NICHE ~ Nurses Improving Care for Health-System Elders

As of March 16, 2009, Halton Healthcare Services has received designation as a NICHE (Nurses Improving Care for Health-System Elders) organization in early 2009. NICHE is an international program to improve care for older hospitalized adults. More that 58 percent of Halton Healthcare Services’ patients are over the age of 65 and, as such, face a variety of health risks specific to elders. Through this program Halton Healthcare Services will undertake a number of steps to recognize and prevent or treat these health problems. In the first phase of the program, Halton Healthcare Services has provided a one month full-time internship program to a core group of Elder Care Mentor Nurses, who are leaders and role models to their peers on the units. These mentors also prepared and delivered three one day workshops to 66 front-line staff that will serve as elder care champions on their units.

In 1994 the John A. Hartford Foundation Institute for Geriatric Nursing, based at New York University, launched the NICHE program to help hospitals improve their methods of caring for older adults. NICHE is now being implemented in more than 277 hospitals across three countries. NICHE was created in recognition of three converging trends: the aging of the population of hospital patients, the ongoing national nursing shortage, especially in geriatric-trained nurses; and the need for hospitals to contain costs while improving patients’ health care experience.

By joining NICHE, Halton Healthcare Services expects to significantly advance our understanding of the needs of our older patients, provide additional education to our nurses to meet those needs, and launch several new protocols to prevent the health care problems that can beset older people in the hospital.

Recognizing the national scarcity of geriatric-trained nurses, NICHE aims to improve care of older people by improving approaches to some core clinical issues such as falls, restraint use, pain, skin breakdown and wounds, use of advance directives, and family involvement in decision-making. Additionally, NICHE aims to make the physical and social environment friendlier to the older adult patient.