Community Mental Health Nursing (RCMN)
HOME VISIT TO A CLIENT WITH SCHIZOPHRENIA
It is a purposeful visit by the RCPN to the home of client diagnosed with schizophrenia. The nurse renders care with respect to the client's and family identified health needs.
Purpose
- Meet the specific health needs of the client and family in their home environment
- Monitor the progress of treatment, recovery and coping strategies of the family
- Monitor the progress of care rendered to client by caregivers
- Prevent client from relapsing
- Maximise client, family and societal level of independence of health or wellbeing
- Assess and identify stressors in the environment
- Build confidence of the client and family
- Monitor the client's home environment for safety
Indications
- Home visits to a client diagnosed with schizophrenia.
- Monitoring treatment, recovery and family coping strategies.
- Assessing behaviour, safety and adherence to treatment in the home.
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
- 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 and identify the home of the client
- Announce your presence, enter on response, greet and introduce yourself to client, family and significant other
- Establish rapport and enquire about the general health of client
- Approach patient in a calm respectful manner to gain clients confidence
- Involve caregiver in the interactions with client's consent
- Enquire and Counsel on:
- Health of client and relatives
- Occupation and or schooling
- Disease condition to family and other tenants (if necessary)
- Personal and environmental hygiene and safety
- Nutritional status of client
- Enquire from client and family about his habits and activities of daily living
- Assess client's behaviour towards self and others
- Observe for the presence of signs and symptoms of schizophrenia
- Educate client and family on the condition emphasizing on:
- Signs and symptoms of relapse
- Adherence to treatment regimen
- Effective communication
- Good interpersonal relationship
- Educate client's family to be supportive in the care of the client
- Educate and direct client and family to the available social support systems in the community
- Enquire about the family support system available to the client
- Inform client and family about rehabilitation services available in the community
- Explain the importance of adherence to medications and reviews
- Refer problems beyond scope to the nearest mental health 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.
- Involve the caregiver in interactions only with the client's consent.
- Observe for signs and symptoms of schizophrenia and monitor the environment for safety.
- Refer problems beyond scope to the nearest mental health 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
- Assess behaviour towards self and others, and habits and activities of daily living.
- Encourage the family to be supportive in the care of the client.
Patient education
- Educate the client and family on the condition, emphasising signs and symptoms of relapse.
- Educate on adherence to treatment regimen, effective communication and good interpersonal relationships.
- Inform the family about rehabilitation services and 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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