Jan 25, 2023
America is getting older, and as people age, their bodies change. They're likely to have multiple chronic illnesses, and when they come into hospital care—that can be a vulnerable time.
Considering that almost 60% of hospital beds are occupied by adults aged 65 and over, receiving specialized geriatric care in the healthcare system is critical.
Learn with us today on This Is Getting Old as we explore how to make the world more age-friendly. Mattia Gilmartin, PhD, RN, is joining us. She will share her insights into NICHE—an incredible program that equips nurses and caregivers with the skills necessary to provide superior care for older adults.
Key points covered in this episode:
✔️ What is the NICHE Program?
Nurses Improving Care for Healthsystem Elders (NICHE) is on a mission to revolutionize nursing care for elderly patients, bringing positive change and patient-oriented practices into the capabilities of healthcare facilities.
NICHE's ultimate goal is to ensure that all seniors age 65+ receive top-notch medical attention - because everyone deserves to be treated with respect as they age.
NICHE focuses on the risks older adults might face when they come to a hospital. The program helps nurses be on the lookout for those risk factors and ensure that older adults do not experience those risks during their hospital stay. For example, laying in a hospital bed for five days is dangerous because an older adults function will go down. So in a NICHE hospital, nurses ensure that older adults are out of bed and moving around.
✔️ The Nuts And Bolts Of The Niche Program
The NICHE Program offers the guidelines, materials, and resources needed to encourage a change in healthcare organizations' organizational cultures and provide patient-centered care for older adults. It has several advantages for institutions and is cost-effective and comprehensive:
- better clinical results
- favorable financial results
- improved nursing capabilities
- community acceptance
- increased satisfaction of the staff, family, and patients
NICHE gives hospitals access to:
- Modern resources, including an interactive 24/7 E-learning center, tools, and training
- Support and coaching for NICHE-based hospital initiatives in project management
- Clinical procedures supported by evidence that address "never occurrences," Joint Commission compliance, and other legal requirements
- Instrument for Geriatric Institutional Assessment (GIAP)
- Information, knowledge, and skill sharing
✔️ How To Join The NICHE Program?
NICHE work with hospitals—mostly. We have about 20 nursing homes that also participate in the program, and the team at NYU works with nurse leaders at the member sites to help them implement our model of care.
However, NICHE has been thinking about transitions of care that go smoothly and anticipate people's needs. We also work with family caregivers so that loved ones who might be caring for older adults also know what to do and feel confident in their role and what the health system asks them to do.
You can check out the NICHE membership page if you’re interested in joining.
✔️ What Are NICHE’s Benchmarking Procedures?
By leveraging the knowledge in our university, community and small hospitals network, we provide specialized support for local leaders striving to improve care for older adults.
Additionally, through a recognition program based on excellence and achievement achieved by implementing models provided by us. We reward members across three levels - general membership level (base-level), senior-friendly level or exemplary performance with awards given accordingly.
✔️ NICHE and Centers for Medicare and Medicaid Services (CMS) Payments
There's lot of innovation in healthcare, but payment is one of the biggest barriers. There’s also the issue of hospitals being willing to invest in making changes in care and putting in change to improve the quality of care.
More hospitals see the value of geriatric-specific services, so they are getting pressure to improve care, be more efficient with their resources, and have a better patient experience. For most older adults, when receiving NICHE services, the Medicare program is paying for that. Medicare has started thinking more about the value and wants more quality for the beneficiaries.
✔️ How To Find NICHE Members Or Units?
NICHE is a voluntary program, and only some hospitals are doing this, even though it should be the standard of care. For consumers, here are some of the places where you can look:
- NICHE has a marketing kit that the members use. So you might look on the hospital website, usually where they have nursing awards,
- If the hospital offers geriatric services, you can check what they're participating in
- Sometimes there are announcements in the newspaper
- If a hospital has a newsletter, they might have some announcements and publications that they’re recognized as NICHE members.
- NICHE also have a certificate. So another place to look is in the hospital, where they might display their awards.
- You can ask when you're being admitted to the hospital, if the hospital's participating in a NICHE, or if they have units specifically designed for older adults.
- You can also check the NICHE website. Down on the bottom, you can click and find the location to see the list of current members.
- Sometimes NICHE nurses have a role called the geriatric resource nurse. The nurses wear pins on their badges that show they are a member.
✔️ Are You Up For The NICHE Challenge?
Hospital care shouldn’t end upon discharge. There should be a follow-up where someone calls it, checking to ensure that home health shows up. But the ball gets dropped, so care ends the minute they roll you out the front door.
The NICHE program helps people who don't have this background or the vision that care should continue at the door. It must carry over to the home to ensure people fully recover and do not have negative outcomes.
If you say YES to specialized geriatrics care and want to learn more about bringing that to their hospital, or even as a consumer who has consumer-driven care—check out the NICHE website and connect with their representative.
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Helpful Links To Connect With NICHE:
Websites:
Nurses Improving Care for Healthsystem Elders (NICHE)
NYU, Roy Myers College of Nursing
Phone: 212-998-5445
Fax: 914-612-9168
Post:
380 2nd Ave. Suite 306 New York, NY 10010
Email: support@nicheprogram.org
Facebook: Nurses Improving Care for Healthsystem Elders (NICHE)
LinkedIn: Nurses Improving Care for Healthsystem Elders (NICHE)
✔️ Register For The 2023 NICHE Conference In New Orleans
The two-and-a-half-day NICHE Conference in 2023 will focus on clinical advancements and fresh research in the treatment of older adults.
This year's conference theme is "The Changing Face of Elder Care". We will look at issues such as evidence-based practice, clinical leadership, care coordination, and management as they pertain to the NICHE practice paradigm.
Come share, learn, and celebrate geriatric nursing excellence.
If you have questions or comments or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question.
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About Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN:
I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 which led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.