Transcript Slide 1

August 2008
The 3 Guiding Goals of the NFP
Model & Programs are:
1. Improve pregnancy
outcomes
2. Improve child health
and development
3. Improve parents’
economic selfsufficiency
NFP has Strong Theoretical Underpinning
• Self-Efficacy Theory - mother’s ability to change certain
behaviors by learning to draw upon her own strengths
and successes. (Albert Bandura, 1977)
• Human Ecology Theory - the mother’s and child’s social
context are profound influences on the mother’s life.
(Urie Bronfenbrener, 1979)
• Attachment Theory - sensitive parental caregiving is a
major influence on the child’s growing sense of security
in the world. (John Bowlby & Mary Ainsworth, 1991)
NFP Services, Competencies, Education, & Guidelines are
focused on:
The Families most at risk and needing to be
Served were:
 Often teens
 Usually unmarried
Outcomes proven to assist in helping
families achieve health, self-sufficiency,
and early attachment & bonding:
 Improving parental health
 Starting early in pregnancy to achieve
healthy births (16-20 weeks)
 Improving infant and toddler development,
health, & safety
 Assisting Families in moving to SelfSufficiency
 And, creating parental prenatal & infant
attachment & bonding
Key Program Components:
• Serves low-income, first-time parents
and their children
• Nurse Home Visitors are highly
educated, ususally BSN, registered
nurses
• Visits begin early in pregnancy and
continue through the first two years of
the child’s life
• Nurses follow developmentally
appropriate guidelines
• Clinical Information System (CIS)
monitors program implementation
• Powerful relationship fosters client
strengths, oriented around client’s goals
NFP Referrals
• Eligibility:
– First-time pregnant, low-income women, no later than
the 28th week of gestation realistically by the 25th
week. Preferred 16-20 weeks
• Likely referral partners:
– WIC clinics
– Family planning / pregnancy testing centers
– Obstetricians and Pediatricians serving low-income/
Medicaid clients
– Prenatal care providers: clinics, community based
organizations, hospitals
– Schools/School Health Nurses
– Churches
– Self-Referrals
Client Enrollment / Caseload Building
• 1 RN = 25 clients
• 50% enrollment means 1 RN needs 50 referrals
• Critical to take into account client attrition over time
• Bottom line: Agency needs 58 referrals, per nurse, over nine
months to meet caseload expectations
• A four NHV team will need 232 referrals over first nine months
of program replication
What does an NFP Program Look Like?
A typical NFP Program consists of:
• 1 Nurse Supervisor – MSN preferred
• 4 Nurse Home Visitors – BSN preferred
• 1 Administrative Clerical Support Staff
Elements of the Nurse-Family Partnership:
Assuring Model Fidelity
 Services offered make sense to eligible women. Services are flexible and guidelines support
the unique needs and wants of the families.
 Mothers enroll voluntarily early in pregnancy. NFP encourages ideal enrollment between 1620 weeks. This allows time for establishing a relationship that allows for healthy behavior
changes in smoking, diet, substance use, and adequate prenatal health care that impact
positive birth outcomes. The earlier services begin the better.
 Frequent home visits by nurses for 2½ years. Typically home visits occur weekly for the first
4-6 weeks of a participant entering the program, then every other week until the birth of the
baby, then weekly for 4-6 weeks, then bi-weekly until the baby is 2 years old. Home Visitors
and families decide on the visiting schedule that best meets their needs.
 Powerful relationship fosters client strengths, oriented around client’s goals. Nurse Home
Visitors with their clinical and nursing education background are trained in cultural sensitivity,
health, clinical assessment, and partnering with individuals to improve health outcomes.
 In addition to the nursing education that comes with an RN, NFP provides specialized nursing
education in the areas of reflective practice, reflective supervision, and practice coaching.
 NFP has Visit-by-visit guidelines that keep intervention focused while addressing the
uniqueness of each family.
 NFP uses a CIS Reporting System that allows for evaluation tied to achieving fidelity to the
model and comparable outcomes. NFP uses this system to assure that the NFP Services are
in keeping with evidenced based practices.
Educational Domains and Sub-domains
Shared During Nurse Home Visits
What does the National Service Office of
Nurse Family Partnership Do?
 NFP provides specialized nursing education in Denver for all home
visiting staff
 NFP provides technical assistance by nurse consultants, program
managers, and program developers throughout the life of the
program
 NFP provides a data specialist to assist in all data training and
collection needs
 NFP provides ongoing support at state and federal levels to assure
funding for home visiting programs
 NFP works in close collaboration with your state to assure that all
data and program information is shared so that you receive the
necessary to implement a quality evidenced based NFP program
Nurse Family Partnership
In Close Collaboration with IDHS!
We can look at how
We Might Work Together
To Assist Illinois Families
in
Reaching Their Dreams