1. Marrelli, Tina MSN, MA, RN
  2. Stanley, Brittany BA

Article Content

All journals have a chosen editorial style-Home Healthcare Nurse's chosen style is the American Psychological Association (APA) style. The complexity of the style can sometimes seem daunting or be an impediment to even the most enthusiastic would-be writers. For this reason, Brittany Stanley, whom some of you know as HHN's Editorial Assistant, provides her thoughts about this style. You need to know that I consider Brittany to be HHN's APA expert and source; when authors (or reviewers or others) have questions about either the complexity or a specific usage issue or question, I send them to Brittany. We hope that this information helps those who seek to submit a manuscript to HHN or other journals that use this particular style. If you have been or are in academia-or have been a student-you may recognize APA as the same format that "school" papers require-and indeed it is the same APA!

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This issue of HHN brings a variety of topics that reflect the specialties and complexity of home care and hospice practice and management. In this July/August issue, Sarah Teel brings us the second part of her two-part manuscript on urinary incontinence entitled "Identifying Urinary Incontinence in the Home Setting: An Overview for Home Care Clinicians, Part 2," one of our CE offerings in this issue. Mary Beth Hoban and colleagues help us better understand telemonitoring and heart failure in "A Prospective Study: The Effect of Telemonitoring at Home on Quality of Life and Self Care Behaviors of Patients With Heart Failure," the second CE offering.


Kristen Murphy and Susan Lowe present an interesting study to reduce falls in "Improving Fall Risk Assessment in Home Care: Interdisciplinary Use of the Timed Up and Go." Shirley Ruder updates us on another important aspect of patient care with her article "Spirituality in Nursing: Nurses' Perceptions About Providing Spiritual Care." The VNAA column this month is by Tracey Moorhead and entitled "Evolution Ensures Survival ... and Success."


As you read through these articles, and every issue of HHN, you may notice that we use APA style-or you may not know what that means. We receive a number of questions about APA and thought we would explain a little about APA style in this editorial.


APA style comes from the Publication Manual of the American Psychological Association, Sixth Edition (for more information, visit Choosing an editorial style helps clarify and keep consistent how information is presented.


What this means for you as a reader (and maybe as a writer) is that you'll understand how to find information from the references a lot easier if you understand APA style, which can vary quite drastically from some other styles you may be used to, like the Modern Language Association (MLA) or Vancouver styles. If you are interested in writing for HHN, it can also mean you will need to learn about this style before you submit your work to HHN. Either way, understanding the basics of APA can help you enjoy HHN more!


The best feature of APA style is that the reference information is easily seen in the text-as opposed to being noted in a numerical manner that forces the reader to check either the bottom of a page or the end of the article to determine the author, the year, and other information about that reference. With APA style, that information is right there at the end of the sentence or paragraph, depending on where that attribution needs to be. As a result, the reader knows at a glance the author's name and the year of that reference. So, for an example:


"Implementing a 'no more wet-to-dry' program in your HHA can help to improve patient quality of life and outcomes, decrease agency costs, and move your agency into the 10% of P4P" (Dale & Wrig ht, 2011, p. 439).


You immediately know the author and, importantly, the year of that reference. It also tells you the page number within the article because this is a quote. You can also easily find the reference in the reference list because it will be listed alphabetically.


Although there can be quirks with any style, as well as both positives and negatives, APA can make reading and finding references particularly easy. Unlike styles that use footnotes or numbered references, APA orders all references alphabetically, and because everything is cited in-text with the author's last name and year, it is very easy to flip to the reference list and find the authors last name in the alphabetical listing.


Here are some examples of reference formatting and coinciding in-text citations that you might come across.


Journal Article

Reference Listing: Dale, B., & Wright, D. (2011). Say goodbye to wet-to-dry wound care dressings: Changing the culture of wound care management within your agency. Home Healthcare Nurse, 29(7), 429-440.


In-Text Citation: (Dale & Wright, 2011)


Reference Listing: Adkins, C. (2013). Wound care dressings and choices for care of wounds in the home. Home Healthcare Nurse, 31(5), 259-267.


In-Text Citation: (Adkins, 2013)



Reference Listing: Grant, S. (2012). A Caregiver's Guide to Throat Cancer: Honesty, Hope, and Humor to Help You Navigate the Wild Ride Called Throat Cancer! Port Ludlow, WA: Bella Vista.


In-Text Citation: (Grant, 2012)


Reference Listing: Marrelli, T. (2012). Handbook of Home Health Standards: Quality, Documentation, and Reimbursement (5th ed.). St. Louis, MO: Mosby Elsevier.


In-Text Citation: (Marrelli, 2012)



Reference Listing: Centers for Disease Control and Prevention. (2012). Pneumonia can be prevented: Vaccines can help. Retrieved from


In-Text Citation: (Centers for Disease Control and Prevention [CDC], 2012)


Note: If CDC has already been spelled out earlier in the manuscript, the in-text citation can appear as (CDC, 2012)


Reference Listing: Centers for Medicare & Medicaid Services. (2013). Home health face-to-face encounter question & answers. Retrieved from


In-Text Citation: (Centers for Medicare & Medicaid Services [CMS], 2013) or (CMS, 2013)


In addition to references and in-text citations, APA also has rules regarding setting up a paper including rules for avoiding bias, like referring to participants in a study in the way they prefer to be referred; rules for labeling figures and data to make it as specific and easy to understand as possible; and how to use quotations correctly, for instance, if a quote is longer than 40 words, a block quotation should be used instead of quotation marks. A block quote is indented, double-spaced, and has the page number of the quotation at the end, but does not have quotation marks around it.


A great resource for APA style, especially varied reference types, is the Online Writing Lab from Purdue, which can be accessed at They include guides for multiple styles, including extensive guides to APA and MLA.


As always, we welcome your feedback and submissions to HHN! Please email me at Any APA-specific questions can be e-mailed to Brittany at Hope you are having a good summer.




American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.


Online Writing Lab. (2012). APA style. Retrieved http://from