Home Visiting Nursing and the Omaha System

Introduction to Emily's Experience

• Emily has been a home visiting nurse for one year.
• Feels the job is worthwhile but has daily concerns about the effectiveness of her nursing care.
• Importance of a holistic approach in home visiting nursing.

Introduction of Omaha Man

• Omaha Man offers support to Emily regarding her holistic approach.
• The Omaha System is a tool that describes the nursing process from assessment to evaluation.
• Developed by the Home Visiting Nursing Association in Omaha City, USA.
• Used worldwide, including in the Netherlands where care plans using the Omaha System are covered by national insurance.

Understanding the Omaha System

• Designed to be easily understood, even by non-healthcare workers.
• Helps in planning, practicing care, and evaluating outcomes.

Case Study: Patient A

• Demographics: 93-year-old female, former elementary school teacher, enjoys karaoke, lives with her son.
• Health Issues: Diagnosed with progressing supranuclear paralysis and developed a bed sore.
• Challenges: Difficulty in attending doctor visits and need for home care.

Nursing Problem Analysis

• Omaha System categorizes 40 nursing problems across various domains: environmental, psychosocial, health-related behaviors.
• Focus on the bed sore: Consider the son's lack of experience in caregiving and the patient's living environment.
• Importance of looking at issues in relation to patients' backgrounds.

Assessment Framework

• Use scoring from three dimensions:
  • Knowledge: Level of understanding (e.g., son's lack of knowledge about bed sore care).
  • Behavior: Actions taken to prevent or treat the issue (e.g., no efforts made to change the patient's position).
  • Status: Current condition (e.g., stage 2 bed sore with no infection).
• This approach promotes family independence from medical care.

Nursing Plan and Interventions

• After assessment, select interventions:
  • Four Types of Interventions:
    1. Surveillance
    2. Treatments and procedures
    3. Teaching, guidance, and counseling
    4. Case management (main feature of the Omaha System)
• Collaboration with multidisciplinary teams for holistic care.

Evaluation Process

• Post-care, evaluate the patient's knowledge, behavior, and status to measure improvements.
• Reflects the effectiveness of care provided.
• Helps Emily plan future care more effectively.

Features of the Omaha System

1. Covers all aspects needed for holistic home visiting nursing.
2. Makes patient and family improvements more visible.
3. Enhances understanding of care effectiveness, allowing for deeper discussions among multidisciplinary staff.
4. Visualizes nursing processes in an easily understandable way.

Conclusion

• Emily feels encouraged to start using the Omaha System to enhance her nursing practice.