Diploma of Nursing
HLTEN608B PRACTISE IN THE DOMICILIARY
HEALTH CARE ENVIRONMENT
Impact of Health Problems on Domiciliary Client Care
Assessment
Introduction
As for all nurses, Domiciliary Nurses are entrusted with:
• Client and family information enabling them to
• Recognise and respond to
- Condition changes
- Care needs
- Coping abilities
• Family involvement is encouraged – however should be:
- Co-ordinated as per the care plan
- Timely and responsive
- And incorporate the philosophy and aims of Domiciliary Care
Case Management
Case management is a system of care provision
• commonly used in the domiciliary health care environment.
• That provides cost effective
• client assessment,
• care planning,
• implementation and
• evaluation of provided care,
• ensuring appropriate care
• An EN plays integral role in facilitating the care management process
Case Management
Working with a case manager
e.g. RN, Allied Health Professional ensuring that the care includes:
• Assessment and evaluation
• Client goal directed care planning
• Education for client and family
• Knowledge of available services
• Co-ordination and appropriate referrals
• Accurate documentation (Video 11 minutes) to ensure timely care plan
and goal revision
• Appropriate goal oriented discharge planning
Funnel et al 2009 p80-81
EN: desired qualities and awareness
To provide effective domiciliary health nursing care a nurse must:
• Adapt to different home environments and
• Adapt to client/family responses and perceptions of support and
care.
• Be aware of
• client history and life experiences,
• immediate environment and
• cultural and religious beliefs.
Domiciliary health care environment EN role
Enrolled nurse role in domiciliary care: ‘Job description’
• Work ethically and professionally within scope of practice
• Independently under indirect S/V but seek guidance
• Recognise, respond to clinical manifestations of client health problems
• Communicate effectively with clients/families and allied health team
• Strong organisational and time management skills - self-motivation
• Client and family advocate; Non-judgmental approach
• Adapt care based on client and family needs
• Maintain safety: own and client; adhere to infection control
• Current driver’s license – no restrictions
Confidentiality, Privacy and Trust
Confidentiality and privacy of client information in all situations
• An ethical, professional and legal obligation in domiciliary health
care environment
• Mandatory reporting obligations challenging but essential
Therapeutic relationship:
• open and honest approach to gain and maintain mutual trust
Patient education:
• Explain to client how information is gathered, documented and
• Used in line with service policies and protocols encompassing
• The need to share information with other health professionals such
as the case manager
8
Recognising impact of Health Problem
Initial assessment involves:
• Initial phone call – establishing initial nurse, client, caregiver...
