The Atlantic Philanthropies, U.S. Ageing Programme, Supports Nurses Improving Care to Health-System Elders (NICHE)
New York, N.Y.-The. Hartford Institute for Geriatric Nursing, part of the New York University College of Nursing, has been awarded a $5 million, five-year grant to expand its widely praised NICHE (Nurses Improving Care to Health-System Elders) program. Since 1996, the Hartford Institute has administered NICHE, which aims for all patients age 65 and over to be given sensitive and exemplary care. NICHE is a national geriatric nursing program that helps hospitals achieve systematic nursing change to benefit older patients. It is currently implemented in 225 hospitals in more than 40 states and parts of Canada.
In most American hospitals, the percentage of patients over age 65 approaches or exceeds 50 percent-and it is rising. Yet many hospital-based nurses have not received specific education about the ways in which older adults differ from younger patients, in terms of symptoms and appropriate treatment. Hospitals are recognizing that such teaching is necessary to prepare for the future. The grant from Atlantic Philanthropies (U.S. Ageing Programme) will help NICHE to build its internal capacity, improve dramatically the program’s “toolkit”-particularly its measurement and reporting capacity-and initiate outreach to accelerate adoption of this program by additional hospitals.
“As we face a rapidly aging population of patients, the NICHE program has been extraordinarily successful in improving nurses’ knowledge and skills in caring for hospitalized older adults,” says NICHE Director Elizabeth Capezuti, PhD, RN, FAAN. “Thanks to this grant, we will be able to implement our business plan and undertake a major marketing effort to bring new hospitals into this program.”
The NICHE program aims to expand to 600 or more hospitals during the five-year grant period.
The project will afford an opportunity to hold regional and audio conferences and develop a new website for NICHE members that will offer interactive, Wikipedia-type technology enabling users to share information about best practices in care of older adults.
NICHE is a modular program that offers hospitals an array of options to improve their nursing resources for older adults. The most frequently used component, the Geriatric Resource Nurse model, helps hospitals train interested and motivated nurses in care for older adults. These nurses then become resources to their colleagues, and many go on to become certified in gerontological nursing. Some hospitals have adopted the ACE (Acute Care for the Elderly) Unit model, and others have institute hospital-wide programs to address specific issues such as falls-prevention, skin care, incontinence, or delirium.
The Hartford Institute for Geriatric Nursing provides curricular materials, ongoing meetings, and day-to-day support for hospitals implementing the NICHE program.
“We have so many hospitals that have adapted our resources in wonderful ways, and we will highlight those achievements-such as reducing falls, restraint use, or medical complications in older adults-as we introduce new hospitals to the NICHE program,” says Dr. Capezuti
Hospitals that join the NICHE program send an initial team of staff to a conference where they are trained in the various elements of the NICHE toolkit. Most hospitals then undertake the GIAP (Geriatric Institutional Assessment Profile) survey, which benchmarks the base level of staff knowledge and comfort in caring for older adults. The Atlantic Philanthropies grant will assist hospitals in conducting deeper benchmarking, for example looking at outcome measures and patient/family satisfaction measures. These compiled data will form a tremendous database that will assist NICHE in examining the relationship between organizational best practices and patient/family outcomes.
The Hartford Institute for Geriatric Nursing at the New York University College of Nursing The Hartford Institute for Geriatric Nursing seeks to shape the quality of health care that older Americans receive by promoting the highest level of competency in the nurses who deliver that care. By raising the standards of nursing care, the Hartford Institute aims to ensure that people age in comfort and dignity. For more information, visit www.hartfordign.org.