Online Program

Empirical Evaluation of a Standardized, Evidence-based Care Plan for Public Health Nurse Family Home Visiting

Wednesday, November 4, 2015 : 12:30 p.m. - 12:45 p.m.

Sadie Swenson, BSN, PHN, School of Nursing, University of Minnesota, Minneapolis, MN
Karen S. Martin, RN, MSN, FAAN, Martin Associates, Omaha, NE
Karen Johnson, PhD, RN, School of Nursing, University of Texas at Austin, Austin, TX
Karen A. Monsen, PhD, FAAN, RN, School of Nursing, University of Minnesota, Minneapolis, MN

Evidence-based guidelines encoded using the Omaha System provides guidance for PHN interventions (N=101) related to ten problems: Caretaking/parenting, Pregnancy, Abuse, Interpersonal relationship, Mental health, Family planning, Postpartum, Income, Substance use, and Health care supervision. The purpose of this study was to empirically evaluate use of the care plan with electronic health record (EHR) data generated by PHNs providing evidence-based family home visiting (FHV) services. The study objective was to compare interventions in the care plan and the PHN practice data, before and after implementation of the new care plan.


This descriptive, comparative study was conducted using a secondary dataset of 145,000 PHN FHV interventions from visits to 464 qualifying adult clients in a Southeast Minnesota county before and after care plan implementation. Standard descriptive and inferential statistics were employed in the analysis.


Over 70% of practice interventions were for Caretaking/parenting, vs. 28% in the care plan. Abuse, Mental health, and Substance use problems had similar percentages in practice and care plan. After care plan implementation the percentage of interventions for Health care supervision increased from 4% to 80% and Interpersonal relationship from 1% to 5% (both p <.05).


Public health nurses demonstrate consistent evidence-based practice while tailoring evidence-based interventions differentially by problem. They emphasized Caretaking/parenting as a priority area for FHV clients. Further research is needed to determine the influence of the care plan on PHN thought processes during EHR documentation, and the relationship between documentation and use of evidence-based interventions in practice.

Learning Areas:

Public health or related research

Learning Objectives:
Describe Omaha System encoded, evidence-based interventions for public health nursing family home visiting. Compare frequencies of interventions in PHN practice to care plan. Compare frequencies of PHN interventions by problem before and after the implementation of the evidence-based care plans.

Keyword(s): Information Technology, Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: In addition to this current project, I have worked as a public health nurse and manager in the area of family home visiting for the past 13 years, working on health informatics and collaboratively developing evidence-based interventions using the Omaha System. These guidelines are published on My long-term research interests involve the examination of public health nursing data to determine how public health nursing interventions impact healthcare quality, customer satisfaction, and cost of services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.