Little research has been done to identify effectiveness in nursing practice. This is especially true in home care nursing practice. Nurse leaders and educators express concern for effectiveness, and the profession seems to be advancing in the development of that body of knowledge.

The purpose of this study was to examine effectiveness in home care from the perspectives of those intimately involved with its enactment: the nurse, the nurse supervisor, and the client.

Conceptually organized within the particular philosophic context of the interpretive paradigm, this study employed the ethnographic methodology of focused interviews as the main resource for gathering data.

Findings. The definition of effective nursing was a complex mixture of structure, process, and outcome activities. There were shared perceptions among the subjects and subject groups in this study about knowledge, skills, and personal qualifications and attributes of the effective nurse. There was also considerable agreement about effective home care nursing behaviors which included a range of complex clinical activities, communication, teaching, and the ability to cultivate family involvement. Each sample group also identified unique categories of effective home care nursing behaviors based on its own subjective view of ideal practice. Effective care outcomes were not readily identified by any of the groups except in vague terms.

The implications for nursing practice, education, and research were discussed.