Home Healthcare Nurses Research Articles

Quality of Hospital Communication and Patient Preparation for Home Health Care: Results From a Statewide Survey of Home Health Care Nurses and Staff

ObjectivesTo evaluate the quality of communication between hospitals and home health care (HHC) clinicians and patient preparedness to receive HHC in a statewide sample of HHC nurses and staff. DesignA web-based 48-question cross-sectional survey of HHC nurses and staff in Colorado to describe the quality of communication after hospital discharge and patient preparedness to receive HHC from the perspective of HHC nurses and staff. Questions were on a Likert scale, with optional free-text questions. Setting and participantsBetween January and June 2017, we sent a web-based survey to individuals from the 56 HHC agencies in the Home Care Association of Colorado that indicated willingness to participate. ResultsWe received responses from 50 of 122 individuals (41% individual response rate) representing 14 of 56 HHC agencies (25% agency response rate). Half of the respondents were HHC nurses, the remainder were managers, administrators, or quality assurance clinicians. Among respondents, 60% (n = 30) reported receiving insufficient information to guide patient management in HHC and 44% (n = 22) reported encountering problems related to inadequate patient information. Additional tests recommended by hospital clinicians was the communication domain most frequently identified as insufficient (58%). More than half of respondents (52%) indicated that patient preparation to receive HHC was inadequate, with patient expectations frequently including extended-hours caregiving, housekeeping, and transportation, which are beyond the scope of HHC. Respondents with electronic health record (EHR) access for referring providers were less likely to encounter problems related to a lack of information (27% vs 57% without EHR access, P = .04). Respondents with EHR access were also more likely to have sufficient information about medications and contact isolation. Conclusions/ImplicationsCommunication between hospitals and HHC is suboptimal, and patients are often not prepared to receive HHC. Providing EHR access for HHC clinicians is a promising solution to improve the quality of communication.

Patient, Caregiver, and Clinician Perspectives on Expectations for Home Healthcare after Discharge: A Qualitative Case Study

Patients discharged from the hospital with skilled home healthcare (HHC) services have multiple comorbidities, high readmission rates, and multiple care needs. In prior work, HHC nurses described that patients often express expectations for services beyond the scope of skilled HHC. The objective of this study is to evaluate and compare expectations for HHC from the patient, caregiver, and HHC perspectives after hospital discharge. This was a descriptive qualitative case study including HHC patients, caregivers, and clinicians. Patients were discharged from an academic medical center between July 2017 and February 2018. The sample (N = 27) included 11 HHC patients, eight caregivers, and eight HHC clinicians (five nurses and three physical therapists). Patient mean age was 66 years and the majority were female, white, and had Medicare. We observed main themes of clear and unclear expectations for HHC after discharge. Clear expectations occur when the patient and/or caregiver have expectations for HHC aligned with the services received. Unclear expectations occur when the patient and/or caregiver expectations are uncertain or misaligned with the services received. Patients and caregivers with clear expectations for HHC frequently described prior experiences with skilled HHC or work experience within the healthcare field. In most cases with unclear expectations, the patient and caregiver did not have prior experience with HHC. To improve HHC transitions, we recommend actively engaging both patients and caregivers in the hospital and HHC settings to provide education about HHC services, and assess and address additional care needs.

日本の訪問看護師の行う訪問看護実践における判断の概念分析

日本の訪問看護師の行う訪問看護実践における判断の概念分析

Health Information Exchange of Medication Lists: Hospital Discharge to Home Healthcare.

Nurses report significant gaps in communication among patients discharged from the hospital with home healthcare (HHC) services. The aim of this pilot study was to quantify the contents of HHC admission packets used to guide nurses' first home visit after hospital discharge. We evaluated 20 randomly selected charts of older adults admitted to HHC after a hospitalization for heart failure. Admission packets contained nearly 50 pages of material, which frequently included duplicate documents printed from the hospital-based electronic health record (EHR). Despite the plethora of documents, most packets omitted key information, such as patients' cognitive and functional status, and even discharge summaries, which would be relevant and actionable for HHC nurses. Moreover, admission packets contained multiple, often discordant, EHR-generated medication lists, which makes reconciliation challenging for nurses and puts vulnerable patients at risk for adverse drug events. Overall, there is an urgent need to improve health information exchange between hospitals and HHC agencies, which will simultaneously promote nurse efficiency and patient safety.

