Complications from her diabetes have landed Mrs. Peterson in the hospital twice. You want to make sure there isn't a third time. She is receiving 6 medications. Ever since her children moved out on their own, frozen dinners have been the staple of her diet. Foot problems have made her skip the walks she used to take with her neighbor. Not only is her diabetes badly controlled; her weight, cholesterol, and blood pressure all are on the rise.

It's Your Job to Help Mrs. Peterson, but Whose Job Is It to Help You?

Luckily, it's the job of leading experts in chronic illness and home care from around the country. And they are on call 24/7 at the VNAA Chronic Care Clearinghouse (http://www.chronicconditions.org or accessible from http://www.vnaa.org.). Launched in 2006, the Clearinghouse catalogues best practices. The site was created in response to evolving trends in the home health industry to improve outcomes through evidence-based practices and to minimize rehospitalizations. The site originally began by offering extensive resources on diabetes. We recently added a large section on heart failure, the most common cause of hospital admission for older adults, with plans to expand into chronic obstructive pulmonary disease (COPD) in 2008.

There is no shortage of information about chronic diseases on the Web. This site is unique because resources are vetted by a panel of nursing experts from organizations such as Yale University, the American Heart Association, and experts in the home care field. Tools are chosen to meet the needs of home care nurses. Our expert panel divided the information in each disease section into 7 areas of care: nutrition, exercise, monitoring, medications, problem solving, coping, and risk reduction. Each area then was organized according to the nursing model, with sections designed to help clinicians assess, plan, implement, and evaluate.

How Does All This Translate Into Helping You Take Better Care of Mrs. Peterson?

Here's an abbreviated sample of what you might find useful: tools to assess medication compliance; patient resources in Vietnamese, Spanish, and many other languages; worksheets for evaluating Mrs. Peterson's flexibility and strength in preparation for an exercise program; and best practices in foot care.

I should elaborate a bit on best practices, a term that unfortunately is becoming something of a buzz word. We define best practices as optimal techniques, procedures, or programs identified through evidence-based research or by the experience of experts in 1 or more organizations. Implementing best practices improves care effectiveness and efficacy while enhancing positive patient outcomes. Best practices are summarized into algorithms, protocols, care pathways, and evidence reports, all supported by the literature.

Best practices are the gold standard in hospitals, where nurses have access to libraries, make rounds, and attend in-services with nurse educators. Those opportunities are rarely available to home care nurses, despite our critical role and the increasing acuity of the patients we serve. The VNAA Chronic Care Clearinghouse offers home care nurses access to the top-flight tools and information. We'll continue to expand this resource and look for other ways to use the Web to help home care nurses get the support they need, when and where they need it.