Community Mental Health Nursing (RCMN)
ROUTINE HOME VISIT TO A PSYCHIATRIC PATIENT
This is a regular or scheduled visit by the RCPN to the home of a client, family and significant others to provide nursing care. This helps to restore, maintain and promote clients' physical, mental and social wellbeing.
Purpose
- Prevent client from relapsing
- Maintain continuity of care
- Interact with clients and family in their natural environment
- Identify stressors in the environment
- Prevent and or reduce institutionalization and stigmatization
- Maximise client, family and societal level of independence of health or wellbeing
- Ensure compliance
- Build confidence of the client and family
Indications
- A routine or scheduled home review of a psychiatric client receiving community care.
- Ongoing monitoring of treatment adherence, mental state and functional wellbeing.
- A client, family member or caregiver requesting home support or follow-up care.
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 containing the necessary items.
- Arrange means of transportation and confirm the route before departure.
Procedure steps
- Read map of the community and identify the home of the client
- Carry home visit bag containing the necessary items
- Announce your presence, enter on response, greet and introduce yourself to client, family and significant others
- Explain purpose of your visit to client, family and significant others
- Observe the client's environment for cleanliness and safety
- Ensure privacy and confidentiality
- Involve family or significant others in the care of the client
- Identify health needs/concerns of client and family
- Set objectives with client and family or significant others
- Enquire about client's adherence to medications
- Enquire about client's sleep pattern, exercise, elimination pattern, socialization, personal hygiene/grooming and behaviour
- Discuss and suggest possible solutions to needs identified
- Educate on prevailing health issues
- Encourage good interpersonal relationship among client, family and significant others
- Encourage client to adhere to review dates
- Inform client and family of your next visit
- Document the care and findings
- Express appreciation and depart
Precautions
- Confirm the visit plan and client details from the area register before departure.
- Assess personal and environmental safety before and during the visit.
- Respect privacy and confidentiality; involve family or significant others with the client's consent.
- Escalate signs of relapse, self-harm, aggression or deterioration promptly.
- Refer problems beyond scope to the nearest mental health unit or health facility.
Aftercare
- Inform the client and family of the date of the next visit.
- Leave contact details with the client or caregiver for emergencies.
Nursing considerations
- Set realistic objectives with the client, family and significant others.
- Maintain continuity of care through scheduled visits and review dates.
- Involve the family in care while preserving the client's autonomy and consent.
Patient education
- Educate the client and family on prevailing health issues and the signs of relapse.
- Encourage adherence to medications and review dates.
- Encourage good interpersonal relationships among the client, family and significant others.
Documentation
- Document the care provided, findings, education and any referral made 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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