Reducing avoidable visual impairment in elderly home healthcare patients by basic ophthalmologic screening.

PurposeTo investigate the prevalence of potential age‐related eye conditions in elderly who are assisted by home healthcare nurses. The number of referrals to the general practitioner (GP), feasibility of screening and associations between vision loss and health outcomes were also studied.MethodsCross‐sectional study in which trained home healthcare nurses screened the eyes of 151 patients [mean age 80 (50–96 years)] using their available correction, with VISION 2020 Netherlands screeners (e.g. acuity/field loss). Health outcomes were assessed with questionnaires.ResultsDistance decimal visual acuity was ≤0.3 in 20.5% (unilateral) and 19.9% (bilateral) of patients, and near visual acuity was ≤0.4 in 17.7% (unilateral) and 33.3% (bilateral). Macular dysfunction was present in 21.5% (unilateral) and 8.3% (bilateral) and peripheral field problems in 11.4% (unilateral) and 7.9% (bilateral). GP referrals were proposed in 21.5%; in 40%, the GP or ophthalmologist was already aware of eye problems. Although health problems were prominent in participants (8.6% fractures, 22% depression and 18% anxiety), no significant associations were found between vision loss and self‐reported outcomes.ConclusionSixty per cent of frail elderly home healthcare patients had an ophthalmologic condition. Although a large number was already known in eye health care, >20% was referred with an unrecognized ophthalmologic problem. Basic ophthalmologic screening by home healthcare nurses might be a potentially relevant tool to reduce the burden of age‐related vision loss, contributing to the joint World Health Organization – VISION 2020 initiative to eliminate avoidable blindness. Relevant health outcomes do not seem to be clearly related to having visual impairment, but rather to having general health problems.

Managing the Elephant in the Room: What Home Health Care Nurses Do and Don’t Do to Support Productive Interaction

Background/Problem: Quality therapeutic communication and relationships are key to delivering effective integrated care management ICM, known to promote health and wellness for elders with multiple chronic conditions MCC, disability, and depression. HHC nurses are in a unique position to establish these relationships because they communicate and engage with elders during routine home visits, often as the sole provider of care. A major barrier to nurse-pt. communication is the high prevalence of untreated comorbid illness/depression interfering with patients’ abilities to collaborate and engage in self-care. Further, therapeutic communication skills empathetic are rarely practiced by nurses, instead they use task-oriented, directive, and controlling communication. Not surprisingly, these types of communication barriers persist in HHC, since the quantity and quality of communication training is almost nonexistent, nor mandated by policy. The in-depth analysis of nurse communication data from observation home visits by this team, found a pervasive underutilization of nurse engagement in therapeutic relationships. Consequently, elders in this study felt insecure and alienated, engaged less in self-care, and experienced more mental distress, which was not expressed/explored. Nurses, experienced similar ambivalent feelings and distress because they lacked the confidence and skill to adequately deal with patients competing demands. This unspoken but shared mental distress and upset led to a parallel process in which both nurses and patients experienced discomfort difficult to express in words – the proverbial elephant in the room. These unaddressed conversational gaps in communication diminished nurses' abilities to therapeutically engage patients in mutual problem solving and self-care action plans. Design: The purpose of this 3-part qualitative descriptive study is to illuminate nurse-patient communication occurring during nurse visits to elders with MCC, depression, disability. Methods: The analysis part 3 focused on 338 transcribed audio-recorded communication incidents in an attempt to shed light on the dynamics underlying nurse-patient relationships; addressing: a common contextual visit features; b what nurses do and don't do to support productive interactions; c therapeutic communication: managing the “elephant in the room.” Findings: Three categories of communication emerged: 1 Connections: 72% social conversations, setting focused agendas, patient assessment, and directive guidance. 2 Disconnections: 25% missed opportunities to engage in patient-centered communication and patient-expressed concerns; impeding productive therapeutic interactions. 3 Therapeutic Communication: 3% active listening, prompting patient expression, and verifying nurse’s perception of patient's messages, nurse-patient collaboration on actions plans. Communication categories highlighted how nurse-patient relationships, typically involve close interpersonal connections, but are susceptible to conversational shifts that create periodic disconnections within HHC episodes. There is much that nurses do to support productive interactions over the course of managing demanding agendas and establishing positive patient-centered connections. Lessons Learned, Future Research: Evidence from this study, was used to develop and pilot-test an educational on-line course, designed to enhance nurses' ICM skills and build capacity in therapeutic communication to improve mental/physical health. This course will be a foundational part of a feasibility test of a nurse-led ICM intervention, for elders with MCC- INSPIRE Interactive Nursing Support to Promote Integrated care for elders REcieving HHC designed to prevent disability worsening and improve psychosocial health.

