We continue our series on the NICHE practice model and its implementation in healthcare delivery settings. The NICHE practice philosophy emphasizes the power of expert nursing practice and clinical leadership at the bedside to transform the care of older adults. This month we focus on the role of the NICHE Coordinator, who serves as the designated leader responsible for designing, implementing, and evaluating improvements in clinical practice to improve the overall quality and safety of care provided to older adults and their family caregivers. The NICHE Coordinator is the formal leader and manager of NICHE activities to advance geriatric nursing excellence at the organizational level. We present a new leadership development class for NICHE Coordinators to enhance their overall effectiveness with implementing the NICHE practice model in their organizations.

Nurses Improving Care for Health Systems (NICHE) is a proven geriatric care and professional nursing practice model that addresses the unique healthcare needs of older adults.1,2 Healthcare delivery organizations adopt the NICHE practice model to close gaps in clinical care, enhance nursing workforce skills in the care of older adults, and meet national quality goals established by the Centers for Medicare and Medicaid Services.3

Like other professional nursing practice models, NICHE enables nurses to practice to the full scope of their education and licensure. The NICHE model emphasizes nurse-initiated protocols to proactively manage the symptoms of geriatric syndromes to improve patient outcomes.1,4 NICHE has been shown to reduce the incidence of common hospital-acquired conditions including preventing falls, reducing the use of potentially inappropriate medications, identifying and mitigating delirium, dementia symptom management, reducing CAUTIs, and improving advance care planning among others.5

Healthcare delivery organizations adopt the NICHE practice model to advance strategic goals to meet the health needs of an aging population. Because NICHE focuses on developing the capabilities of the nursing workforce, it is the backbone of any age-friendly care initiative. The overall success of NICHE to realize improvements in key patient, nurse, and organizational outcome measures in hospital and nursing home settings relies on the abilities of the management team to transform care delivery at the bedside. A major focus of the NICHE program is to develop leadership and change management skills of nurses across the member network to realize the full potential of direct care nurses to improve patient outcomes.