Nurse-Family Partnership (NFP)®

The Nurse-Family Partnership (NFP) is designed for first-time, low-income mothers and their children. It includes one-on-one home visits by a trained registered professional nurse to participating clients. The visits begin early in the woman’s pregnancy (with program enrollment no later than the 28th week of gestation) and conclude when the woman’s child turns 2 years old. NFP is designed to improve (1) prenatal and maternal health and birth outcomes, (2) child health and development, and (3) families’ economic self-sufficiency and/or maternal life course development. 

This report also includes a review of an alternate implementation of NFP, which had paraprofessionals, rather than nurses, conduct the home visits. The paraprofessionals received the same length of training as the nurses and carried the same caseloads, but had a higher supervisor-to-home visitor ratio.

For more information, see the research database. For more information on the criteria used to rate research, please see details of HomVEE’s methods and standards.

Nurse-Family Partnership^® (NFP) is a home visiting model shaped by attachment theory, human ecology theory, and social-cognitive or self-efficacy theory. The model is client-centered, and client-identified goals drive it. NFP nurse home visitors use input from parents, nursing experience, nursing practice, and model-specific resources – coupled with the principles of motivational interviewing – to promote low-income, first-time mothers’ health during pregnancy, care of their child, and own personal growth and development.

The NFP model includes one-on-one home visits between a registered nurse educated in the NFP model and the client. The NFP nurse home visitor visits the client in her home (permanent or temporary), as defined by the client, or in a location of her choice.

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.

NFP is designed for first-time, low-income mothers and their children. Mothers may invite fathers and other family members to participate in home visits.

NFP requires a client to be enrolled in the program early in her pregnancy and to receive a first home visit no later than the end of the woman’s 28th week of pregnancy. Services are delivered until the child is 2 years old.

Nurse-Family Partnership^® (NFP) is a home visiting model shaped by attachment theory, human ecology theory, and social-cognitive or self-efficacy theory. The model is client-centered, and client-identified goals drive it. NFP nurse home visitors use input from parents, nursing experience, nursing practice, and model-specific resources – coupled with the principles of motivational interviewing – to promote low-income, first-time mothers’ health during pregnancy, care of their child, and own personal growth and development.

NFP is supported by the Nurse-Family Partnership National Service Office (NSO), a Denver, Colorado-based national nonprofit organization. The NSO helps states and communities implement and sustain NFP.

NSO nurse consultants provide regular, ongoing coaching and consultation to implementing agencies and nursing supervisors on model fidelity, organizational capacity, organizational culture, nursing practice, nursing management, establishing and retaining caseloads, use of data to improve practice, community linkages and program sustainability, and participation in research.

In addition, the NSO provides technical support in 10 areas: (1) orientation to the model and its implementation and evaluation requirements; (2) community planning; (3) selection of implementation agency or entity; (4) staff recruitment, retention, consulting development, education, and coaching; (5) model implementation; (6) continuous quality improvement; (7) research; (8) evaluation; (9) contracts; and (10) marketing and communication.

NFP is designed for first-time, low-income mothers and their children. Mothers may invite fathers and other family members to participate in home visits.

NFP requires a client to be enrolled in the program early in her pregnancy and to receive a first home visit no later than the end of the woman’s 28th week of pregnancy. Services are delivered until the child is 2 years old.

The NFP model includes one-on-one home visits between a registered nurse educated in the NFP model and the client. The NFP nurse home visitor visits the client in her home (permanent or temporary), as defined by the client, or in a location of her choice.

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.

NFP nurses partner with their clients to determine the content and frequency of visits. NFP nurses assess their clients using the NFP Strengths and Risks Framework at every visit. Visit frequency is flexible and content is adapted to meet the needs of the client based on the client’s strengths, risks, and preferences. Home visits typically last 60 to 75 minutes.

The NFP program begins as early as possible in pregnancy, but not later than the end of the 28th week of pregnancy. Clients complete the program when the child turns 2 years old.

With input from tribal communities, NFP has modified its outreach materials for tribal communities to reflect tribal members. In addition, NFP nurses participate in a community of practice with an internal consultant with expertise working with tribal communities.

Model developer Dr. David Olds at the Prevention Research Center at the University of Colorado oversees adaptations to the model in collaboration with the NSO. Two adaptations are available. Implementing agencies may request to (1) enroll clients after the 28th week of gestation, and (2) serve clients who have had a previous live birth. Dr. Olds and the Prevention Research Center also manage requests for enhancements to the model.

The NSO does not specify a type of agency that can implement the model. It does require, however, that implementing agencies be organizations known in the community for providing prevention services to low-income families. All agencies that want to implement NFP must submit an implementation plan demonstrating that the organization is prepared to implement the model with fidelity.

The NSO requires implementing agencies to adhere to 19 fidelity standards. Please contact the model developer for additional information about these standards.

Implementing agencies must have four types of staff: (1) nurse home visitors who conduct home visits with families, (2) nursing supervisors who supervise nurse home visitors, (3) an administrative assistant who manages data entry and other administrative tasks, and (4) a site administrator who oversees implementation of the model and sustainability of the program.

The NSO requires that nurse home visitors and nursing supervisors be registered professional nurses with a minimum of a bachelor’s degree in nursing. The NSO prefers that supervisors have a master’s degree in nursing.

Nursing supervisors provide nurse home visitors with clinical and reflective supervision and facilitate professional development essential to the nurse home visitor role. Clinical supervision involves discussing topics such as client care and how to translate into practice the theories on which NFP is based. During reflective supervision, the supervisor and nurse home visitor discuss the nurse home visitor’s work with clients, the impact of the work on the nurse home visitor, and strategies to strengthen the nurse home visitor’s client relationships. Supervisory activities include one-on-one clinical and reflective supervision, case conferences, team meetings, and field supervision. NSO nurse consultants regularly meet with nurse supervisors, by teleconference, video conference, and in person, to support operational efficiency, clinical practice, quality improvement, and implementation fidelity through collaborative data analysis, goal setting, and monitoring of progress.

The NSO requires that nurse home visitors complete three core education sessions, in both distance and in-person training formats. The sessions take place over about nine months. Nursing supervisors must complete the same core education sessions as the nurse home visitors. They also must complete four introductory education sessions designed for supervisors, including two in-person sessions. Please contact the model developer for additional information about the pre-service training requirements.

Supervisors receive topical, electronic team meeting education modules to use based on the training needs of their nursing teams. In addition, the NSO nurse consultant supports supervisors to create professional development plans for each nurse home visitor and to use the expertise of other professionals in their communities to meet unique team learning needs. Agencies and supervisors also have access to reports that support quality improvement by making data analysis and program performance monitoring more accessible and user-friendly. Please contact the model developer for additional information about the ongoing professional development requirements.

Nurse-Family Partnership
National Service Office
1900 Grant Street, Suite 400
Denver, CO 80203

Phone: (866) 864-5226
Fax: (303) 327-4260

Email:
 info@nursefamilypartnership.org
Website:
 http://www.nursefamilypartnership.org