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Nurses Improving Care for Healthsystem Elders (NICHE)

Nurses Improving Care for Healthsystem Elders (NICHE)

History of NICHE

Started in 1992, NICHE is a program of The John A. Hartford Foundation Institute for Geriatric Nursing at New York University, the goal of NICHE is to achieve systematic nursing change that will benefit hospitalized older patients. The vision of NICHE is for all patients 65 and over to be given sensitive and exemplary care. The mission of NICHE is to import principles and tools to stimulate a change in the culture of healthcare facilities to achieve patient-centered care for older adults.
NICHE is unlike other programs in that it does not prescribe how institutions should modify geriatric care; rather, it provides the materials and services necessary to stimulate and support the planning and implementation process. The focus of NICHE is on programs and protocols that are dominantly under the control of nursing practice; in other words, areas where nursing interventions have a substantive and positive impact on patient care.

 Upon implementation of NICHE, hospitals report there is enhanced nursing knowledge and skills regarding treatment of common geriatric syndromes, greater patient satisfaction, decreased length of stay for elderly patients, reductions in readmission rates, increases in the length of time between re-admissions, and reductions in costs associated with hospital care for the elderly.


St Mary Medical Center is a designated NICHE facility. NICHE is a leading organization designed to help hospitals improve the care of older adults and is a program of the Hartford Institute for Geriatric Nursing at New York University College of Nursing. As a NICHE facility, St Mary Medical Center joins over 350 hospitals and healthcare facilities throughout North America.
The Shared Vision of St Medical Center’s NICHE Program

Our shared vision for improving geriatric care at St Mary Medical Center is that older adults will receive care sensitive to the physiological, functional, psychological, and spiritual needs that are different from younger adults. We want St Mary Medical Center colleagues to be familiar with the evidence-based body of knowledge about care of older adults and integrate this knowledge into professional practice standards.

NICHE and St Mary Medical Center recognize that patients and family caregivers are key members of the healthcare team. NICHE has developed a number of useful tools and resources for patients and their families to help them cope with hospitalization and communicate better with the healthcare team. These tools and resources include:

“Need to Know by NICHE” Series

The "Need to Know" series is an effort to meet the important information needs of older adult patients and their families. These informational sheets, written in simple, easy-to-understand terms, help prepare people for the realities of hospitalization. The Need to Know" series is made available to the public through the NICHE Hospital network:

Communicating with the Healthcare Team



Managing Medications

Meals & Nutrition

Patient Environment

Restraint Use

Skin Care Pressure Ulcers



Dementia Transition Series

This Need to Know series is presented in partnership with the St. Louis Chapter of the Alzheimer's Association. The new patient and family education tool is designed and written to provide older adult patients with dementia and their family’s guidance to help them understand and cope with hospitalization and transitions. Family Caregiver Reports are included on the back of each document to communicate patient information to health care providers. Transitioning to the hospital, long-term care facility, rehabilitation facility and back to the home can be a difficult and stressful time for patients with dementia. The change to an unfamiliar environment - and ultimately to home following treatment - is likely to increase confusion and worry. The series provides patients and their families with information and communication strategies to help them prepare for these transitions and thus relieve unnecessary anxiety and uncertainty.

What to Communicate at the Hospital 

Home to Hospital

Hospital to Home

Hospital to Long Term Care (LTC) or Rehabilitation