Changes in the Geriatric Care Environment Associated with NICHE (Nurses Improving Care for HealthSystem Elders).
The aging of the U.S. population has profound implications for acute care nursing practice. NICHE (Nurses Improving Care for HealthSystem Elders) is the only national nursing program that addresses the needs of the hospitalized older adult. This secondary analysis examines the influence of the NICHE program on nurse perceptions of the geriatric nursing practice environment and quality of geriatric care, as well as geriatric nursing knowledge in a sample comprising 8 acute care hospitals in the United States that administered the Geriatric Institutional Assessment Profile before and after NICHE implementation. Results were compared in a sample of 821 and 942 direct care nurses, respectively. Controlling for hospital and nurse characteristics, both nurse perceptions of the geriatric nursing practice environment (P < .0001) and quality of geriatric care (P =.0004) increased, but not geriatric nursing knowledge (P =.1462), following NICHE implementation. NICHE tools and principles can exert an important influence over the care provided to older adult patients by increasing the organizational support for geriatric nursing.
New York University College of Nursing, New York, New York, USA.
Marie
M
Boltz
Elizabeth
E
Capezuti
Susan
S
Bowar-Ferres
Robert
R
Norman
Michelle
M
Secic
Hongsoo
H
Kim
Susan
S
Fairchild
Mathy
M
Mezey
Terry
T
Fulmer
D000208:Acute Disease / Q000451:nursing*; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D017598:Efficiency, Organizational; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000193:education / Q000458:organization & administration*; D006272:Health Facility Environment / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006760:Hospitalization; D006801:Humans; D016014:Linear Models; D008297:Male; D016294:Models, Nursing; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009936:Organizational Innovation; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States