Abstract
NICHE (Nurses Improving Care for Healthsystem Elders) is the only national nurse-driven program designed to assist healthcare organizations in improving the care of older adults across the care continuum. The exponential growth of the older adult population over the last three decades created the need for specialized nursing care that addresses the unique needs of this population. Originally created over 30 years ago as a small pilot of nurses trained in geriatrics, the program is now implemented in over 550 care settings in 40 states as well as Canada, Bermuda, Singapore, and Mexico. The program can be tailored to each facilities’ unique infrastructure, educational, and clinical needs by providing tools to implement and sustain geriatric sensitive care. NICHE sites improve care by creating organizational structures that address workplace needs, promote leadership skills in nursing staff, geriatric staff competence and interdisciplinary processes, patient- and family-centered approaches in an environment that is safe for older adults and focused on improving quality of care. Appropriate for any healthcare setting, the NICHE program promotes nursing practice that provides evidenced-based, patient- and family-centered care in an environment that welcomes change and is dedicated to improving the care of the older adults.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Fulmer T. The geriatric resource nurse: a model of caring for older patients. Am J Nurs. 2001;102:62.
Francis D, Fletcher K, Simon LF. The GRN model of care: a vision for the future. Nursing Clinics of North America. 1998;33(3):481–96.
Inouye SK, Acampora D, Miller RL, Fulmer T, Hurst LD, Cooney LM. The Yale geriatric care program: a model of care to prevent functional decline in hospitalized elderly patients. J Am Geriatr Soc. 1993;41(12):1345–52.
Capezuti EA, Briccoli B, Boltz MP. Nurses Improving the Care of Healthsystem Elders: creating a sustainable business model to improve care of hospitalized older adults. J Am Geriatr Soc. 2013;61(8):1387–93.
Hall MJ, DeFrances CJ, Williams SN, Golosinskiy A, Schwartzman A. National hospital discharge survey: 2007 summary. National health statistics reports; no 29. Hyattsville, MD: National Center for Health Statistics; 2010.
http://www.cdc.gov/nchs/data/nsltcp/long_term_care_services_2013
Permpongkosol S. Iatrogenic disease in the elderly: risk factors, consequences, and prevention. Clin Interv Aging. 2011;6:77–85.
Boltz M, Capezuti E, Zwicker D, Fulmer T, editors. Evidence-based geriatric nursing protocols for best practice. 4th ed. New York, NY: Springer; 2012.
Capezuti E, Boltz M, Cline D, Dickson V, Rosenberg M, Wagner L, Shuluk J, Nigolian C. NICHE – a model for optimizing the geriatric nursing practice environment. J Clin Nurs. 2012;21:3117–25.
Leff B, Burton L, Mader SL, Naughton B, Burl J, Inouye SK, et al. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med. 2005;143(11):798–808.
Fulmer T, Abraham IL. Rethinking geriatric nursing. Geriatr Nurs. 1998;33(3):387–94.
Pfaff J. The geriatric resource nurse model: a culture change. Geriatr Nurs. 2002;23(3):140–4.
Conley DM, Burket TL, Schumacher S, Lyons D, DeRosa SE, Schirm V. Implementing geriatric models of care: a role of the gerontological clinical nurse specialist – Part II. Geriatr Nurs. 2012;33(4):314–8.
Capezuti E, Boltz M, Shuluk J, et al. Utilization of a benchmarking database to inform NICHE implementation. Res Gerontol Nurs. 2013;6(3):198–208.
Fletcher K, Hawkes P, Williams-Rosenthal S, Mariscal CS, Cox BA. Using nurse practitioners to implement best practice care for the elderly during hospitalization: the NICHE journey at the University of Virginia Medical Center. Crit Care Nurs Clin North Am. 2007;19:321–37.
Kim H, Capezuti E, Boltz M, Fairchild S, Fulmer T, Mezey M. Factor structure of the geriatric care environment scale. Nurs Res. 2007;56:339–47.
Boltz M, Capezuti E, Shuluk J, Nickoley S. NICHE measurement and program evaluation. In: Boltz M, Capezuti E, editors. NICHE planning and implementation guide. New York, NY: Nurses Improving Care for Healthsystem Elders; 2013.
Abraham IL, Bottrell MM, Dash KR, et al. Profiling care and benchmarking best practice in care of hospitalized elderly: The Geriatric Institutional Assessment Profile. Nurs Clin North Am. 1999;34:237–55.
