title: Nurses Improving Care for Healthsystem Elders (NICHE): using outcomes and benchmarks for evidenced-based practice.
abstract: This article describes Nurses Improving Care for Healthsystem Elders (NICHE), a project begun in 1992 with four pilot hospitals. These pilot hospitals gathered baseline data using a geriatric institutional assessment profile (GIAP) with a pre- and postdesign to capture changes in staff attitudes, knowledge, and perceptions of the care of older adults. Based on the success of the pilot effort, NICHE, now in its eighth year, has evolved into a program that involves 32 health systems comprising 105 hospitals nationally. To date, more than 10,000 GIAPs have been collected by NICHE hospital staff. All NICHE settings are able to benchmark their GIAP data against comparable institutions (eg, urban, rural, university, community settings) to understand how they compare and then interpret the data at their unique sites. The opportunities for continuous quality improvement through the NICHE program are described.
authors.affiliation: Division of Nursing, Steinhardt School of Education, New York University, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Fulmer
authors.forename: Mathy
authors.initials: M
authors.lastname: Mezey
authors.forename: Melissa
authors.initials: M
authors.lastname: Bottrell
authors.forename: Ivo
authors.initials: I
authors.lastname: Abraham
authors.forename: Julie
authors.initials: J
authors.lastname: Sazant
authors.forename: Sheryl
authors.initials: S
authors.lastname: Grossman
authors.forename: Emily
authors.initials: E
authors.lastname: Grisham
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D019985:Benchmarking / Q000458:organization & administration*; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000193:education / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D016294:Models, Nursing; D020380:Needs Assessment; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010351:Patient Discharge / Q000592:standards; D010865:Pilot Projects; D011321:Primary Nursing / Q000592:standards; D014481:United States