VNAA - Visiting Nurse Associations of America

What is the Nursing Procedure Manual?

About the NPM

The VNAA Nursing Procedure Manual (NPM) is recognized nationally by visiting nurse agencies, home health and hospice agencies as well as accreditation organizations and consultants as the leading procedure manual for home healthcare and hospice. A VNAA panel of expert nurse clinicians and consultants routinely reviews and updates these procedures on a biennial basis, ensuring that the highest clinical standards are met.

The NPM is designed expressly for home health and hospice clinicians and is organized according to body systems, general nursing practice, age appropriate care and clinical programs. Available in paper and electronic formats, the NPM features more than 900 pages of content covering nursing and home health aide procedures to support care of the patient in the home environment. Available in paper and electronic format (CD or USB drive), agencies have the option of implementing the procedures directly from the manual or using the electronic format and customizing the procedures to meet federal, state and local regulations in addition to specific agency requirements and/or emerging evidence-base practice guidelines specific to patient populations or accreditation standards. Utilizing the standard templates saves staff time and resources, only requiring you to review and update as needed for compliance.

The VNAA Nursing Procedure Manual is reviewed on an ongoing basis to ensure the validity of its content for all home healthcare staff caring for patients at home. The VNAA conducts this review process utilizing professional clinical experts with a variety of homecare experience including but not limited to: registered nurses, intravenous certified nurses, wound and ostomy specialists, certified diabetes educators, physical and occupational therapists, physicians and dietitians


The VNAA initially developed the NPM in 1986 and later reviewed and revised the manual for national distribution of the first publication edition in 1991 by the VNAA Standards Committee. The manual represents early efforts by the Coalition of Nurse Association/Services of Southern California with biennial reviews, additions, edits and updates by the VNAA Expert Clinical Review Panel.

Traditionally oriented towards nursing and personal care procedures in the home setting, the VNAA chose to expand the manual in 2010 to include rehabiliatation procedures for patients receiving therapy care in home healthcare and hospice. In addition the revision included procedure development and revisions based on evidence based practice and there is a new indicator on the procedures indicating strength of evidence for use of the procedure to ensure references, screening tools, charts, table and new procedures are the best practices to implement.

Available in paper and electronic formats, the NPM features more than 900 pages of content covering nursing and home health aide procedures to support care of the patient in the home environment. As a membership benefit, VNAA member agencies receive the publication at a substantial savings; however, the NPM is available for purchase for anyone interested in home health, hospice, private duty and personal care service in the home environment and has been purchased in more than 40 states and internationally, including Guam, Canada and Australia.

Nursing Procedure Manual Task Force

The VNAA has a Nursing Procedure Manual Task Force, which is a group of clinical and operational experts from VNAA member agencies who review the previous year's manual and assist in updating and producing new procedures and content for the next edition of the manual. The NPM Task Force provides the opportunity for clinicians to collaborate with their peers and expand their own knowledge base while building the best clinical practice and program model for home healthcare and hospice agencies. This is also the VNAA's opportunity to showcase member agencies commitment to performance excellence and quality clinical care. The individuals and member agencies are recognized as contributors/reviewers at the front of the manual by name, title and the home healthcare and/or hospice organization they represent. In addition the Nursing Procedure Manual Task Force also utilizes the skills and talents from individuals representing other professional organizations that are interested in advancing the nursing profession, improving patient care quality and outcomes.

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