Nurses Improving Care for Healthsystem Elders - a model for optimising the geriatric nursing practice environment.
OBJECTIVE
To explain the relationship between a positive nurse practice environment (NPE) and implementation of evidence-based practices. To describe the components of NICHE (Nurses Improving Care for Healthsystem Elders) programmes that contribute to a positive geriatric nursing practice environment.


BACKGROUND
The NPE is a system-level intervention for promoting quality and patient safety; however, there are population-specific factors that influence the nurses' perception of their practice and its' relationship with patient outcomes. Favourable perceptions of the geriatric-specific NPE are associated with better perceptions of geriatric care quality.


METHODS
Discursive paper.


METHODS
In this selective critical analysis of the descriptive and empirical literature, we present the implementation of geriatric models in relation to the NPE and components of the NICHE programme that support hospitals' systemic capacity to effectively integrate and sustain evidence-based geriatric knowledge into practice.


RESULTS
Although there are several geriatric models and chronic care models available, NICHE has been the most successful in recruiting hospital membership as well as contributing to the depth of geriatric hospital programming.


CONCLUSIONS
Although all geriatric care models require significant nursing input, only NICHE focuses on the nursing staff's perception of the care environment for geriatric practice. Studies in NICHE hospitals demonstrate that quality geriatric care requires a NPE in which the structure and processes of hospital services focus on specific patient care needs.


CONCLUSIONS
The implementation of evidence-based models addressing the unique needs of hospitalised older adults requires programmes such as NICHE that serve as technical resources centre and a catalyst for networking among facilities committed to quality geriatric care. Unprecedented international growth in the ageing population compels us to examine how to adapt the successful components of NICHE to the distinctive needs of health systems throughout the world that serve older adults.
New York University College of Nursing, New York, NY, USA. ec65@nyu.edu
Elizabeth
E
Capezuti
Marie
M
Boltz
Daniel
D
Cline
Victoria Vaughn
VV
Dickson
Marie-Claire
MC
Rosenberg
Laura
L
Wagner
Joseph
J
Shuluk
Cindy
C
Nigolian
D000368:Aged; D003299:Cooperative Behavior; D005851:Geriatric Nursing / Q000592:standards*; D006801:Humans; D009726:Nurses; D011787:Quality of Health Care; D014481:United States