Implementing Nurse-Family Partnership (NFP)® Meets HHS Criteria

Implementation last updated: 2019

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Materials and forms to support implementation

Operations manuals

The NSO provides reference materials (including handbooks, home visit guidelines, online documents, and CD/DVDs) to nurse home visitors and supervisors attending training sessions.
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Service delivery forms

The data collection system incorporates required forms.
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Assessment tools

The home visit guidelines and the data collection system incorporate assessments.
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Curriculum

Nurse home visitors provide the NFP intervention through the nursing process, clinical assessment, and individualized goal-setting with the client. Nurses use visit-to-visit guidelines to support clients’ goals and meet the individual needs of families.
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Available languages

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

The NSO monitors data entered into the data collection system to make sure the program is meeting fidelity benchmarks. The NSO reports data to agencies to assess and guide model implementation. Agencies may download these reports at any time and use them to monitor implementation trends and key performance indicators. NSO nurse consultants also monitor program performance and provide support for quality improvement, as needed, to meet fidelity benchmarks.

Implementing agencies and NSO nurse consultants together establish measurable goals to monitor progress in nursing practice, adherence to model fidelity, and operational efficiency. Progress toward these goals is monitored and updated on an ongoing basis and reviewed at least once per year during annual site visits.

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Fidelity standards

The NSO requires implementing agencies to adhere to 19 fidelity standards:

  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, as defined by the clients, or in a location of their choice.
  7. Clients are visited throughout their pregnancy and the first two years of their children’s lives in accordance with NFP guidelines or on an alternative visit schedule agreed upon by the client and nurse home visitor.
  8. Nurse home visitors and nurse supervisors are registered professional nurses with a minimum of a bachelor’s degree in nursing.
  9. Nurse home visitors and nurse supervisors complete all educational sessions that the NSO requires. A site administrator completes the administrator orientation that the NSO requires.
  10. Nurse home visitors use professional knowledge, nursing judgment and skills, screening tools and assessments, frameworks, guidance, and the NFP visit-to-visit guidelines to individualize the program to the strengths and risks of each family and apportion time across defined model domains.
  11. Nurse home visitors and nurse supervisors apply nursing theory, process, and standards of practice, as well as the theoretical framework that underpins the model, emphasizing self-efficacy, human ecology, and attachment theories through current clinical methods.
  12. Full-time nurse home visitors carry a caseload of at least 25 active clients.
  13. NFP implementing agencies employ an NFP nurse supervisor at all times.
  14. Nurse supervisors provide nurse home visitors clinical and reflective supervision, 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 and reflective supervision, case conferences, team meetings, and field supervision.
  15. Nurse home visitors and nurse supervisors collect data specified by the NSO and promptly and accurately enter the data into the NFP data collection system.
  16. Nurse home visitors and nurse supervisors use data and NFP reports to assess and guide program implementation, inform clinical practice and supervision, enhance program quality, and demonstrate model fidelity.
  17. 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.
  18. NFP implementing agencies convene a long-term Community Advisory Board that reflects the community composition and meets at least quarterly to implement a community support system for the program and to promote program quality and sustainability.
  19. Nurse home visitors and nurse supervisors have adequate organizational support and structure to implement the model.
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Implementation notes

The information contained on this page was last updated in October 2019. 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 October 28, 2019. HomVEE reserves the right to edit the profile for clarity and consistency.

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