COMMUNITY HEALTH NURSING FOR HOUSEHOLD RISK ASSESSMENT AND HOME-BASED CARE

Abstract

Community health nursing has long recognized the household as a legitimate and necessary unit of assessment and intervention, extending the reach of the health system beyond the clinic wall and into the lived environment of individuals and families. Two functions sit at the core of this practice. The first is household risk assessment: a systematic, nurse-led process of identifying hazards, vulnerabilities, and unmet needs within the home and family system before they escalate into injury, hospitalization, or crisis. The second is home-based care: the direct delivery of nursing interventions, monitoring, education, and coordination within the client's own residence, rather than within an institutional setting. These two functions are deeply interdependent; assessment without follow-through offers little protective value, while home-based care that is not grounded in a structured understanding of household risk is unlikely to be targeted, safe, or sustainable.

Community health nursing occupies a pivotal position at the interface between the household and the wider health system, translating population-level public health goals into concrete, individualized action within the home. This chapter examines two interlocking dimensions of community health nursing practice: household risk assessment and home-based care. The conceptual foundations of community and home-based nursing, describes structured approaches to identifying risk within the household environment across the life course, and analyzes the models, competencies, and safety considerations that underpin high-quality care delivered in domiciliary settings. Particular attention is given to falls prevention among older adults, self-management of chronic conditions such as hypertension, maternal home visiting, oral health, comprehensive geriatric assessment, transitional care from hospital to home, telenursing, medication safety, and the central role of family caregivers and health literacy.