Family Case Study Presentation

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Family Case Study Presentation

• Trina Boddez-Chiu and Tracy Cameron

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Definition of a Home Visit

• No-cost health education and social services
  assistance to infants and their families

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The purpose of home visits

• A source of support for mothers regardless of
  race/ethnicity or economic status
• Link infants with a healthcare provider
• Ensure that the family is coping well to the new
  addition in the family.
• Increase parenting knowledge that will promote
  the well being of the infant

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Home Visit 1- Engagement

• I introduced myself and my partner and explained
  the home visit process with her.
• I reassured her that her twin sister was welcome
  to join in on the teaching and that I would
  schedule our home visits to be worked around
  their other commitments.
• Developed a trusting relationship.

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Assessment

• I used the McGill model as a guideline and in
  particular the McGill models 5 inquiry
  questions.

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What is the family dealing with?

• We discussed how the family is coping with caring
  for Hailee and Ty.
• The family works together to take care of Hailee
  and Ty yet continue with their personal lives and
  other commitments such as their jobs.

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What does the family want?

• To optimize Hailee and Tys cognitive and
  physical development is Trinas 1 health goal.

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How are they going about it?

• The family organizes their time effectively and
  have are very supportive towards one another.
• Trina takes care of both Hailee and Ty while
  Tracy works at the Hair Salon they own next door.
  
• Their husbands are very supportive in helping to
  care for Hailee and Ty regularly and try to give
  Trina and Tracy breaks.
• Their mother often drops by to help babysit
• Their best friends daughter also helps to
  babysit.

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What is their potential to develop and find
healthier ways of living?

• The family has a very high potential because they
  motivated to do whats best for Hailee and Ty.

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What resources are they making use of and what
others could be mobilized?

• They have read books about child growth and
  development
• They visit the St. Albert Health Unit regularly
  for the childrens immunizations.

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Calgary Family Assessment Model

• I made an ecomap to assess external structure and
  context by depicting Trinas contact with larger
  systems.
• I assessed the quality of her relationships with
  family, friends, the neighbours, the church,work
  and health services.
• I assessed them as sources of support.

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Safety- assessment

• They have started to lock cupboards and drawers
  in the kitchen.
• They keep Ty away from the kitchen when they are
  cooking
• They have baby gates to prevent Ty from falling
  down the stairs
• They keep only bamboo and plastic plants in the
  house.
• They have baby monitors that will sound an alarm
  if the baby stops breathing.

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Growth and Development Assessment

• I assessed Hailee and Ty for the age specific
  milestones through discussion with Trina and
  Tracy.
• I also assessed them through observation.

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Speech-Assessment

• They played music while Hailee and Ty were still
  in the womb and still play music from the radio
• Trina uses speech techniques such as talking
  about everything Hailee does
• Trina makes farm animals sounds with Ty
• Trina sings many songs to Hailee and Ty

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Solid foods Assessment

• I assessed Tys eating habits according to Trina
  and Tracy by asking them questions about which
  foods hes already tried and his responses to
  them

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Planning

• We collaborated and prioritized which four 4
  topics she would like me to teach her about. She
  would tell me her concerns and health goals and
  then I would ask her if she would like me to
  teach about a particular one.

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Implementation

• Growth and Development
• I used the child development chart and All about
  Me pamphlets from capital health to teach about
  the major milestones for Hailee and Ty.
• I taught them about various toys and activities
  they could do with Hailee and Ty to help with
  growth and development regarding visual,
  auditory, tactile and kinetic stimulus that is
  categorized into appropriate age groups.

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Implementation

• Safety
• I taught them about the common injuries that
  occur at Hailee and Tys age group
• I briefly talked about car seat safety but Trina
  said she would take them to the car seat
  inspection at the fire hall
• I taught them about the hazards of things that
  could easily fall on Ty

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Implementation-Cont

• I made and taught from a handout about sudden
  infant death syndrome
• I talked to them about keeping poisons locked
  away and gave them a checklist as homework to see
  how many poisons there are in their home and to
  take action to locking it away.
• I encouraged them to continue to take safety
  measures around the home and keep a watchful eye.

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Application of the McGill Model

• I encourage active participation.
• I ask them which topic they would like to start
  with first.
• I brought an interactive book so that I could
  role model some techniques used to facilitate
  speech and then I asked Trina since she was
  holding Hailee to do a return demonstration.

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Application of the McGill Model

• During the second home visit, I talked to them
  about keeping poisons locked away and gave them a
  checklist that I encouraged they do as homework
  to see how many poisons there are in their home
  and to take action to locking it away.
• On the third home visit, I evaluated the
  intervention by asking them about it. They had
  done their homework and were surprised to find
  how many things were poisonous. They took
  measures to lock the poisons up.

