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Implementing Nurse Family Partnership (NFP)®

Meets DHHS criteria for an evidenced based model

Materials and Forms to Support Implementation

Last Updated

June 2011


Operations Manuals

Reference materials (including handbooks, home visit guidelines, online documents, and CD/DVDs) available through NFP NSO are provided to nurse home visitors and supervisors attending training sessions.


Service Delivery Forms

Required forms are incorporated into the ETO data system.


Assessment Tools

Assessments are incorporated into the home visit guidelines and ETO.



NFP NSO requires nurse home visitors to follow visit-by-visit guidelines; they are instructed to adapt these guidelines to meet the individual needs of families.


Available Languages

NFP materials are available in English and Spanish. Additionally, in service areas with high concentrations of immigrants, local agencies offer services, curricula, and materials in other languages and may employ interpreters.


Fidelity Measurement

NFP NSO monitors data entered into ETO to ensure that the program is meeting fidelity benchmarks. The NFP NSO reports data to agencies to assess and guide program implementation; agencies download these reports at any time and use them to monitor implementation trends. Nurse consultants and regional quality coordinators also monitor program performance. Nurse consultants establish an annual plan for integrating trends and suggest improvements needed in operational efficiency, clinical processes, and quality improvement.


Fidelity Standards

NFP NSO requires implementing agencies to adhere to 18 fidelity standards, including:

  1. Clients participate voluntarily in NFP.
  2. Clients are first-time mothers.
  3. Clients meet low-income criteria at intake.
  4. Clients are enrolled in NFP early in the pregnancy and receive the first home visit by no later than the end of the 28th week of pregnancy.
  5. Clients are visited one to one (one nurse home visitor to one first-time mother and her family).
  6. Clients are visited in their homes.
  7. Clients are visited throughout their pregnancy and the first two years of their children’s lives in accordance with NFP guidelines.
  8. Nurse home visitors and nurse supervisors are registered professional nurses with a minimum of a B.S. in nursing.
  9. Nurse home visitors and nurse supervisors complete core educational sessions required by NFP NSO and deliver NFP with fidelity to the model.
  10. Nurse home visitors use professional knowledge, judgment, and skill and apply the NFP visit guidelines, individualizing them to the strengths and challenges of each family and apportioning time across defined program domains.
  11. Nurse home visitors apply the theoretical framework that underpins the program, emphasizing self-efficacy, human ecology, and attachment theories in their work with clients.
  12. A full-time nurse home visitor carries a caseload of no more than 25 clients.
  13. A full-time nurse supervisor provides supervision to no more than eight individual nurse home visitors.
  14. Nurse supervisors provide nurse home visitors clinical supervision with reflection, demonstrate integration of the theories, and facilitate professional development essential to the nurse home visitor role through specific supervisory activities, including one-to-one clinical supervision, case conferences, team meetings, and field supervision.
  15. Nurse home visitors and nurse supervisors collect data specified by NFP NSO and use NFP reports to guide their practice, assess and guide program implementation, inform clinical supervision, enhance program quality, and demonstrate program fidelity.
  16. NFP implementing agencies are located in and operated by organizations known in the community for being successful providers of prevention services to low-income families.
  17. NFP implementing agencies convene a long-term Community Advisory Board that meets at least quarterly to promote a community support system to the program and to promote program quality and sustainability.
  18. Adequate support and structure are in place to support nurse home visitors and nurse supervisors to implement the program and to ensure that data are accurately entered in the ETO data collection system in a timely manner.



The information contained on this page was last updated in June 2011. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Nurse Family Partnership National Service Office on June 17, 2011. HomVEE reserves the right to edit the profile for clarity and consistency.