NICHE relies on use of 1 of 2 nursing care models to support integration of knowledge. One model is the Geriatric Resource Nurse (GRN) model. Nurses receive specialized training in geriatric nurses.31, 32 and 33 The specially trained nurses serve as a resource for all nurses on the floor. When questions arise in care of an elderly patient, the GRN can provide guidance to support care. The other model is the Acute Care for Elders (ACE) Unit.31, 32 and 33 The ACE model can be applied as part of the NICHE program. Both the GRN model and ACE model can be implemented together or separately, depending on the preferences of the hospital. However, a hospital is not required to use the NICHE program if an ACE unit is in place. ACE is reviewed separately here because many hospitals implement ACE programs without following other NICHE recommendations. Only 2 NICHE research reports were identified for review.
Boltz and colleagues31 used the GIAP in a pre- and post-test cross-sectional survey of registered nurses in 8 acute-care hospitals in urban areas. The geriatric nursing practice environment, including institutional values regarding older adults and resource availability, was significantly improved after NICHE implementation. Institutional values regarding respect for the rights of older adults, inclusion of older adults in decision-making regarding care was significantly improved. The actual quality of geriatric care according to nurses in the survey was also significantly improved (see Appendix A). Quality of care was defined as “geriatric-specific, evidence-specific, individualized care that promotes informed decision making and is continuous across settings.”31 Boltz and colleagues found that geriatric care, nursing environment, and values regarding geriatric care were improved.
Mezey and colleagues33 also conducted a survey of hospitals that implemented NICHE to determine what aspects of the NICHE program were adopted. One-hundred thirty-seven hospitals implementing NICHE in 2002 were surveyed, and 103 hospitals responded. The majority of hospitals reported using the GRN model, best practice protocols, the NICHE listserv, and hospital benchmarking protocols. Hospitals were likely to use more than one NICHE tool. The most popular programs were the GIAP survey and GRN model. NICHE was most commonly used to reduce and monitor falls, restrains, and pressure ulcers.
โพรงอาศัยใช้ของ 1 2 พยาบาลดูแลรุ่นสนับสนุนการบูรณาการความรู้ รุ่นหนึ่งคือ รุ่น Geriatric ทรัพยากรพยาบาล (GRN) พยาบาลได้รับการอบรมใน geriatric nurses.31, 32 และ 33 ที่พยาบาลได้รับการฝึกฝนเป็นพิเศษทำหน้าที่เป็นทรัพยากรสำหรับพยาบาลทั้งหมดบนชั้น เมื่อคำถามเกิดขึ้น in care of มีผู้ป่วยสูงอายุ GRN ที่สามารถให้คำแนะนำการสนับสนุนดูแล รูปแบบคือ แบบเฉียบพลันดูแลผู้สูงอายุ (เอ) Unit.31, 32 และ 33 รุ่น ACE สามารถใช้เป็นส่วนหนึ่งของโปรแกรมนิช GRN รุ่นและรุ่นเอสามารถนำมาใช้ร่วมกัน หรือ แยกกัน ขึ้นอยู่กับลักษณะของโรงพยาบาล อย่างไรก็ตาม โรงพยาบาลจะไม่จำเป็นต้องใช้โปรแกรมเฉพาะหน่วยหนึ่งอยู่ในสถานที่ เอสจะทานนี่ต่างหากเนื่องจากโรงพยาบาลหลายแห่งใช้โปรแกรม ACE ไม่ทำตามคำแนะนำเฉพาะอื่น ๆ รายงานการวิจัยเฉพาะ 2 ได้ระบุสำหรับการตรวจทานBoltz and colleagues31 used the GIAP in a pre- and post-test cross-sectional survey of registered nurses in 8 acute-care hospitals in urban areas. The geriatric nursing practice environment, including institutional values regarding older adults and resource availability, was significantly improved after NICHE implementation. Institutional values regarding respect for the rights of older adults, inclusion of older adults in decision-making regarding care was significantly improved. The actual quality of geriatric care according to nurses in the survey was also significantly improved (see Appendix A). Quality of care was defined as “geriatric-specific, evidence-specific, individualized care that promotes informed decision making and is continuous across settings.”31 Boltz and colleagues found that geriatric care, nursing environment, and values regarding geriatric care were improved.Mezey and colleagues33 also conducted a survey of hospitals that implemented NICHE to determine what aspects of the NICHE program were adopted. One-hundred thirty-seven hospitals implementing NICHE in 2002 were surveyed, and 103 hospitals responded. The majority of hospitals reported using the GRN model, best practice protocols, the NICHE listserv, and hospital benchmarking protocols. Hospitals were likely to use more than one NICHE tool. The most popular programs were the GIAP survey and GRN model. NICHE was most commonly used to reduce and monitor falls, restrains, and pressure ulcers.
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