Family Home Visiting

The purpose of the Evidence-based Family Home Visiting Guideline (EB-FHV) is to provide a shared care plan for public health nurses and families in order for all infants and children to achieve optimal health and wellbeing, and live safely in their families, homes, and communities. In 2008, an Omaha System care plan for FHV was developed using a content expert approach by a team consisting of a PH N supervisor and four home visiting PHNs in the Pacific Northwest, and an Omaha System expert. In 2012, the EB-FHV care plan was reviewed and revised in two phases by a multi-state expert panel of nine EB-FHV PHNs and three supervisors in two Midwestern US states and an Omaha System expert. During the review, the panel first considered the concepts of EB-FHV care and reached consensus on the Omaha System problems that semantically represented those concepts. Second, the panel members reached consensus regarding each intervention in the EB-FHV for semantic representation of EB-FHV practice, and evaluated the fit of the intervention within the context of the EB-FHV care plan. Finally, a revised EB-FHV care plan was then sent to all panelists for individual review. No further changes were necessary at this stage. In the 2012 revision of the EB-FHV care plan, the Omaha System problems remained the same. Intervention content s revised to streamline documentation by reducing duplication and semantic equivalence. In the 2013 revision, the Residence problem was added, and interventions for immunizations, breastfeeding support, and discipline were dded or revised. In addition, child/infant interventions were specified to accompany the adult/adolescent interventions. In 2014, further revision was completed by reviewing each intervention and using previous care plans including expert informed interventions and current best practice within the field of public health nursing for family home visiting. Problems included in this guideline were identified by national stakeholders, including home visiting nurses and scholars. Interventions were synthesized from the literature and validated by providers, scholars, and consumers. The interventions are intended to be non-overlapping across problems, and to build a comprehensive, holistic plan of care for those problems deemed applicable by the consumers and members of the health care team.


Monsen, K. A., Swenson, S. M., & Kerr, M. J. (2016). Public health nurse perceptions of using standardized care plans to translate evidence-based guidelines into family home visiting practice. Kontakt,18(2), e75–e83.doi: 10.1016/j.kontakt.2016.04.001

Monsen, K. A., Swenson, S. M., Klotzbach, L., Mathiason, M. A., & Johnson, K. E. (2017). Empirical evaluation of change in public health nursing practice after implementation of an evidence-based family home visiting guideline. Kontakt. 19(3) e 7 5 – e 8 5.