NICHE names Upstate as a 'senior friendly' hospital

SYRACUSE, N.Y.-- Upstate University Hospital has achieved a higher level designation from NICHE, Nurses Improving Care of Healthsystem Elders. The new Level 3 status, referred to as “Senior Friendly,” has been achieved as a result of several initiatives now in place throughout the hospital.

Upstate’s NICHE steering committee includes representation from both campuses including medicine, acute rehabilitation, transitional care, and the geriatric emergency department. A number of geriatricians, pharmacy staff and social work staff are also involved in the NICHE implementation at Upstate.

To achieve the Senior Friendly designation, NICHE requires that Geriatric Resource Nurses (GRN) be present on more than one nursing unit. The designation also requires evidence-based protocols on multiple units, including specialty units; systemic aging-sensitive policies; and include the input of patient, families, and community-based providers in the planning and implementation of the NICHE initiative. To date, Upstate nurses at the Downtown and Community Campuses have completed the specialized training needed to achieve GRN status.

NICHE views the GRN Model as the foundation for improving geriatric care. “The underlying goal, improving the geriatric knowledge and expertise of the bedside nurse, is foundational to implementing system wide improvement in the care of older adult patients.”

The Level 3 status also requires education for nursing aides on units hosting geriatric resource nurses to ensure that care of the elderly concepts are consistent for all caregivers.  In meeting this requirement, the NICHE steering committee has primarily focused on 10G at the Downtown Campus, in addition to 3W, and the Transitional Care Unit and Geriatric Emergency Medicine (GEM) department at the Community Campus. To educate nursing staff and to ensure baseline knowledge, an “Introduction to Gerontology” core curriculum is included in general orientation of all clinical staff working on these units. Some  staff have participated in a four-hour class and/or the “Geriatric Patient Care Associate program” offered by NICHE.

“To date, 46 registered nurses throughout the hospital have completed the Geriatric Resource Nurse modules,” said Kelly Dolan, MS, RN, nurse manager of 10G Medicine.  “Of these 46, 13 nurses work on Downtown’s 10G unit, which continues to have 100 percent of its RN workforce complete the initial training in addition to 8 hours of continuing education each year.”

The steering committee is currently developing a process to identify and recruit additional Upstate nurses with interest in specializing in elder care. This is an effort to enroll two to three nurses on every nursing unit to complete the NICHE geriatric specialty training.

The vision of NICHE is that all patients 65 years of age and older are to be given sensitive and exemplary care, while its mission is to import principles and tools to stimulate change in the culture of health care facilities to achieve patient-centered care for older adults.

NICHE designation allows its 575 member hospitals and health care facilities to participate in leadership and training programs and to use resources, tools and evidence-based strategies to enhance the care of older hospitalized adults. It also allows member hospitals to join a communications network with nurses nationwide who are trained in understanding the special needs of older hospitalized adults.

“Upstate began the journey towards NICHE designation in 2010,” said Sharon Klaiber, MS, RN, NEA-BC, director of nursing at the Community Campus. “At that time, the hospital had the ACE - Acute Care of the Elderly - Team, in place, and although it is a multidisciplinary function, it is not specific to nursing. Since that time, Upstate’s focus on elder care has grown exponentially.”

With the new Level 3 NICHE designation, Upstate will undergo an annual goal review and recommitment process.

The NICHE steering committee is working to achieve the next and highest designation, Level 4. One requirement for this designation is to include older adults and caregivers on the NICHE steering committee. As such, the committee recently added representation from social work, pharmacy, Upstate’s ACE Team and nutritional services. The committee’s next step will be to include older adults or caregivers and representatives from community-based programs for the elderly.

“Every member of the steering committee is to bring forth information from their area as it pertains to the environment of care,” said Clinical Educator Cindy DeBartolo, MS, RN, CDE. “Our goal is to provide an environment that is safe, functional and comfortable for older adults. Having a multi-disciplinary team, including representatives from the community and older adults and caregivers, will allow us to make meaningful observations of and improvements to our environment for the older adult.”

Upstate’s NICHE steering committee includes representation from both campuses including medicine, acute rehabilitation, transitional care, and the geriatric emergency department. A number of geriatricians, pharmacy staff and social work staff are also involved in the NICHE implementation at Upstate.

Caption: NICHE Site Coordinator and Patient Service Supervisor Kelly Dolan, MSN, RN, BC, right, reviews NICHE training materials with 10G nurses Sarah Willer, center, and Tatyana Dyda.