Allison Squires1,2, Komal Patel Murali1, Sherry A Greenberg1, Linda L Herrmann3, Catherine O D'amico4. 1. Rory Meyers College of Nursing, New York University, New York, New York. 2. Division of General Internal Medicine, Langone School of Medicine, New York University, New York, New York. 3. Hartford Institute for Geriatric Nursing, New York University, New York, New York. 4. Nurses Improving Care for Healthsystem Elders Program (NICHE), Rory Meyers College of Nursing, New York, New York.
Abstract
BACKGROUND AND OBJECTIVES: The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. RESEARCH DESIGN AND METHODS: Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. RESULTS: Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. DISCUSSION AND IMPLICATIONS: The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.
BACKGROUND AND OBJECTIVES: The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. RESEARCH DESIGN AND METHODS: Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. RESULTS: Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. DISCUSSION AND IMPLICATIONS: The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.
Authors: Sarah Lesser; Stanislav Zakharkin; Christina Louie; Marcus R Escobedo; John Whyte; Terry Fulmer Journal: J Am Geriatr Soc Date: 2021-11-27 Impact factor: 7.538