1. Marrelli, Tina MSN, MA, RN

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"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has." - -Margaret Mead


I have been receiving e-mails from nurses practicing in many aspects of what we call home care or home healthcare nursing. For example, one e-mail I recently received stated "we home health nurses NEED (author's emphasis) a professional organization"; this statement summarizes the gist of many messages I receive from Home Healthcare Nurse subscribers. This has been phrased as the need to nurture/enhance/promote the "caring" side of home care more than the service, organization, or delivery side. To that end, a small group convened and wondered if there is a place for a true, nurse-focused professional association or society in which the sole mission is the support, advocacy, and education of nurses practicing in patients' homes. Those of you who have been practicing for some years ("experienced" nurses, like myself) may remember the wonderful, collaborative educational meetings that were held annually at the University of Michigan in Ann Arbor for many years. Though it has been some time since those meetings, luncheons, and other small sessions were held, such is the culture and sharing of evidence-based practice and information that such a specifically nurse-focused organization could provide.

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If you believe there is a place for such an entity, please e-mail me directly at If you wish, comment on what your specific needs are, why you think this is a good idea (or don't think this is a good idea), and any other thoughts you wish to share. We are particularly interested in inviting nurses from other countries to participate in this effort because of the importance of home care and home-based care. We know there are home care nurses in Thailand, Botswana, Korea, and Israel, to name just a few places, and we think we could all learn from each other. Whatever your thoughts, kindly get them to me no later than October 1, 2008.


In this July/August 2008 issue of Home Healthcare Nurse, the continuing education articles are appropriate for any nurse in any specialty practicing in home healthcare. As you may know, the government is becoming more and more focused on safety and across healthcare sites. Two articles, "Ergonomics for Home Care Providers" and "Insulin Management: A Guide for the Home Health Nurse," support educational safety initiatives in home care.


A thoughtful article by Timothy Kirk addresses the complex issue of "Deactivation of Automatic Implantable Cardioverter-Defibrillators in Hospice and Home Care Patients at the End of Life." This technology-focused article highlights the intersection of technology and the human condition.


The issue of reducing avoidable hospitalizations is important from both cost and quality-of-life perspectives. Many of you participated in the Home Health Quality Improvement (HHQI) national campaign in 2007. Donna Anderson, project coordinator for the Home Health QIOSC, and her colleagues provide detailed information about the initiative in their column highlighting "Home Health Quality Improvement National Campaign: The Journey and Potential Impact on Clinical Practice." In another column, entitled "Research on Reducing Avoidable Hospitalizations," authors Judith C. James-Borga, Natalie Carey, and Margaret V. McDonald identify manuscripts published in the Archives of Internal Medicine, Disease Management, and two papers from Circulation that describe various factors related to potentially avoidable hospitalizations and specific strategies to reduce them. As always, for additional information on the research study and the published findings, readers are advised to review the original, published articles.


As we plan the 2009 editorial themes for Home Healthcare Nurse, please e-mail me any topics you would like to see addressed. In addition, if there is a topic you would like to develop and submit for peer review, please contact me directly at Thank you and I look forward to hearing from you!!


Tina Marrelli, MSN, MA, RN