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Application of the McGill Model

• I focused on their strengths.
• One of their biggest strengths is their
  motivation to help Hailee and Ty. In the initial
  assessment they told me that they read a book
  that tracks growth and development on a weekly
  basis so I felt that handouts would be
  appropriate since I felt they would read them.

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Application of the McGill Model

• I collaborated with my home visit clients by
  helping them identify and prioritize topics that
  would be good for teaching.
• I collaborated with my them in the
  implementation stage. I suggested various
  implementations and they decided which ones they
  would like to try. I tried not to force anything
  on them.

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Application of the McGill Model

• I asked them some of the things they do to
  already facilitate speech and cognitive
  development. I also asked what safety measures
  have they already implemented and which foods is
  Ty currently eating.
• I focused on health promotion.

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Application of the McGill Model

• I empowered by home visit clients to take action
  in preventing injuries around the home and in the
  betterment of their childrens growth and
  development physically and cognitively.
• I used my knowledge base to be a health resource
  for my home visit clients. I taught them about
  their topics of choice but I also had the
  opportunity to provide information about other
  topics of concern such as teething, dental
  hygiene, and prevention of ear infections.

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Application of the McGill Model

• I focused on the family rather then just one
  person. I made the interventions applicable to
  both Trina and Tracy and encouraged them to talk
  to their husbands about some of the interventions
• I also promoted family activities

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Calgary Family Intervention Model

• The family had started to baby proof the home and
  knew of many of the recommended safety measures
  however there were still some safety hazards.
• I encouraged that they implement the safety
  measures as soon as they can especially since Ty
  was already very mobile.

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Calgary Family Intervention Model

• By giving them information about the seriousness
  of safety hazards, giving them homework to see
  for themselves the safety risks around the home
  and providing encouragement they seemed to really
  take control of the situation and put safety
  measures into action.
• Thus I helped them realize that child safety is a
  serious matter which affects family functioning
  in the behavioral domain.

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Evaluation Techniques

• I evaluated my teaching by asking them about if
  they did the activities I suggested in the
  previous visit.
• I also evaluated my teaching by assessing the
  changes they have made since my last home visit.

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Evaluation Techniques

• I also evaluated my teaching by asking them to
  fill out evaluation forms I made.
• On the evaluation forms there is a rating system
  as well as a written portion for feedback on
  things I could have done differently.
• I also evaluated my teaching through self
  reflection.

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Evaluation

• I feel that my overall performance was good. I
  really enjoyed creating a effective nurse client
  relationship and being a health resource for my
  home visit clients.
• I could improve on assessing my home visit
  clients better before teaching. Next time I will
  ask them before I start what they are currently
  doing.

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Teaching Techniques

• I made summary handouts and made the color
  coordinated the font according to the category
  and I added pictures relating to the topic to
  keep my home visit clients attention.
• I asked them if they had any questions about the
  topics afterwards.
• I ask them if they have any questions or concerns
  in general that I can try to answer.

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Teaching Techniques

• I specified my teaching towards the age groups of
  Hailee and Ty to help with time management as
  well as make the teaching presently applicable.
• I provided additional All about Me pamphlets as
  a resource for future reference.
• I provided the capital health website at the
  bottom the summary handout so they could refer to
  it for further information in the future.

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Communication Techniques

• I sat across from them so that I could make eye
  contact and create enough personal space between
  the clients and myself.
• I talked clearly and paused if they stopped to do
  something. I asked them if it would be alright if
  I continued when they had something to do that
  was time consuming.

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Communication Techniques

• I actively listened to my home visit clients
  stories and responses to my questions.
• I used encouraging responses to praise them for
  what they were doing right.
• I used summarization so I could recap on the main
  points

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Taking from experience

• The nurses that Ive worked with have used the
  McGill model in the way they have each focused on
  health promotion and have used their wealth of
  knowledge to be a health resource for the client.
  This is a role that Ive played in my home
  visits.
• In clinic,the nurses assess what the client
  already knows about the diseases that are being
  vaccinated so they dont teach the client
  something they are uninterested about.

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Self Evaluation

• I will improve on time management. I will predict
  how much time each topic will take beforehand so
  I can plan the flow of the home visit better.
• I will improve on evaluation of my teaching. I
  will ensure that I get feedback each time from
  the client, my partner in addition to self
  reflection.

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References

• Clark, M. Olson, J. (2000). Nursing within a
  faith community Promoting health in times of
  transition (pp. 83-90). Thousand Oaks, CA Sage.
• Leeseberg Stamler, L., Yiu, L.(2005).
  Community health nursing A canadian
  perspective. Toronto Prentice Hall

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References

• Potter, P. S., Perry, A. G. (2001). Canadian
  fundamentals of nursing (2nd ed.). (J.C.
  Ross-Kerr M.J. Wood, Canadian Eds.) Toronto
  Mosby.

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THE END

• By Grace Han