Implementing Nurses for Newborns®

Model implementation summary last updated: 2015

The information in this implementation report 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 manuscripts 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. Please see the Effectiveness button on the left for more information about any research on the effectiveness of the model, including any version(s) of the model with effectiveness research. Versions of the model that are described in the Adaptations and enhancements section of this implementation report may include (1) versions that were identified by the model’s developer and (2) versions that have been implemented by researchers and have manuscripts that HomVEE rated high or moderate, but that are not supported by the model’s developer.

Model overview

Theoretical approach

NFN was founded in 1991 in response to the frequency with which newborns were being seen in the emergency department within a few days following their birth or discharge from the special care nursery. NFN is based on the premise that home visits to pregnant and postpartum women and families by NFN-trained nurses can help reduce infant mortality, child abuse, and neglect by monitoring child health and educating and supporting parents.

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Implementation support

Nurses for Newborns (NFN), a nonprofit, community-based organization, developed and administers a maternal and child health home visiting program of the same name. NFN is headquartered in St. Louis, Missouri, with a satellite program in Nashville, Tennessee. The St. Louis office provides implementation support for both program sites.

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Intended population

NFN provides services to pregnant and postpartum women and families with children up to age 2 who reside within select counties in eastern Missouri and central Tennessee. The program targets families with medically fragile infants, teenage mothers, parents with mental health concerns or intellectual or physical disabilities, and families with limited resources.

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Targeted outcomes

The program aims to decrease poor birth outcomes, prevent child abuse and neglect, reduce infant injuries and preventable hospitalizations and emergency department visits, increase immunization rates, and connect families with community resources.

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Model services

NFN consists of home visits with a nurse who conducts maternal and child health and developmental assessments, and screens for risk factors such as maternal depression, stress, and domestic violence. During prenatal visits, the nurse discusses maternal health and well-being, including nutrition, substance use, and access to routine prenatal care and needed resources. After delivery, the NFN nurse works with the family to develop an action plan for the infant’s health, safety, and optimum development. In subsequent visits, the nurse monitors the infant’s health and developmental progress and the family’s implementation of the action plan. Nurses may also present educational topics designed to address identified issues, build on family strengths, and enhance parenting skills.

The program maintains a donation bank and can provide families with items such as baby clothes, toys, diapers, blankets, portable cribs, and formula as needed. Nurses may also refer parents to other community resources identified through the NFN resources and agencies database, which is updated regularly.

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Model intensity and length

NFN offers services based on an overall assessment of the needs of the child and family, rather than on a set number of visits. Ideally, visits are initiated prenatally and are offered more frequently following the child’s birth. Some families receive only a few visits, whereas others receive services until the child’s second birthday. Generally, prenatal home visits occur once per month. Following delivery, visits occur weekly for four weeks, twice in the infant’s second month of life, and then once per month until the child’s second birthday. The number of visits may increase depending on the severity of family need. Home visits typically last 60 to 75 minutes. Families may contact their nurse home visitor between visits by telephone or text message.

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The program is implemented in 20 eastern Missouri counties and six central Tennessee counties.

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Adaptations and enhancements

In areas where funding is available, NFN community health workers (CHWs) and a licensed clinical social worker (LCSW) are also available to support families. The CHW provides language interpretation, peer support, and aid in navigating and accessing available resources. The LCSW assists families with extensive environmental or mental health needs, which are not covered by the nurse home visitor, and provides in-home cognitive-behavioral therapy. The CHW and LCSW work collaboratively with the nurse to serve the family. A CHW or LCSW typically visits families once per month for approximately 60 to 75 minutes. Families may contact their CHW or LCSW between visits by telephone or text message.

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Implementation notes

The information contained on this page was last updated in June 2015. Recommended further reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by Nurses for Newborns in May 2015. HomVEE reserves the right to edit the profile for clarity and consistency.

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