As a new member of NICHE (Nurses Improving Care for Healthsystem Elders), UConn Health has embarked on a new initiative to further improve patient care, patient satisfaction, and clinical outcomes for those 65 years of age and older through education and coordination of its multidisciplinary resources.
NICHE is a North American program led and founded by NYU’s College of Nursing that uses proven principles and educational tools to improve the care of older adults at higher risk of developing health complications while hospitalized.
“More than 40 percent of patients admitted to UConn John Dempsey Hospital are over the age of 65,” says APRN Heather Spear, a leader in the NICHE program at UConn Health. “Seniors are at higher risk for a variety of medical problems while in the hospital, including falls, infections, and acute confusion. Through staff education and the use of evidence-based policies and procedures, the UConn Health NICHE program will seek to improve the care of all older patients hospitalized.”
UConn’s NICHE program will begin on the medicine inpatient floor, and will then expand to all parts of the hospital where older patients are cared for. The program will initially focus on identifying older adult patients who are at risk of developing delirium and those who are taking multiple medications, with the goal of reducing the risk and duration of delirium, and reducing the number of medications taken, especially those that are known to be poorly tolerated by older patients.
Ann Marie Capo, RN, the chief nursing officer was instrumental in bringing the NICHE initiative to UConn Health. The seven-member NICHE leadership team includes its physician director Dr. Patrick P. Coll, medical director of senior health at UConn Health; five APRNs including Spear, Barbara Baron, Damaris Figuera, Courtney Holmes, and Rachel Meehan; nurse manager Anne Niziolek, RN and Carolyn Guarino, RN of quality assurance.
In addition to daily multidisciplinary medical team rounds that will concentrate on the care of older patients, the backbone of the NICHE program will be the dedicated fleet of round-the-clock geriatric registered nurses (GRNs) and geriatric registered care nurse attendants (GRCNAs). These dedicated staff will receive specialized, evidence-based NICHE training, and will have access to the online NICHE Knowledge Center.
Although NICHE is primarily a nursing initiative, many care providers from various backgrounds, including hospitalists, geriatricians, surgeons, rehabilitation staff, quality improvement experts, case managers, and others, will be important members of this team effort. Faculty from the UConn School of Nursing will also play an important role in academic aspects of the program.
“Nurses are key to providing high quality care for older patients,” says Coll of the UConn Center on Aging at UConn Health. “Our NICHE program, led by a core of dedicated nurses, will work to improve nursing care for all older patients at UConn Health. By adopting best practices in geriatric nursing and by working closely with doctors and other members of the health care team, our NICHE program will add to UConn Health’s reputation as the best geriatric care provider in the region.”