The role of medications in home care and hospice is well-known to clinicians and managers. We acknowledge that the best part of home care and hospice is the team effort and care being centered on the patient and family. With this in mind, two specific CE articles in this issue look at the very different aspects of medications and their management, from two very different perspectives and roles. With the known role of medication and problematic side effects or adverse events, and their contributions to hospital (re)admissions, these topics are very timely. Gretchen Riker and Stephen Setter's article about polypharmacy, entitled "Polypharmacy in Older Adults at Home: What It Is and What To Do About It? Implications for Home Healthcare and Hospice Nurses," presents Part 2 of that topic. Part 1 of this article was published in the September 2012 issue of Home Healthcare Nurse. In the second medication-related article, Shannon Reidt and colleagues present an innovation related to the role of the pharmacist in home care, including home visits. This article is titled "The Role of a Pharmacist on the Home Care Team." Both of these articles address the issues that impact clinicians and patients and their families every day in the community. If your organization has a program that may be an exemplar related to pharmacy in home care or hospice, please e-mail me-I believe the collaboration between nurses and pharmacists will only expand as the complexity of medications and the medication-related therapies continues to increase. Because of the value and detail in these articles, both are CEs. Readers may also want to know about a new, free resource/toolkit called "Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation." This toolkit was created by the Agency for Healthcare Research and Quality (AHRQ) to "help acute care and post-acute care facilities evaluate and improve their current medication reconciliation process" and can be accessed at http://www.ahrq.gov/qual/match/(AHRQ, 2012). For past articles about medication management, readers should refer to Box 1.
The third CE article in this issue is "Skin Tears: Care and Management of the Older Adult at Home" by Teresa J. Kelechi and colleagues. The need for an in-depth CE and article on this topic came from a personal story. I had recently visited a 98-year-old woman whose arms were wrapped in white gauze up to her shoulders, "mummy-like." Through the white gauze I could see specs of blood and she told me that she thought some new soap was irritating her delicate skin. She reported that she went to see her doctor and she was to keep the bandages on and keep her hands and lower arms out of dishwater. I clearly remember her saying to me "you would think with all these advances that there would be an easier way to prevent this problem and then to heal my skin tears." I agree, and this article is the result of that interaction. I hope it helps your patients. The authors address the many aspects of this problematic skin issue that impacts so many frail older adults. There are also pictures and a case study.
The hospice and palliative care feature in this issue is "The Challenges Patients Experience in Speaking About Death: A Guide for Home Healthcare and Hospice Clinicians," authored by Lyn Rabbetts. The communication-related aspects of caregiving and nursing are one of the most important aspects at end-of-life care. This article addresses the communication at this important part of life. Another hospice-related article is the Commentary authored by Elizabeth Bettini, "Concurrent Care for Children: How this New Legislation has Opened Hospice Care to Children with High Technology Home Care Needs." In this Commentary, Ms. Bettini presents a pediatric patient's case report that explains this legislation that provides parents of children with high-technology needs, such as a ventilator, the opportunity to have both hospice and skilled bedside care in the home. This new provision is a part of the Patient Protection and Affordable Care Act.
As always, we welcome your feedback and ideas for new manuscript submissions. Feel free to e-mail at [email protected]. I look forward to hearing from you!
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