Opportunities for Workforce Development Among Nurses in the Nurse-Family Partnership Program

Background: Nurse-Family Partnership (NFP) is an evidence-based nurse home-visitation program designed to improve the health and development of low-income first-time mothers and their babies. This study examined aspects of the NFP workforce including educational and professional backgrounds of nurses and nurse supervisors, how they interacted with diverse clients, their knowledge about community resources, and opportunities for further education and training.

Methods: A multiple case study using a grounded theory approach was conducted through 122 interviews including NFP nurses (41%), Child Protective Services (CPS) workers (50%), and other stakeholders (9%) across 14 Colorado counties. Analysis was conducted using NVivo 10. Validation steps included coding consistency statistics and expert reviews.

Results: Nurses and nurse supervisors shared about varying opportunities for their professional development. Many nurses stated that they struggled with adapting the curriculum to fit cultural norms, considering potential cultural differences when conducting assessments, and building trust with culturally diverse communities and that they relied on informal opportunities to learn about cultural norms around post-pregnancy traditions. Many nurses and nurse supervisors also felt that they lacked an understanding of CPS terminology and procedures which limited their ability to effectively collaborate with Child Welfare. For these reasons, several nurses and nurse supervisors indicated a desire for additional ongoing education on topics including strengthening client relationships and mandatory reporting.

Conclusion: Many opportunities exist for strengthening the NFP workforce to continue improving maternal and child health outcomes. This research has informed trainings for NFP and CPS as well as state-level policy and programmatic recommendations.