Co-designing a framework for integrated home care planning with older adults, family caregivers and health care providers

Background: Older persons want to remain in their own homes as long as possible, making home care services essential for maintaining independence, completing daily activities and delaying entry into institutional care 1. While home care has the potential to improve health and well-being and reduce health care costs, provision of these services to the geriatric population is complicated by complex, multi-morbid health issues requiring care from a range of providers who work in isolation of each other. Improved integration from planning through delivery is a key priority for Canadian home care 2. Aims: This study aimed to develop an implementation framework for an integrated geriatric care planning approach in home care. Key objectives were to: a investigate current geriatric assessment practices; b collect ideas for improving person- and family-centred goal setting; and c co-design solutions for more integrated geriatric care planning with older adults, family caregivers and health care providers. Methods: This study applied a sequential transformative mixed methods design 3. Quantitative data were collected through a web-based survey that was developed with and delivered to frontline home health care nurses, occupational therapists and physiotherapists n=303. Qualitative data were collected in-person through solutions-focused key informant interviews with older adults and family caregivers n=24. Statistical and thematic analysis of the data was iterative and ongoing. Survey and interview data were brought together during the interpretation phase, where older adults, family caregivers, and health care providers n=19 were engaged in a workshop to co-design solutions for more integrated geriatric home care planning. Results: An implementation framework for integrated geriatric care planning in home care was developed. Components of the framework include: a common clinical and non-clinical information needed by everyone involved; b key touch points and actions for achieving the integrated care planning experience everyone involved wants; and c nine ideas for tools and technology to support integrated data collection, goal-setting and communication. Conclusions: Older adults, family caregivers and health care providers have both common and unique needs for sharing and receiving information to support planning care in the home. Home care planning should begin with a holistic baseline understanding of an individual person that prioritizes and applies information on personal background, goals, needs and preferences in seeking to understand individuals’ health challenges and plan for their care. Limitations: This study was conducted in a single region within Ontario, Canada. Suggestions for Future Research: Next steps for this research include additional co-design workshops in other regions, to develop prototypes of these new processes and tools for integrated geriatric care planning to be pilot tested in home care practice.

Educating Nurses About End-of-Life Care for Patients With Implanted Cardioverter Defibrillators.

Many people with implanted cardioverter defibrillators (ICDs) are living at home and receiving nursing services through home health care agencies. Near the end of life, it is not unusual for patients to request comfort measures and care that promotes quality rather than quantity of life. The purpose of this pilot study was twofold: (1) to educate home health care nurses on care of patients with ICDs nearing the end of life and (2) to measure changes in nurse knowledge pre to post educational session. None of the registered nurses in this study reported ever caring for a patient who had died with an ICD in place. Subsequently, their knowledge in end-of-life care surrounding this patient population significantly improved after the educational session (P < .006). Knowing how to care for such patients as they are dying is imperative for nurses, especially because many ICD recipients have insufficient knowledge themselves and can benefit from education provided by nurses.

A dynamic application of PRECIS-2 to evaluate implementation in a pragmatic, cluster randomized clinical trial in two nursing home systems

