Heart failure (HF) is a major public health problem in the United States. Approximately 5 million Americans are living with HF, and each year, 550,000 more are newly diagnosed. With recent, rapidly advancing technologies, many studies have examined the effects of technology-based HF management programs. Most of these studies focused on telemonitoring devices, lacking an aspect to motivate individuals to manage their own illnesses. This exploratory study was conducted to (1) examine the readiness of patients with HF in using an eHealth program that includes both telemonitoring and motivational components (ie, Web learning modules, eCommunication) and (2) assess the specific needs of patients with HF that can be addressed by a future eHealth program. This was a single group descriptive study using a convenience sample. A total of 44 patients with HF (mean age, 72.8 years; range, 55Y85 years) were recruited from the pool of enrollees of the Medicare Coordinated Care Demonstration project for HF management that used only a telemonitoring component. Although only 10 participants were users, among 34 nonusers, 17 reported availability of Web access, and 15 reported that they would use the Internet if access and training were available. Overall, confidence for using telemonitoring devices and Web-based health modules was high, with means of 27 (range, 3Y30) and 7.6 (range, 1Y10), respectively. Confidence for learning health information using Web modules, however, was lower with a mean of 41.5 (range, 8Y80). The 2 most highly rated health information needs were research findings (n = 41, 93.2%) and medication (n = 39, 88.6%). Most participants would like to have e-mail communication with healthcare providers. The findings showed the participants' high readiness to use the proposed eHealth program if access and training were provided. This study used a small convenience sample. Further studies are needed with larger, diverse samples.

Both PCAs and RNs reported exposures to sharps, blood, and body fluids in the home setting at rates that warrant additional training, prevention, and protection. PCAs appear to be at increased risk of injury when performing nursing-related activities for which they are inexperienced and/or lack training. Further efforts are needed to protect home care workers from blood exposure, namely by assuring coverage and enforcement of the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogen Standard [Occupational Safety and Health Administration. 1993. Frequently Asked Questions Concerning the Bloodborne Pathogens Standard. Available at: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS &p_id=21010#Scope. Accessed May 30, 2008].

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The purpose of this descriptive study was to assess home health care nurses' exposure to bloodborne pathogens, evaluate Medicare Certified Home Healthcare Agency (MCHHA) and hospice organization practices related to the Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogens Standard and the Needlestick Safety and Prevention Act, and link the two to recommend safety improvements. This study evaluated the experiences of 355 home health care nurses and 30 MCHHA and hospice employers in one mid-Atlantic state regarding bloodborne pathogen programs and practices and blood and sharps contact. An index was developed to evaluate employer compliance with OSHA's Bloodborne Pathogens Standard. Employer policies and nurse practice related to the OSHA Bloodborne Pathogens Standard did not meet all requirements despite identified risk. Thirty-eight home health care nurses from 12 of the 30 employers reported needlestick injuries within the past year, yet employers reported only 18 nurse needlestick injuries within the same year. Using the bloodborne pathogen compliance index, employers can review and revise their exposure control plans to ensure compliance. This intervention should benefit both employer policies and nurse practice to improve safety and decrease the risks from bloodborne pathogens in the home health care setting.