A

initial routine visit
subsequent routine visit(if needed)
-emergency crisis intervention visit

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4
Q

contacting phase of home visit coordination

A

-liason nurse(hospital) make referral during discharge planning
-intake coordinator take info
-nurse contacts client
-preparing for the visit (supplies, nursing bag, house/client details, resource info)

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5
Q

entry phase of home visit

A

-going-to-see phase to seeing phase
-assessment, planning, and intervention
-removing shoes & applying “indoor” shoes
-work as a resource to client/family

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6
Q

2 forms of termination phase of home visit

A

-ending of home visit or cessation of services
-referral and documentation
-evaluate/document interventions
-give contact info
-discuss next visit/cessation of visits

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7
Q

advantages of home visit

A

-dignity for client
-environmental/SDOH visible
-family visible
-accessibility/no travel costs for client

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8
Q

disadvantages of a home visit

A

-safety of the nurse
-adequate equipment/supplies
-no extra staff/second opinion
-may be more time consuming (travel, set-up/down etc)
-client may not be home/may not allow nurse in
-fear of pets

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9
Q

stages of a home visit - #1 planning

A

-deciding best place to meet(home or clinic)
-review agencies policy on meetings
-contact family
-inform how they were referred to cHN
-arrange a time that is most convenient for most family members
-confirm date/time/place/ or directions

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10
Q

advantages of meeting at clinic

A

-can see more clients in shorter time
-more cost-effective than home visits
-access to other HCPs
-avoid intense/unsafe family interactions

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11
Q

disadvantages of meeting at clinic

A

-not able to assess home/neighborhood/community
-may not access family members/natural interactions
-limited access to cultural/religious traditions
-may be a burden to client

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12
Q

eastern health responsibilities of client for home visits

A

-no smoking 1h before/during visit
-animals must be controlled
-firearms placed in a locked cabinet
-staff will be required to wear footwear
-walkway free of ice/snow

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13
Q

what if the client refuses the visit?

A

-review the referral info
-explore reasons for referral
-offer to meet elsewhere
-inform case manager/physician

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14
Q

what if a client refuses a visit that ISNT mandatory?

A

-accept clients right
-inform Dr
-inform cline you will contact them in a few days to reassess need for home visits
-document

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15
Q

what if the client refuses a visit that IS mandatory?

A

-inform client it is mandatory
-if refusal continues, inform client supervisor will need to be involved
-follow agency policy regarding follow up

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16
Q

4 safety features for nurse during home visits

A

-can refuse unsafe visits/bring a 2nd nurse
-staff safety risk assessment tool
-safety line: can check-in/check-out of visit

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17
Q

stages of home visit - #2 engagement stage

A

-provides professional identification & tells the client the location fo the agency
-engages in a brief social conversation to help establish rapport
-describes his/her role, responsibilities, and limitations
-determines the clinet’s expectations

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18
Q

stages of home visit - #3 assessment phase

A

family assessment: a systematic assessment process by which the CHN identifies family health concerns and strengths using CFAM, friedman, McGill

19
Q

stages of home visit - #4 intervention stage

A

-calgary family intervention model(CFIM)
-mutual goal setting and care planning with a family’s approach
-if interventions are needed post-assess CHN will use CFIM
- can only OFFER interventions, do with that what they will (no instruction, direct, demand, insist)

20
Q

family nursing interventions

A

-direct care
-teaching
-anticipatory guidance
-coordinator of care
-advocacy
-therapeutic conversation
-commendation of strengths
-child protection
-normalizing situations
-crisis intervention
-caregiver support
-referrals

21
Q

the calgary family intervention model (CFIM)

A

-the first nursing family intervention model, accompanies CFAM.
-CFIM focuses on promoting, involving, and sustaining effective family function in 1-3 areas: cognitive, affective, and behavioural
-interventions need to be tailored to each family & chosen area

22
Q

cognitive domain of CFIM

A

-offer commendations, information, our opinion

23
Q

affective domain of CFIM

A

-validating or normalizing emotional responses
-encouraging illness narratives

24
Q

behavioural domain of CHN

A

-encouraging family supports
-supporting family caregivers
-encouraging respite

25
Q

contracting with families

A

continuously negotiable agreement between 2+ parties
-can be written, signed, revised
-involves a shift in responsibility towards control/shared effort by client and CHN
-involves family in nursing process
-made with all responsible and appropriate members of the family

26
Q

contracting with families - beginning phase

A

1.mutual data collection and exploration of needs and problems
2.mutual establishment of goals
3.mutual development of a plan

27
Q

contracting with families - working phase

A

4.mutual division of responsibilities
5.mutal setting of time limits
6.mutual implementation of plan
7.mutual evaluation and renegotiation

28
Q

contracting with families - termination phase

A

8.mutual termination of contract
-provides a smooth transition and closure to family and CHN

29
Q

advantages of contracting with families

A

-gives direction and structure when working with families
-reinforces the commitment on both parties

30
Q

disadvantages of contracting with families

A

-requires time and effort
-requires willingness for increased responsibility on the part of the family
-nurse may be reluctant to relinquish control
-is not appropriate in all situations

31
Q

mutual goal setting and care planning with families

A

-involves shift in responsibility toward a shared client and CHN effort
-family control to increase healthful choices
-formally involves family in care plan

32
Q

Beginning phase of goal setting with families

A

-mutual data collection and exploration of needs and problems
-mutual establishment of goals
-mutual development of a plan

33
Q

working phase of goal setting with families

A

-mutual division of responsibilities
-mutual setting of time limits
-mutual implementation of plan
-mutual evaluation and renegotitation

34
Q

stages of a home visit - #5 termination & evaluation

A

mutual termination of working relationship
-purpose of visit has been accomplished, CHN reviews whats has occured/been accomplished
-phase provides basis for evaluating if further home visits are needs or referrals to community resources are required

35
Q

stages of a home visit - #6 post-visit documentation at the office

A

-debrief emotions and stress
-reinforce objectives of care/care provided
-review knowledge/information
-enhance critical thinking and problem solving
-foster reflective thinking

36
Q

post-visit documentation may consist of:

A

-narratives
-flow sheets
-problem orientated medical records
-subjective and objective assessment plans
-combination

37
Q

health risk

A

the factors that determine or influence whether disease or other unhealthy results occur

38
Q

social risk

A

risky social situations that can contribute to the stressors experienced by families

39
Q

health risk reduction

A

assumption that decreasing # of risks or magnitude of risk will result in lower probability of the event occuring

40
Q

family crisis

A

occurs when family is not able to cope with an event and becomes disorganized
-attempt to gather their resources to deal with demands created

41
Q

family empowerment

A

-used to promote and protect the health of families, encourage autonomy, provide families w info to actively involve them so they can make informed choices

42
Q

empowered family seeking help

A

-access and control over needed resources
-deicison-making and problem solving abilities
-abilities to communicate and obtain needed resources

43
Q

empowerment requirements for intervention

A

-directed towards the building of nurse/family relationships
-emphasizes health risk reduction and health promotion

44
Q

family resiliency

A

-the ability to cope with expected and unexpected stressors
resilient families will:
-recognize and draw on their strengths to cope
-choose adaptive responses to restore equilibrium
-maintain positive outlook
-work together to find solutions
-have flexible roles to deal with stressors
-maintain routines; functions are achieved
-reach out for support as needed