BackgroundPRECIS-2 (PRagmatic Explanatory Continuum Indicator Summary-2) can assess how clinical trial design decisions (along the explanatory-pragmatic continuum) influence the applicability of trial results to intended stakeholders. The tool has been used to assess features of trials during the trial design phase and also upon completion. The ongoing PRagmatic trial Of Video Education in Nursing homes (PROVEN), which is evaluating the effectiveness of a suite of videos to improve advance care planning, is one of the first large pragmatic, cluster randomized trials within nursing home health care systems. While certain features of pragmatic trials remain static once designed (e.g., recruitment, outcomes), successful implementation of a system-wide program requires on-going evaluation and adaptation. This report’s objectives were to apply PRECIS-2 in a novel manner during the actual conduct of the PROVEN trial to assess how dynamic adaptations shifted implementation to either a more explanatory or a more pragmatic approach.MethodsWe assessed PROVEN’s protocol as initially designed according to the three PRECIS-2 domains pertinent to implementation: (1) Organization, (2) Flexibility-Delivery, and (3) Flexibility-Adherence. We then applied this framework to conduct a formative evaluation of decisions made while the trial was ongoing to adapt the implementation approach along the pragmatic versus the explanatory continuum in response to emergent challenges.ResultsBased on the PRECIS-2 rubric, the initial design of the PROVEN implementation approach reflected a hybrid of pragmatic and explanatory features. Most notably, within the Flexibility-Delivery, the trial had a relatively pragmatic approach to protocol delivery by front-line nursing home providers, balanced with a more explanatory approach to protocol monitoring enabled by the analytic capabilities of the research team. This more intensive monitoring proved critical in revealing implementation problems once the study began. Dynamic adaptations made in response to these challenges generally reflected shifts to more explanatory approaches within the Flexibility-Delivery and Flexibility-Adherence domains including ever more intensive compliance monitoring, as well as detailed coaching of front-line providers delivering the intervention by the research team.ConclusionsPragmatic trials conducted in the nursing home setting may benefit from a more dynamic approach to implementation. Allowing fluidity between pragmatic and explanatory features may still preserve the trial's applicability to intended stakeholders’ needs. PRECIS-2 provides a useful formative evaluation tool to assess these adaptations in “real-time.”Trial registrationUS National Library of Medicine, ClinicalTrials.gov, ID: NCT02612688. Registered on 19 November 2015

The Feasibility of Home Palliative Care for Cancer Patients: The Perspective of Iranian Nurses

Background: Cancer is one of the major health challenges that requires palliative care. Home care is one of the most desirable palliative care models. The implementation of any model of care requires the assessment of the views of the service providers and as nurses represent most of the manpower providing home care, their point of view should be considered. Objectives: This research aimed at investigating nurses’ views on the feasibility of home palliative care in Iran. Methods: In this descriptive study, 196 nurses were selected purposefully from all over Iran and filled out demographic information and the Global Home Health Nursing Care Assessment questionnaires. Data analysis was performed, using SPSS software version 20. Results: According to the opinion of the nurses, in order to provide home palliative care for patients with cancer, there is social acceptability and relative satisfaction regarding access to medications, equipment, and pain management. However, lack of access to end-of-life services and hospices as well as achieving educational opportunities are amongst the most important obstacles to the implementation of this kind of care. Conclusions: By having proper planning to promote home palliative care, using the existing potentials as well as applying functional changes to the nursing curriculum at Bachelor’s level, home palliative care can be developed for patients with cancer.

Decision-makers and mediators in a home healthcare digitisation process: nurses’ experiences of implementation and use of a decision support system

Background: This study focuses on a decision support system (DSS) for home healthcare and the implementation of it.Aim: To describe home healthcare nurses’ experiences of the implementation and use of a new DSS, with a focus on how it influences decision making in everyday work practice.Design: A qualitative research design.Methods: Data was collected through three focus group interviews with six home healthcare nurses.The data analysis was drawn from Burnard’s method for content analysis.Results: The DSS was experienced as bringing support to decisions, but sometimes incompatible with home healthcare nurses’ work practice. Professional understanding and the DSS were sometimes experienced as parallel support systems not assisting work across healthcare organisations.Conclusion: When a DSS is used to transform work of healthcare organisations several aspects should be highlighted. If the organisation does not consider these aspects, nurses may adopt a role as mediator in the implementation process.

Home Health Nurses’ Perspectives and Care Processes Related to Older Persons with Frailty and Depression: A Mixed Method Pilot Study

ABSTRACTThe objectives of this study were (1) to describe home health care (HHC) nurses’ perception of and care processes related to geriatric depression and frailty, and (2) to identify barriers to care delivery for older persons with these two conditions. Ten semi-structured interviews were conducted with HHC nurses, and 16 HHC nursing visits to 16 older patients (≥65 years) were observed. Mixed method analysis showed that HHC nurses did not routinely assess for frailty and depression. Major barriers to care delivery included insufficient training, documentation burden, limited reimbursement, and high caseload. Addressing these barriers would facilitate HHC nursing care for frail, depressed elders.

