Patient Care

Strong Earns "Senior Friendly" Status for Efforts to Improve Care for Older Patients

Mar. 28, 2014
School of Nursing Collaborates to Support Goal

 UR Medicine’s Strong Memorial Hospital achieved "senior friendly" status this month for its successful implementation of the NICHE (Nurses Improving Care for Healthsystem Elders) program, a goal that was accomplished with support from the UR School of Nursing.

NICHE is the leading nurse-driven program designed to help hospitals improve the care they provide to older adults. The program provides principles and tools to stimulate culture change in health care facilities and ensure that all patients 65 and over receive sensitive, exemplary care. Based at the New York University College of Nursing, the program has engaged more than 500 hospitals and health care facilities nationwide in the effort to achieve and sustain NICHE designation.

“Programs like this are essential in helping our nurses meet the unique needs of our older patients,” said Patricia Witzel,R.N., M.S., M.B.A., chief nursing officer and associate vice president of Strong Memorial Hospital.

Sally Norton, associate professor, School of Nursing

Achieving "senior friendly" status is the second-highest distinction out of four levels of NICHE implementation—the highest being exemplar implementation. The status was assigned following a rigorous self-evaluation of the current state and future goals of Strong’s NICHE program. It recognizes the hospital for implementing the NICHE Geriatric Resource Nurse (GRN) model and aging-sensitive policies, and for having included input from patients, families and community-based providers in the planning and implementation.

Within Strong, the GRN model means that each unit identifies a nurse who is interested in geriatrics and serves as the lead GRN. Throughout the year, the unit leader provides evidence-based geriatric information to their co-workers and serves as a role model in the care of geriatric patients. The GRNs from each unit also meet monthly to discuss geriatric needs throughout the hospital, and initiate programs to enhance geriatric care.

The School of Nursing is playing an important role in supporting the NICHE endeavor by collaborating to develop and provide core educational courses in caring for hospitalized older adults. This effort was led by School of Nursing associate professor Sally A. Norton, Ph.D., R.N., F.P.C.N.,F.A.A.N., and made possible by a two-year $136,000 New York State Health Workforce Retraining Grant. To date, more than 800 nurses within both Strong and Highland hospitals have completed the courses. The School also offers an advanced educational program to help develop geriatric nurse resource experts.

“Educating hospital nurses in the care of older adults wasn’t something being done as recently as five or ten years ago,” said Norton.  “Today we have a growing body of research about how best to care for hospitalized older adults to achieve the best outcomes. Our goal is to bring this evidence directly to nurses who are caring for older patients at the bedside. The educational model we’ve developed is sustainable but can also be modified to reflect emerging best practices as they are developed through research.”

Norton added that the ongoing collaborative educational efforts “really illustrate the close ties between clinical practice and the School of Nursing, and our shared desire to improve the care we provide for older adults.”

The core course that nurses completed included case studies, as well as online interactive programs and videos. Much of the curriculum was developed with input from elderly patients and families on Strong’s and Highland’s patient advisory councils.

In particular, the curriculum gives nurses useful information to help them make the important, and often difficult, distinction between dementia and delirium in elderly patients. The course also provides information on some of the various medical and environmental factors that can impede an accurate diagnosis. In addition to other topics, participating nurses also gained knowledge in safe walking techniques for elderly patients, and learned about the various elements of hospitalization that can contribute to functional decline in older patients.

Witzel thanked Norton, along with assistant professor of clinical nursing Elizabeth Palermo, M.S., R.N., A.N.P.-B.C., A.C.N.P.-B.C., senior associate Pamela Brady, M.S., R.N., F.N.P.,Cindy Berry, R.N., B.S., in the center for nursing professional development, Barb Schrage, R.N., M.S., F.N.P., from Highland Hospital, and Brandon Qualls, M.P.A., coordinator of the clinical nursing research center, for their roles in the program’s success.