As guest editors of this special issue of Home Healthcare Nurse, Ann Frantz and I began talking with Carolyn Humphrey last year about developing a unique cardiac issue that both challenges experienced home care cardiac clinicians and would be a helpful review on the basics. Our main objective was to develop an issue that increases each reader's competency and confidence in managing patients with cardiac disease.

Confidence is derived from practice and experience and by maintaining up-to-date knowledge which you will find in this issue. With knowledge and confidence we can successfully teach patients and advocate for better care. Confidence also emerges when home clinicians recognize their unique position as healthcare providers.

In contrast to our colleagues who care for patients experiencing short acute care stays and brief physician appointment times, we follow patients over a relatively long period of time allowing us to assess and teach patients in depth-at a time and place where anxiety is reduced. What other healthcare providers are consistently able to directly observe and assess how patients manage their care, from medications to dietary intake?

The articles published in this issue are intended to help you:

Fine tune your cardiac assessment skills. When a thorough cardiac assessment is performed at admission and with each subsequent home visit, subtle changes in condition are identified, reported, acted upon-potentially reducing your patient's risk for rehospitalization. Jessica Coviello offers an up-to-date review of key areas for cardiac assessment. Forgot some of the cardiac basics? Read "A Review of Cardiac Anatomy and Physiology in last month's issue (January, 2004).

Challenge pre-existing beliefs. A focus on evidence-based practice is constantly changing the way we manage, monitor, and teach patients. Diane Recker and I tackle five "cardiac myths" and explain the latest practice recommendations.

Focus on helping your patients overcome barriers to self-care management. What keeps your patients from doing what they should-lack of understanding, financial limitations, an inability to recognize the benefits? Ann Frantz offers a valuable perspective on helping patients improve self-care skills.

Improve your understanding of cardiac medications. Many cardiac home care patients have multiple diagnoses and take many medications, often including OTC remedies. Pharmacist Patricia Neafsey addresses significant medication interactions associated with commonly prescribed cardiac drugs.

Use reliable and accurate Internet resources. With the explosion of endless Web sites, clinicians increasingly turn to the Internet for information. Carol Long has selected several cardiac care-related Web sites to help you in your search for reliable and accurate information.

Teach patients about diet and nutrition more effectively. An important area for cardiac patient education is diet yet home care agencies often do not have the benefit of a dietitian. Jody Vogelzang arms you with information to increase your confidence and skill when teaching patients alternative and complimentary nutrition choices.

I want to issue two challenges to all HHN readers. First, learn something new from this issue and incorporate it into your practice. Second, recognize your ability to make a difference in the lives and outcomes for these patients and their families.