Boltz M, Capezuti E, Bowar-Ferres S, et al. Hospital nurses’ perceptions of the geriatric care environment. J Nurs Scholarsh. 2008;40(3):282–9.
Tavares JP, da Silva, AL, Sá-Couto P, Boltz M, Portuguese nurses knowledge of and attitudes toward hospitalized older adults. Scand J Caring Sci. 2015;29(1):51–61.
American Nurses Association. The National Database of Nursing Quality Indicators (NDNQI®) website. Available at: http://www.nursingworld.org/Research-Toolkit/NDNQI. Accessed July 16, 2014.
St. Pierre J, Twibell R. Developing nurses’ geriatric expertise through the geriatric resource nurse model. Geriatr Nurs. 2012;33(2):140–9.
Wright, S. Environmental and social approaches to improve outcomes for the hospitalized older adult. Solutions series. 2010. Available at: http://nicheprogram.org/uploads/File/solutions/NICHE_Solutions_9.pdf. Accessed July 16, 2014.
Flood K. Improving medication safety in older adults at the University of Alabama at Birmingham Hospital. Solutions series. 2010. Available at: http://nicheprogram.org/uploads/File/solutions/Solution%201_Final_Screen.pdf. Accessed July 16, 2014.
Salman A, McCabe D, Easter T, et al. Cultural competence among staff nurses who participated in a family-centered geriatric care program. J Nurses Staff Dev. 2007;23(3):103–11.
2012 NICHE conference poster: a rural hospital’s approach to prevention and treatment of delirium in the elderly hospitalized patient improves outcomes. Arun Nagpaul, MD, Pam Elsberee, RN, BSN, CCM and Karole Shafer, DNP, ACNP, Newark Wayne Community Hospital, Wayne County, New York.
Boltz M, Capezuti E, Shuluk J, et al. Implementation of geriatric acute care best practices: initial results of NICHE sites self-evaluation. Nurs Health Sci. 2013;15:518–24.
Nickoley S. Aligning NICHE and magnet initiatives. In: Bub L, Boltz M, Capezuti E, editors. NICHE planning and implementation guide. New York, NY: NYU; 2013.
Flood KL, MacLennan PA, McGrew D, Green D, Dodd C, Brown CJ. Effects of an acute care for elders unit on costs and 30-day readmissions. JAMA Intern Med. 2013;173:981. doi:10.1001/jamainternmed.2013.524.
Boltz M, Capezuti E, Bower-Ferres S, Norman R, Secic M, Kim H, et al. Changes in the geriatric care environment associated with NICHE. Geriatr Nurs. 2008;29(3):176–85.
Bond C, Rodenhausen N, Spragens L, Yellig R. Developing a NICHE action plan. In: Bub L, Boltz M, Capezuti E, editors. NICHE planning and implementation guide. New York, NY: NYU; 2013.
Wurmser TA. Obtaining financial support through grants and gifts. In: Bub L, Boltz M, Capezuti E, editors. NICHE planning and implementation guide. New York, NY: New York University; 2013.
Landefeld CS, Palmer RM, Kresevic DM, Fortinsky RH, Kowal J. A randomized trial of care in a hospital medical unit especially designed to improve the functional outcomes of acutely ill older patients. N Engl J Med. 1995;332(20):1338–44.
Malone ML, Vollbrecht M, Stephenson J, Burke L, Pagel P, Goodwin JS. Acute Care for Elders (ACE) tracker and e-Geriatrician: methods to disseminate ACE concepts to hospitals with no geriatricians on staff. J Am Geriatr Soc. 2010;58(1):1.
Inouye S, van Dyck C, Alessi C, Balkin S, Siegal A, Horwitz R. Clarifying confusion: the confusion assessment method. Ann Intern Med. 1990;113(12):941–8.
Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288:1987–1993.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Bub, L., Boltz, M., Malsch, A., Fletcher, K. (2015). The NICHE Program to Prepare the Workforce to Address the Needs of Older Patients. In: Malone, M., Capezuti, E., Palmer, R. (eds) Geriatrics Models of Care. Springer, Cham. https://doi.org/10.1007/978-3-319-16068-9_5
Download citation
DOI: https://doi.org/10.1007/978-3-319-16068-9_5
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-16067-2
Online ISBN: 978-3-319-16068-9
eBook Packages: MedicineMedicine (R0)