Factors for compliance with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control

Infection is a leading cause of hospitalization among home healthcare patients. Nurses play an important role in reducing infection among home healthcare patients by complying with infection control procedures. However, few studies have examined the compliance of home healthcare nurses with infection control practices or the range of sociocultural and organizational factors that may be associated with compliance. This study analyzed survey responses from nurses at 2 large, certified home healthcare agencies (n = 359), to explore levels of compliance with infection control practices and identify associated demographic, knowledge, and attitudinal correlates. Nurses reported a high level of infection control compliance (mean = 0.89, standard deviation [SD] = 0.16), correct knowledge (mean = 0.85, SD = 0.09), and favorable attitudes (mean = 0.81, SD = 0.14). Multivariate mixed regression analyses revealed significant positive associations of attitudinal scores with reported level of compliance (P < .001). However, knowledge of inflection control practices was not associated with compliance. Older (P < .05) and non-Hispanic black (P < .001) nurses reported higher compliance with infection control practices than younger and white non-Hispanic nurses. These findings suggest that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.

ASSOCIATION BETWEEN THE ORGANIZATION AND ENVIRONMENTAL FACTORS AND WORK INJURIES AMONG HOME HEALTH CARE NURSES

Work-related injuries have an adverse impact on health and safety of the employees, patients, and health care organization. Nurses’ exposure to work injuries is one of the highest rates in home and community care institutions. Nurses working in home health care (HHC) encounter multidimensional risk factors, including the organizational and environmental hazards associated with HHC. The purpose of this cross-sectional study was to examine the relationship between the organization and environmental factors and the work injuries (WIs) as experienced by HHC nurses (HHCNs). A prediction of the significant factors related to work injuries was explored. A self-reported data was obtained from 74 nurses working in nine HHC units in the Makkah Region, KS, using the Safety Home Care Nursing (SHCN) questionnaire. The results showed that the supervisory support (SS) (β = -0.36, p = .009) and the access to a client's home (AC) (β = -0.25, p= 0.05) were negatively affecting the WIs as experience by HHCNs. This implies that the training of Front-line supervisors and HHC providers in safety management and safety communication would improve competence in effective implementation of safety practices. This study suggests to ensure a safe HHC through the execution of an integrative approach involving managers, nurses, and other practitioners, as well as the patients’ and their informal caregivers. Article DOI: https://dx.doi.org/10.20319/lijhls.2018.41.6581 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

Pediatric Nasogastric Tubes in the Home: Recommendations for Practice.

One of the dilemmas facing home healthcare nurses is the placement of a nasogastric tube (NGT) in the home setting coupled with being assured and confident that the NGT tip is in the correct position, that is, the stomach. There are very limited data to address the issue of management of an NGT in the home care setting with even less guidance for the pediatric population. Therefore, home healthcare nurses must use agency policy and procedures coupled with their own education, knowledge, experience, and skills when performing this procedure. These may vary from agency to agency, thus providing inconsistencies in teaching and techniques.

Establishing Relationships and Navigating Boundaries When Caring for Children With Medical Complexity at Home

Children with medical complexity receive care from many healthcare providers including home healthcare nurses. The objective of our study, based on a conceptual framework, was to describe the relationships between parents/caregivers of children with medical complexity and home healthcare nurses caring for these children. We collected qualitative data in 20 semistructured in-depth interviews (15 English, 5 Spanish) with 26 primary caregivers of children with medical complexity, and 4 focus groups of 18 home healthcare nurses inquiring about their experiences about home healthcare nursing services for children with medical complexity. During an iterative analysis process, we identified recurrent themes related to caregiver-nurse relationships. Our study showed that: (1) caregiver-nurse relationships evolved over time and were determined by multiple factors; (2) communication and trust were essential to the establishment of caregiver-nurse relationships; (3) both caregivers and nurses described difficulties of navigating physical, professional, personal, and emotional boundaries, and identified strategies to maintain these boundaries; and (4) good caregiver-nurse relationships helped in the care of children with medical complexity, reduced caregiver burden, resulted in less stress for nurses, and was a factor in nurse retention. We conclude that trusted relationships between caregivers and nurses are important to the home care of children with medical complexity. Interventions to develop and maintain good caregiver-nurse relationships are necessary.

