1. nicheprogram.org NICHE Nurses Improving Care for Healthsystem Elders An Introduction to NICHE © 2015 NICHE All Rights Reserved

2. NICHE - Nurses Improving Care for Healthsystem Elders NICHE is the PREMIERE international geriatric nursing program that addresses the needs of hospitalized older adults Currently there are NICHE Designated hospitals and healthcare facilities in the U.S., Canada, Bermuda and Singapore. Over 100 hospitals are joining NICHE every year! NICHE collaborates with over 20,000 healthcare providers in the NICHE network on important geriatric issues

3. Older Adults Are Hospitals’ CORE Consumers By 2050, the older adult population will number nearly 89 million, more than double the current population in 2010 Reason for the increasing population: –People living longer –Baby Boom population becoming 65 and older Every day until 2031; 10,000 Baby Boomers turn 65 By 2030 healthcare expenditure will increase by 25% for older adults Medicare spending will go from $555 billion yearly to $903 billion by 2020 http://www.cdc.gov/aging/help/dph-aging/state-aging-health.html

4. The Quality Imperative: Improve Clinical and Fiscal Outcomes! Older adults comprise 13% of the US population, Your local data here: But comprise 37% of hospital discharges and 43% of hospital days Have longer lengths of stay (7.8 days vs. 5.4 days) Higher rates of 30 day hospital re-admissions Higher rates of functional decline and medical errors Reference: U.S. Dept. of Health and Human Services, Centers for Disease Control. Trends in Health and Aging. Retrieved October 31, 2008 from http://www.cdc.gov/nchs/hdi.htm Hall, M.J., DeFrances, C.J., Williams, S.N., Golosinskiy, A., & Schwartzman A. (2010). National Hospital Discharge Survey: 2007 summary. National health statistics reports; no 29. Hyattsville, MD: National Center for Health Statistics. 2010

5. Older Adults Are Your hospital name here CORE Consumers This slide should have your statistics by unit, include a graph to show a few months data if you can.

6. Improving Care for Hospitalized Older Adults Is Good Business Optimal care requires appropriate skills –Aging demographics –Geriatric skill gap –High cost of inaction Older adult patients are everywhere –Need for flexibility –Ongoing training and coaching roles –Cost effective “train the trainer” virtual services

7. Improving Care for Hospitalized Older Adults Is Good Business Proactive & skilled nursing care avoids costly problems – “Never” events – Complications that increase LOS and costs Patient and family satisfaction – Better functional status at discharge – Smoother transitions Improved nurse satisfaction & efficiency, less turnover Creating an interdisciplinary team environment Improved MD satisfaction and improved efficiency

8. NICHE Program –Achieve systemic nursing change that will benefit hospitalized older adults –Provide geriatric sensitive and exemplary care to all hospitalized adults 65 years and over –Import principles and tools to stimulate change in the culture of healthcare facilities and achieve patient-centered care for older adults Goal Vision Mission

9. What Is the Focus of NICHE? …focuses on programs and protocols that are predominately within the scope of nursing practice.

10. 1. Improve patient outcomes 2. Improve the patient experience 3. Promote staff effectiveness and satisfaction 4. Establish leadership as a provider of care to older adults 5. Provide fiscally responsible care 6. Increase collegial networks NICHE Program Goals

11. Geriatric Resource Nurse (GRN) Model The online curriculum contains the latest evidence-based practice content, and is designed for easy access and navigation. The GRN is based on the book Evidence-Based Geriatric Nursing Protocols for Best Practice. Why Geriatric Nursing? Age-Related Changes in Health Depression, Delirium, Dementia Falls Family Caregiving Function Healthcare Decision Making Medications Nutrition, Hydration, and Oral Health Pain Pressure Ulcers and Skin Tears Restraints Sleep Urinary Incontinence

12. Rewards of the GRN Model Clinical ladder Novice expert growth Respect within the role Deeper geriatric expertise Outcomes described by NICHE sites Improved clinical outcomes Increased staff skill Increased satisfaction, both staff and patient

13. NICHE Program for “ Members Only ” Training and Education Programs –Core Curricula: for Nurses, Patient Care Techs (CNAs), other disciplines and general staff –Webinars and in-service materials –Contact hours –Educational resources for patients and families –Conferences National Community –NICHE Discussion Boards resource, topic and special interest based

14. NICHE Program for “ Members Only ” Measurement –Geriatric Institutional Assessment Profile (GIAP) –Clinical outcomes –Program self-evaluation Clinical Management Tools –Organizational Strategies & Clinical Improvement Models

15. © 2015 NICHE All rights reserved. The information contained in this module is provided for informational purposes only. The content has been developed by NICHE participants and the NICHE staff at New York University’s College of Nursing and is protected by copyright under the laws of the United States and foreign laws. Under no circumstances may these materials be reproduced for sale or profit. Any use of content not expressly permitted may violate copyright, trademark, and other laws.