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

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This editorial begins the new year, and new years traditionally begin with the wish to "do" better or "be" better-a New Year's resolution. In some ways, the new year is a very good thing-those devastated by the natural disasters named Katrina and Rita can only hope this year brings a sense of hope and success in new beginnings.


This issue initiates our plan for theme-based issues in 2006, and it addresses the important topic of emergency preparedness-something that we don't always want to deal with, but current events tell us that whether we want to or not, it is an important topic. With Katrina this past season and Charley before that, and the other three hurricanes that crisscrossed and devastated parts of Florida the year before, it is evident that all of us need to be aware of how to deal with such disasters. For all those who have seen the worst of nature-blizzards, floods, mudslides, and other storms-and Californians who have experienced earthquakes, fires, or other disasters, our goal is to assist you, your team, and your patients in staying safe. The article entitled "Emergency Preparedness for the Home Healthcare Nurse" is a review of the fundamentals of this important operational and safety function. One of its authors, Carol O. Long, a long-time contributor to Home Healthcare Nurse, also contributed to a companion piece, "Essential Links: Emergency Preparedness" that lists Web resources for effectively managing during such a crisis.


The dreaded influenza season is now in full swing, and unfortunately, could be the linchpin that initiates an emergency-preparedness plan. "Flu" season can wreak havoc on our loved ones, our staffing projections, and ourselves. The timely article by Sharon Dezzani Martin addresses a topic we are hearing more and more about on the news, avian flu. We definitely hope it does not come to our shores, but home care and other healthcare workers in the community might be the first to identify a trend or a change in the flu. The article by Ms. Martin is entitled, "Avian Flu: Should We Worry in Home Healthcare?" The answer is decidedly yes!!


According to an article in the New York Times, "'the biggest weak link is hospital capacity,' claims Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University." This article states that for the past 2 years, the federal government has been working on national plans and has taken the lead role in dealing with a pandemic. It details the concerns about this particular flu and presents the historical perspective from the 1918 pandemic. One alarming statistic is revealed in the statement that "if a pandemic similar to the one of 1918 occurred today, as many as 2.8 million New York City residents could be infected within months, sending more than 200,000 to the hospital and clogging the morgues with 400 deaths a day during the peak infection period" (Santora, 2005). With this in mind, this article seeks not to frighten but to empower with the resources and skill-set needed to identify symptoms, notify municipal healthcare leaders, and marshal resources. It provides the framework as more is learned about this disease.


This issue is also cardiac care-focused and presents a CE feature article about a commonly seen patient population in home care who are often at risk of infection owing to susceptible comorbidities. Cory Lord has written an article that is a guide for nurses caring for coronary artery bypass graft surgery patients and their loved ones during the postoperative stage. The first of the new departments is "Patient Education," and that department column editor, Mary Hindelang, writes a compelling piece about the patient education needs of the cardiac patient. Penny Feldman of the Visiting Nurse Service of New York is coordinating the research update, and she has focused this on the heart and circulatory system. Dr. Feldman succinctly provides the nursing implications for home care that are very important as pay for performance (P4P) at some point becomes integrated as the methodology used to reimburse home health agencies. Think about that-agencies being paid for what patients "take away" and can adhere to or what they do not understand. All of a sudden patient education will be more important than ever. P4P will lead to more demands related to patient education, such as how to reduce hospitalizations, increase adherence to medication goals, and so forth.


As we move into 2006, home care and hospice continues to be the heart of healthcare. Data reporting and outcomes management will improve and strengthen the stance of community-based healthcare and the unique and, most importantly, safe and desired services for patients in the comfort, safety, and privacy of their own homes.


Happy New Year and wishing you, your family, colleagues, and team members only the best in the coming year!!




Santora, M. (August 21, 2005). When a bug becomes a monster: New York prepares an already overburdened system for the threat of avian flu. New York Report, New York Times, p. 20. [Context Link]