Happy New Year from all of us at Home Healthcare Now. We are looking forward to another year of bringing you the high quality content you have come to expect. We changed our format somewhat this year. We will be bringing you bi-monthly issues packed with clinical, operational, and educational articles about home care and hospice. You will see all our usual columns and features focusing on practical, up-to-date approaches to everyday situations, as well as analysis and interpretation of how healthcare trends affect the practice of home care clinicians, managers, educators and administrators. I am also happy to announce the addition of a new column titled Legal Matters by attorneys Kyle Clark and Andrew George. And of course, we’ll bring you continuing education opportunities in every issue, about the topics you have asked us for.
As you know, medication reconciliation and patient education in home care have been identified as critically important in reducing adverse drug events and preventing unnecessary hospital admissions. It has been estimated that 51% of patients discharged from the hospital to home will have at least one serious medication error related event within a month of discharge (Conklin et al., 2014). The Joint Commission (2017) established medication reconciliation as a National Patient Safety Goal in an effort to reduce patient harm from adverse drug events. The Institute for Healthcare Improvement (nd) in its 100,000 Lives campaign, identified adverse drug event prevention as a national priority.
Three of the articles in this issue focus on some aspect of medication safety in the home. The aim of a pilot study by Sheehan et al. was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. In another article, Author Beth Bayer makes a plea for medication management to be considered skilled care in some circumstances. She relates three personal experiences as a home care nurse when patients remained stable under her supervision, but were quickly readmitted to the hospital because of medication noncompliance once discharged from home care. I’m certain you will identify with her experiences. This “revolving door” is costly to society and dangerous to the safety of patients. Finally, Dr. Gina Panozzo conducted a quality improvement project to develop and implement a tool to assist clinicians to engage in mutual goal setting with patients in an effort to improve medication compliance.
If you are a home care manager or educator, or know someone considering a move to home care, you will love the excerpt of a chapter from Tina Marrelli’s book “Home Care Nursing: Surviving in an Ever-Changing Care” (2016). Tina is the former editor of Home Healthcare Now and a long-time home healthcare consultant and author. This chapter is titled “Becoming a Home Care Clinician or Manager: Information Needed for Success”. It contains a list of questions that prospective home care clinicians or managers should contemplate to determine if home care is the right choice for them. The questions she poses reflect the knowledge, skills and attitudes necessary for a successful career as a home care clinician or manager. I think this article will be very useful in ensuring that the right candidates are hired into home care.
Finally, we have an article by Linda Berti-Hearn and Brenda Elliott, which provides resources for home care clinicians with regard to care of patients with new ostomies. With only 10% of wound, ostomy, continence nurses working in home care, it is imperative that clinicians be aware of the educational and support resources that are available. The authors have promised to write articles about ostomy care for upcoming issues of Home Healthcare Now, so stay tuned!
Once again, I wish our readers health, happiness and a prosperous 2018. I welcome your thoughts and suggestions. Email me at HHNEditor@gmail.com.
Maureen Anthony, PhD, RN