Dynamically accepting and scheduling patients for home healthcare

The importance of home healthcare is growing rapidly since populations of developed and even developing countries are getting older and the number of hospitals, retirement homes, and medical staff do not increase at the same rate. We consider the Home Healthcare Nurse Scheduling Problem where patients arrive dynamically over time and acceptance and appointment time decisions have to be made as soon as patients arrive. The objective is to maximise the average number of daily visits for a single nurse. For the sake of service continuity, patients have to be visited at the same day and time each week during their episode of care. We propose a new heuristic based on generating several scenarios which include randomly generated and actual requests in the schedule, scheduling new customers with a simple but fast heuristic, and analysing results to decide whether to accept the new patient and at which appointment day/time. We compare our approach with two greedy heuristics from the literature, and empirically demonstrate that it achieves significantly better results compared to these other two methods.

A Survey of Epilepsy-related Knowledge, Attitudes and Practices of Home Healthcare Nurses in the San-in Region of Japan

Comprehensive care is necessary for people with epilepsy (PWE) to lead a fulfilling life at home and in the community. The purpose of this study was to determine the epilepsy-related knowledge, attitudes and practices of home healthcare nurses (HHNs) in the San-in region of Japan. A questionnaire survey was conducted by mail of 546 HHNs working in Tottori and Shimane Prefectures. The questionnaire assessed the epilepsy-related knowledge, attitudes and practices of HHNs. For the analysis, simple and cross tabulation of questionnaire responses were conducted, and the chi-squared test was used for statistical testing. A total of 285 HHNs participated in the study. Of the respondents, 43.9% had experience taking care of PWE in a home healthcare nursing setting. Regarding the cause of epilepsy, in descending order the percentage of correct responses were 86.7% for stroke, 85.3% for head injury, and only 13.3% for dementia. Concerning how to respond to an epileptic seizure, almost all respondents answered correctly, but 29.8% gave the incorrect answer of "place something inside the mouth." Regarding the practices of HHNs in relation to caring for PWE, nurses scored 52.0% for collaborating with the attending physician, indicating the need for improvement. The score for "provide information about social resources" was low at 18.4%. Of the respondents, 95.8% answered that epilepsy-related knowledge and technical skills were necessary for home healthcare nursing practice, and 87.7% were interested in participating in a workshop on epilepsy. The study revealed an inadequate level of knowledge of epilepsy with dementia and corresponding epileptic seizures, a low awareness of nursing care in collaboration with physicians, and the importance of providing information about social resources. There is a need to offer information and education on the latest knowledge about epilepsy to HHNs.

Medication Management in Municipality-Based Healthcare: A Time and Motion Study of Nurses.

The objective of this observational time and motion study was to increase our understanding of how nurses in home healthcare currently distribute their work time with a focus on the medication management process. The research was conducted in four municipalities in the southern part of Sweden. Participants were nurses working in home healthcare. The study measured proportion of time, comparison of proportions of time, proportion of time spent multitasking, and rate of interruptions per hour. Of total observed time, 20.4% was spent on medication management and of these tasks the highest proportion of time was spent on communications and dispensing medications. Nurses in nursing homes spent more time (23.0% vs. 17.4%, p = 0.001) on medication management than nurses in private homes. Nurses spent 47.9% of their time completing tasks with someone else, including patients, but had minimal interaction with prescribers. We observed a rate of 1.2 (95% CI 1.1-1.4) interruptions per hour on average and 30% of all interruptions occurred during medication management tasks. Nurses spent 3.7% of their time multitasking. Interruptions while performing medication-related tasks were common, as well as multitasking. Causes and consequences of the results need to be addressed in order to improve the safety of medication management for patients receiving municipality-based home care.

A Resource Guide to Improve Nursing Care and Transition to Self-Care for Patients With Ostomies.

Clinical management of patients with an ostomy can be complex and stressful. With only 10% of Wound Ostomy Incontinence Nurses working in home health, home healthcare nurses need to be knowledgeable about care of patients with new ostomies. This article provides an overview of the resources available to guide nurses caring for ostomy patients. In addition, resources nurses can share with patients as they transition into the community are provided.