1. Marrelli, Tina MSN, MA, RN, FAAN

Article Content

The theme for this month's issue of Home Healthcare Nurse is an important and growing one-"Technology and Its Use at Home." And this topic is not just important to us in home care and hospice. In fact, the "National Health Statistics Reports" (number 66, May 20, 2013) released the 11-page report entitled "Adoption and Use of Electronic Health Records and Mobile Technology by Home Health and Hospice Care Agencies." Published by the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention, the abstract the objective is that it "presents national estimates on the adoption and use of electronic health records (EHR) and mobile technology characteristics associated with adoption" (U.S. Department of Health and Human Services, 2013, p. 1). This can be accessed at This is quite heartening. I think such reports show the value of the services of home care and hospice and continue the dialog about the need to effective technology use and across all setting for care-including the home as the site for healthcare!

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In "Bridging the Gaps in Supportive Information Systems," Pamela B. Hall, Rebecca Poole, and Clayton A. Hall skillfully review the need for actionable information and systems that assist clinicians-based on the evidence. They also address roadblocks and strategies for success to bridge those gaps.


"Pediatric Nurses' Views of Ideal Home Nursing Care for Technology Dependent Children," authored by Michele Mendes, is a descriptive study examining home nursing care of children dependent on technology-and from the perspective of experienced home care nurses. Pediatrics is a growth area in home care and it has been hard to quantify "how many" children are at home and dependent on technology.


"Should My Patient Use a Mechanical Lift? A Review of the Literature," by Susan M. Lowe, Brenda Douglas, Diane Fitzpatrick, and Ann Golub-Victor, addresses the facts related to injuries and home care workers. The projected growth of patients, aging caregivers, and many other factors make this a very important question. Many of us know someone-an aide or a nurse-who has been injured while either lifting or transferring or otherwise working with a patient. The purpose of this article is to present a review of the literature to help guide decision making. The various kinds of available patient lifts are also discussed. The complexity of the individual situation, such as the patient status, caregiver, and the environment are all factors. In addition, the authors provide "Safe Patient Handling Resources" for readers seeking more information. This is such an important area and, in fact, the American Nurses Association published "Safe Patient Handling" standards with the goal of also preventing injury to nurses and caregivers. Information on this resource can be accessed at


The CE article is entitled "Root Cause Analysis: Responding to a Sentinel Event." This article by Brenda M. Ewen and Gale Bucher defines and addresses the processes related to improving patient safety and care while proving an evidence-based structure for such an investigation and review. A patient case study is included in this in-depth article to illustrate an example and the process.


The VNAA column of this issue addresses "Connecting Health Literacy and Patient Engagement: A Priority for Community Providers" submitted by Beth Hennessey and Paula Suter. This interesting piece integrates these two topics into a practical approach for engaging patients to achieve their goals. Thank you Beth and Paula!


On the topic of engagement, the Nursing Alliance for Quality Care (NAQC) released a White Paper in March 2013 entitled "Fostering Successful Patient and Family Engagement: Nursing's Critical Role." This 31-page document "was initially drafted by a national expert on patient engagement, was honed through a national consensus process" (Sofaer & Schumann, 2013, p. 2). The NAQC, representing both consumers and nurses, defined patient engagement as "patient engagement is the involvement in their own care by individuals (and others they designate to engage on their behalf), with the goal that they make competent well-informed decisions about their health and health care and take action to support those decisions" (Sofaer & Schumann, 2013, p. 5).


This issue's Commentary, entitled "The Final Analysis," is authored by Cindy Heffron, a hospice nurse. She eloquently opines that some patient satisfaction may not ever be measured holistically solely by survey tools. She looks at the handwritten notes that are a staple of a family's communication back to nurses after a loved one's death. This last article speaks to the need for all our great technology to (also) interface with the people communicating. Some interactions should be face-to-face and not electronic, but that is a topic for another day.


There is no question that technology has the power to bring us the information we need, real time, to help make improved decisions. More information on a given topic generally leads to better decisions. And technology helps us in our daily lives to "keep up"-I would never go without an Ipad after using/having one. It is so intuitive that after a day or two of using it, it all made sense-and I think this is what many of us seek in healthcare technology-we just want it to make sense and not redefine processes and methods that work operationally and have been successful. I welcome your input. I am seeking articles related to technology and its use (e.g., Smart phones or other technology or applications) related to diabetes or heart failure in home care.


I look forward to hearing from you!




Sofaer S., Schumann M. J. (2013). Fostering Successful Patient and Family Engagement: Nursing's Critical Role. Retrieved from[Context Link]


U.S. Department of Health and Human Services. (2013). Adoption and Use of Electronic Health Records and Mobile Technology by Home Health and Hospice Care Agencies. Retrieved from[Context Link]