Geriatr Nurs
October 2023
Nurses Improving Care for Healthsystem Elders (NICHE), a program of NYU Rory Meyers College of Nursing, is a national quality and safety program that enhances clinical nursing in the care of older adults. Hospitals, long-term care, and hospice organizations adopt the NICHE practice model to advance professional practice, improve quality of care, and expand capacity to meet the growing demand for age-friendly care. In this month's column, I highlight three clinical improvement projects that were developed during the NICHE Leadership Training Program.
View Article and Find Full Text PDFAs NICHE enters its fourth decade, it is a nursing innovation that has endured and adapted to meet the needs of older adults by fortifying the geriatric nursing workforce. Examining "Why NICHE and why now?" to guide NICHE implementation is important for the NICHE program and its members. The next steps for the NICHE community aim to build on our collective strengths, deepen integration with established geriatric quality programs and nursing professional organization partners, and increase the adoption of the NICHE practice model.
View Article and Find Full Text PDFThis month we focus on the role of the NICHE Coordinator, who leads NICHE program activities to advance the use of evidence-based practices that improve the quality and safety of care delivered to older adults in healthcare delivery settings. We present a new leadership development class for NICHE Coordinators to enhance their overall effectiveness with implementing the NICHE practice model in their organizations.
View Article and Find Full Text PDFNurses Improving Care for Healthsystems Elders (NICHE), one of the original geriatric care models, enhances the overall quality and safety of nursing care provided to older adults in hospital and post-acute care settings. NICHE is a relatively low-cost, high-impact investment in the nursing workforce to improve performance on the nurse-sensitive quality indicators including falls, pressure injuries, medication safety, urinary incontinence, restraint reduction, delirium identification and management, reducing preventable readmissions, among others. NICHE also serves as a foundation to enhance nursing care to achieve national accreditation standards for a number of geriatric and nursing quality programs.
View Article and Find Full Text PDFGeriatr Nurs
January 2023
Changing practice is complex and multifaceted. I discuss an evidence-based change management model that can be applied to guide clinical practice improvement projects. I use NICHE as a case example.
View Article and Find Full Text PDFBackground: Hospitalization can be hazardous for older people, but most hospitals in Europe are not prepared to meet the unique needs of older adult inpatients. Adaptations of the physical environment, care processes, and staff knowledge and skills in geriatric care are essential to improve the quality of care for older people. An assessment of baseline organizational approaches to older adult care is an important first step toward recognizing the challenges organizations face when delivering acute care services to older adults and attempting to improve them.
View Article and Find Full Text PDFBackground: Registered nurses are often underprepared with the knowledge and skills to care for hospitalized older adult patients. One strategy to bridge this gap is for hospitals to adopt the Nurses Improving Care for Healthsystem Elders (NICHE) program: A nurse-led interdisciplinary organizational intervention to improve care of hospitalized older adults.
Objectives: This study aimed to identify the market, organizational and managerial, and sociotechnical factors associated with the adoption of NICHE among U.
Introduced in 2003, the Clinical Nurse Leader (CNL) role is the first new nursing role introduced in more than 30 years. The hallmark of CNL practice is the management of client-centered care and clinical excellence at the point of care. As part of multifaceted efforts to implement the CNL role, understanding how an individual's self-efficacy with the identified role competencies changes over time has important implications for individuals, educational programs preparing CNLs, and health care organizations employing CNLs.
View Article and Find Full Text PDFAim: To compare how the use of different "doses" of simulation in undergraduate clinical teaching affect faculty capacity.
Background: Since 2008, the NYU College of Nursing has used a "high dose" of simulation to substitute for 50 percent of the clinical hours in core medical-surgical courses to address a shortage of faculty and clinical sites. Johns Hopkins University School of Nursing has used limited, "low-dose" simulation hours to supplement clinical hours.
Clinical nurse leader (CNL) practice, by definition, requires individuals to make career transitions. CNLs must adjust to their new work role and responsibilities and doing so also entails individual adjustment. Prior work has not examined the role of individual-level factors in effective CNL role transition.
View Article and Find Full Text PDFAlthough social justice and action for change are among the nursing profession's core values, curricular content on social entrepreneurship for nurses is not as well developed as it is in the educational programs for students in business, engineering, or public policy. This article describes an undergraduate honors elective course in social entrepreneurship offered at New York University College of Nursing. The course uses a seminar format and incorporates content from the humanities, business, and service-learning, with the goal of promoting participants' understanding of the sources of inequality in the United States and providing the requisite skills to promote effective nursing action for social change.
View Article and Find Full Text PDFRealistic job previews are well-established, cost-effective, and evidence-based recruitment and retention tools that nurses in professional development have largely overlooked. A realistic job preview for experienced staff nurses pioneering the Clinical Nurse Leader® role is presented along with implications for nursing professional development practice.
View Article and Find Full Text PDFMed Care Res Rev
February 2013
Despite the substantial amount of useful prior work on turnover among nurses, our understanding of the causal mechanisms explaining why nurses voluntarily leave their jobs is limited. The purpose of this article is to promote the development of stronger conceptual models of the causes of voluntary turnover among nurses. The author compares the nursing-specific literature to research on voluntary turnover from the general management field over the past 30 years and examines the evolution of key theories used in the nursing literature.
View Article and Find Full Text PDFTo address the faculty shortage problem, schools of nursing are reexamining how they provide clinical education to undergraduate students to find ways to use faculty resources more efficiently and to maintain student enrollment. We describe a unique clinical teaching model implemented at the New York University College of Nursing. The new model currently being evaluated shifts from the traditional clinical education model, in which all clinical education is in a hospital or agency setting, to a model that substitutes high-fidelity human patient simulation for up to half of the clinical education experience.
View Article and Find Full Text PDFThis article examines the recent controversy in health care delivery about whether it should be conceptualized as a business. The current debate implicitly appeals to a common understanding of business and business practices that is no longer very useful. This common notion, which the authors call "cowboy capitalism," conceptualizes business as a competitive jungle resting on self-interest and an urge for competition in order to survive.
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