Nursing Component Task
Nursing procedures & clinical learning

Community Mental Health Nursing (RCMN)

HOME VISIT AND OR TRACING THE DEFAULTED CLIENT

It is a purposeful visit by the RCPN to the home of a client who has defaulted in treatment. The nurse identifies factors influencing the default and help resolve challenges identified. She also educates the client and family on the importance of adhering to treatment and reviews.

Purpose

  • Identify factors leading to defaults and manage possible relapse
  • Prevent hospitalization/institutionalisation
  • Educate client and family on the importance adhering to treatment
  • Monitor the progress of treatment, recovery and the coping strategies of the client
  • Assess the client's home environment for safety
  • Prevent or minimize client's level of anxiety
  • Maintain continuity of care
  • Assess and identify stressors in the environment
  • Maximise client, family and societal level of independence of health or wellbeing
  • Ensure compliance
  • Build confidence of the client and family

Indications

  • Visits to identify and trace a client who has defaulted in treatment.
  • Identifying factors influencing the default and resolving challenges identified.
  • Educating the client and family on the importance of adhering to treatment and reviews.

Equipment

  • A Well-Equipped Home Visit Bag
  • Community Map and or GhanaPost Global Positions System (GPS)
  • Manual/electronic area register/ records of the client
  • Means of Transportation

Preparation

  • Identify details of the defaulter using the register.
  • Use the community map or GPS to identify the home of the client.

Procedure steps

  • Identify details of defaulter using register
  • Use community Map and or GhanaPost Global Positions System (GPS) to identify the home of the client
  • Announce your presence, enter on response, greet and introduce yourself to client, family and significant other
  • Establish rapport (refer to procedure) and enquire about the general health of client
  • Explain purpose of your visit
  • Observe environment for cleanliness and safety
  • Ensure privacy and confidentiality by asking client's family to identify a suitable place for the interaction
  • Approach patient in a calm and respectful manner to gain client's confidence
  • Involve caregiver in the interactions with client's consent
  • Identify and make brief assessment of client's health needs
  • Enquire and Counsel client and family on:
  • Health of client
  • Adherence to treatment, reviews and other psychological appointments
  • Occupation and or schooling
  • Disease condition to family
  • Personal and environmental hygiene and safety
  • Nutritional needs of client
  • Enquire about family support system available to client
  • Educate and or direct client and family to social support systems available in the community
  • Encourage family members to always support client with treatment regimen
  • Draw a care plan based on needs identified and set at least three (3) priority care objectives with client and family
  • Discuss needs that can be addressed immediately with client and family and help find solution if possible
  • Educate client and family on prevailing health issues
  • Refer problems beyond scope to the nearest mental health unit or health facility
  • Inform client and family about your next visit
  • Leave your contact with client and or caregiver and encourage them to call in case of emergency
  • Document the care and findings in the report book
  • Express appreciation and depart

Precautions

  • Identify the details of the defaulter using the register before departure.
  • Approach the client in a calm and respectful manner to gain confidence.
  • Ensure privacy and confidentiality by asking the client's family to identify a suitable place for the interaction.
  • Set at least three priority care objectives with the client and family and refer problems beyond scope.

Aftercare

  • Inform the client and family about the next visit.
  • Leave contact details with the client or caregiver for emergencies.

Nursing considerations

  • Identify and make a brief assessment of the client's health needs.
  • Draw a care plan based on needs identified and set at least three priority care objectives with the client and family.
  • Discuss needs that can be addressed immediately and help find solutions.

Patient education

  • Counsel the client and family on adherence to treatment, reviews and psychological appointments.
  • Educate the client and family on the disease condition and personal and environmental hygiene and safety.
  • Direct the client and family to available social support systems in the community.

Documentation

  • Document the care and findings in the report book.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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