This is a purposeful visit by the RCPN to the home of a client suffering from postpartum depression. The nurse renders care to the client, baby, husband and the family with respect to their specific health needs.
Aims
· Meet the specific health needs of the client, baby, husband/partner and family in their home environment
· Monitor the progress of treatment, recovery and the coping strategies of the client
· Assess client’s home environment for safety to prevent suicide and or infanticide
· Prevent recurrence
· Assess and identify stressors in the environment
· Maintain continuity of care
· Maximise client, family and societal level of independence of health or wellbeing
· Ensure compliance
· Build confidence of the client and family
Requirements
· 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
Steps
1. Read map of the community to identify the home of the client
2. Announce your presence, enter on response, greet and introduce yourself to client, family and significant others
3. Explain the purpose of the visit to client, husband/partner and family
4. Establish rapport (refer to procedure) and enquire about the general health of client and baby
5. Approach client in a calm and respectful manner to gain her trust
6. Ensure privacy and confidentiality by asking client and family to identify a suitable place for the interaction
7. Involve caregiver in the interaction with the consent of client
8. Educate and Counsel client, husband/partner and family on:
· Health of client and baby
· Occupation and or schooling
· Disease condition
· Possible recurrence after each delivery
· Personal and environmental hygiene needs and safety
· Nutritional status of client and baby
· Sleep pattern
· Underlying medical conditions/infections
9. Assess client’s level of depression and other psychotic symptoms
10. Enquire from family and husband any history of alcohol and or substance use
11. Enquire from husband/partner and family about client’s activities of daily living
12. Enquire from husband/partner and family about contact hours of client with her baby
13. Encourage the family members to identify a surrogate for the baby if necessary
14. Educate surrogate on the care of the baby
15. Refer mother and baby to the social welfare department for assistance if necessary
16. Encourage husband/partner and family to show love and affection
17. Advise husband/partner to provide physical and financial support
18. Educate family members on suicidal cues
19. Refer client and husband/partner to a family planning clinic
20. Educate client, husband/partner and family on the condition with emphasis on:
· Signs and symptoms of relapse
· Adherence to treatment regimen
· Effective communication
· Good interpersonal relationship
21. Refer client, husband/partner and family for psychotherapy
22. Counsel husband/partner and family members not to leave baby alone with client
23. Educate husband/partner and family on client’s self-harm and possible infanticide
24. Refer problems beyond scope to the nearest unit or health facility
25. Inform client/family about your next visit
26. Leave your contact with client/caregiver and encourage them to call in case of emergency
27. Document the care and findings in the report book
28. Express appreciation and depart
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