Studies find nurse-led program improves care of older adults

November 04, 2019

An analysis of research on the Nurses Improving Care for Healthsystem Elders (NICHE) program finds that it improves older adult care, including preventing falls, improving patient safety and quality of care, reducing potentially inappropriate medications, and helping healthcare providers to care for patients with dementia. The study is published in the journal The Gerontologist.

The NICHE program at NYU Rory Meyers College of Nursing is a nurse-led education and consultation program designed to help healthcare organizations improve the quality of care for older adults. When member organizations--which include hospitals, long-term care facilities, and other healthcare facilities--join the NICHE program, they gain access to clinical education and resources, guidelines, and nursing practice models designed to improve nurses' abilities to provide patient- and family-centered care for older adults. To date, there are 580 acute care hospitals and nursing homes that are NICHE program members in the United States, Singapore, Canada, and Bermuda.

"Nurses are at the forefront of providing care to complex older adults in the United States and many countries around the world," said Mattia Gilmartin, PhD, RN, FAAN executive director of the NICHE program at NYU Meyers. "The NICHE program emphasizes education and practice development for front-line clinical staff through leadership training, mentorship, and educational programming, which promotes the role of the clinician as paramount to implementing high-quality care."

In the new study published in The Gerontologist, the researchers reviewed existing research on the NICHE program to better understand how the program influences patient outcomes, nursing professionals, and the work environment. The researchers identified 43 studies published between January 1992 and April 2019 to include in their analysis. The collective findings represent NICHE program-related evidence across settings involving 12,254 patients and more than 50,000 nurses and other healthcare professionals.

Using a content analysis, the researchers identified four thematic categories in the research: specialized older adult care, the geriatric resource nurse model, work environment, and NICHE program adoption and refinement.

The researchers found that specialized older adult care, a key feature of the NICHE program, resulted in improved quality of care and patient safety, and decreased complications and length of hospital stay. The studies showed how the NICHE program helps member sites improve the care of hospitalized older adults by addressing issues specific to this population including falls, potentially inappropriate medications, catheter-associated urinary tract infections, and dementia symptom management.

Another theme that emerged was the geriatric resource nurse model, which assists nurses in becoming unit-based leaders through continuing education in order to provide specialized care of older adults. Research showed that implementing the geriatric resource nurse model resulted in significant culture changes within organizations and improved nursing knowledge about specific health issues in older adults, including incontinence and sepsis.

To measure the geriatric nurse work environment, studies looked at perceptions of the quality of care, aging-sensitive care delivery, resource availability, institutional values, and capacity for collaboration. Research shows that after implementation of the NICHE program, these factors improve.

"In the face of a robust increase in the number of older adults globally, which is projected to continue to rise sharply over the next 50 years, organizational stressors will only increase. The evidence on NICHE program is promising, though more research examining patient outcomes and the impact on healthcare professionals is needed to better help healthcare organizations to meet their goals and improve outcomes for older adults," said Allison Squires, PhD, RN, FAAN, associate professor at NYU Meyers and the study's lead author.

"In light of the growing needs in the U.S. and around the world, it has never been more important for NICHE and other programs geared toward improving health outcomes for older adults to have strong evidence on how to empower geriatric specialists to provide the best care," said Catherine D'Amico, PhD, RN, NEA-BC, director of programs and operations at the NICHE program at NYU Meyers and one of the study's authors.
In addition to Squires and D'Amico, study authors include Komal Patel Murali and Linda L. Herrmann of NYU Meyers, as well as Sherry Greenberg of Seton Hall University.


Nurses Improving Care for Healthsystem Elders (NICHE) is a nursing education and consultation program designed to improve geriatric care in healthcare organizations. The NICHE program of NYU Rory Meyers College of Nursing provides resources for nursing and interdisciplinary teams to achieve organizational goals for the care of older adult patients. Connect with NICHE on Facebook and LinkedIn.

About NYU Rory Meyers College of Nursing (@NYUNursing)

NYU Rory Meyers College of Nursing is a global leader in nursing and health. Founded in 1932, the College offers BS, MS, DNP, and PhD degree programs providing the educational foundation to prepare the next generation of nursing leaders and researchers. NYU Meyers has three programs ranked in the top 10 by U.S. News & World Report and is among the top 10 nursing schools receiving NIH funding, thanks to its research mission and commitment to innovative approaches to healthcare worldwide.

New York University

Related Nursing Articles from Brightsurf:

Dismantling structural racism in nursing
Confronting the uncomfortable reality of systemic racism - the system that creates and maintains racial inequality in every facet of life for people of color - is having a national heyday.

MU School of Nursing programs help nursing homes respond to COVID-19
As the coronavirus pandemic continues to put a strain on health care systems, nursing homes have become overburdened with the challenge of keeping both patients and staff safe and healthy.

Palliative nursing's role during COVID-19 and beyond
As a rapid influx of patients overwhelmed health systems during the coronavirus pandemic, palliative nurses played dual roles supporting patients, patient families, and colleagues.

Calling for nursing support amid COVID-19 pandemic
There are close to 28 million nurses around the world who comprise a global workforce that delivers about 90 percent of primary healthcare, including frontline response to the COVID-19 pandemic.

Nursing research informs response to COVID-19 pandemic
Nursing research has an important influence on evidence-based health care practice, care delivery, and policy.

Designing better nursing care with robots
Robots are becoming an increasingly important part of human care, according to researchers based in Japan.

A work patch for better nursing home care
A research team, including a Purdue University work-life balance expert, studied work schedules in nursing home facilities and found a patching approach could benefit patients and staff.

Nursing science could help reduce firearm violence and its impact
Firearm violence is a significant public health problem worldwide. In the United States, firearms are used to kill almost 100 people daily.

A nursing perspective on the opioid crisis
Addictions nursing specialists have a unique role to play in caring for patients, families, and communities affected by the crisis.

Nursing notes can help indicate whether ICU patients will survive
Researchers at the University of Waterloo have found that sentiments in the nursing notes of health care providers are good indicators of whether intensive care unit (ICU) patients will survive.

Read More: Nursing News and Nursing Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to