Nurses Improving Care for Healthsystem Elders (NICHE): using outcomes and benchmarks for evidenced-based practice

Area of Science:

• Geriatric Nursing
• Healthcare Quality Improvement
• Hospital Administration

Background:

• The Nurses Improving Care for Healthsystem Elders (NICHE) project initiated in 1992 with four pilot hospitals.
• NICHE aims to enhance the quality of care for older adults within health systems.
• The program has expanded significantly, now involving 32 health systems and 105 hospitals nationally.

Purpose of the Study:

• To describe the evolution and impact of the NICHE program.
• To highlight the use of the Geriatric Institutional Assessment Profile (GIAP) for data collection and benchmarking.
• To illustrate opportunities for continuous quality improvement in geriatric care.

Main Methods:

• Utilized a pre- and post-design with the Geriatric Institutional Assessment Profile (GIAP) in pilot hospitals.
• Collected over 10,000 GIAPs nationally across participating NICHE sites.
• Enabled benchmarking of GIAP data against comparable healthcare institutions (urban, rural, university, community).

Main Results:

• Demonstrated successful data collection and analysis through GIAP across numerous hospitals.
• Facilitated comparative analysis of geriatric care practices through institutional benchmarking.
• Provided a framework for understanding and interpreting site-specific data for quality improvement.

Conclusions:

• The NICHE program has successfully expanded and demonstrated its value in improving geriatric care.
• The GIAP serves as a robust tool for assessing and enhancing staff knowledge, attitudes, and perceptions regarding older adult care.
• NICHE offers significant opportunities for continuous quality improvement in health systems nationwide.