Nursing Component Task
Nursing procedures & clinical learning

Community Mental Health Nursing (RCMN)

HOME VISIT TO A CLIENT WITH ALCOHOL/OTHER SUBSTANCE ABUSE

It is a special visit made by the RCPN to the home of a client diagnosed with alcohol and or substance abuse. The nurse renders care with respect to the client's/family identified health needs.

Purpose

  • Promote rehabilitation and reintegration of the client back to society
  • Monitor client's adherence to treatment and recovery
  • Educate client on coping strategies for withdrawal symptoms
  • Assess the client's home/work environment for safety
  • Meet the specific needs of clients in their home/work environment
  • Interact with client, family and significant others in their natural environment
  • Prevent client from relapsing
  • Maintain continuity of care
  • Assess, identify and manage stressors in the environment
  • Maximise client, family and societal level of independence of health or wellbeing
  • Ensure compliance
  • Build confidence and boost self-esteem of the client and family

Indications

  • Home visits to a client diagnosed with alcohol or other substance abuse.
  • Promoting rehabilitation and reintegration of the client back into society.
  • Educating the client on coping strategies for withdrawal symptoms.

Equipment

  • A Well-Equipped Home Visit Bag
  • Community Map and or GhanaPost Global Positions System (GPS)
  • Area Register
  • Means of Transportation

Preparation

  • Read the community map or GPS and identify the home of the client.
  • Carry a well-equipped home visit bag and arrange transportation.

Procedure steps

  • Read map of the community to identify the home of the client
  • Announce your presence, enter on response, greet and introduce yourself to client, family and significant others
  • Explain the purpose of your visit
  • Establish rapport (refer to procedure) and enquire about the general health of client
  • Approach client in a calm and respectful manner to gain his confidence
  • Ensure privacy and confidentiality by asking client to identify a suitable place for the interaction
  • Involve caregiver in the interaction with the consent of client
  • Assess and Identify the underlying factors and or reasons for client's addiction
  • Enquire and Counsel on:
  • Health of client and relatives
  • Occupation and or schooling
  • Disease condition and signs of relapse to the family and or significant others
  • Personal and environmental hygiene needs and safety
  • Nutritional status of client
  • Sleep pattern
  • Enquire about the role of client in the family
  • Draw a care plan to manage the problems identified
  • Teach and encourage family/caregivers on the need to be supportive
  • Encourage family to be observant and be with the client so as to provide the needed support when necessary
  • Inform client and family about other psychotherapies and social support systems available such as Rehabilitation centres, Addiction Disease Unit, Detoxification Unit, self-help groups, NGOs etc.
  • Teach client to use the various coping strategies such as relaxation and cognitive restructuring techniques
  • Encourage family or caregiver to reinforce positive behaviour through the use of behaviour modification techniques
  • Educate client on ways to withdraw gradually from the substance
  • Educate client and family on the condition emphasizing on:
  • Signs and symptoms of relapse
  • Adherence to treatment regimen
  • Effective communication
  • Good interpersonal relationship
  • Encourage client to avoid friends and places where substance are available and accessible
  • Refer problems beyond scope to the nearest unit or health facility
  • Inform client/family about your next visit
  • Leave your contact with client/caregiver and encourage them to call in case of emergency
  • Document the care and findings in the report book
  • Express appreciation and depart

Precautions

  • Approach the client in a calm and respectful manner to gain confidence.
  • Assess and identify the underlying factors or reasons for the client's addiction.
  • Involve the caregiver in the interaction only with the client's consent.
  • Refer problems beyond scope to the nearest unit or health facility.

Aftercare

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

Nursing considerations

  • Enquire about the role of the client in the family and the family's support system.
  • Inform the client and family of psychotherapies and social support systems such as rehabilitation and detoxification units.

Patient education

  • Teach the client coping strategies such as relaxation and cognitive restructuring techniques.
  • Educate the client on ways to withdraw gradually from the substance.
  • Encourage the client to avoid friends and places where substances are available and accessible.

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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