As 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.1 When new organizations become NICHE members, each determines “Why NICHE and Why now?” to guide program implementation activities. As NICHE continues to equip and empower its members to drive change, it is an opportune time to consider this question for the program as a whole and initiate its next steps.

Why NICHE? NICHE member organizations continue to recognize the benefits of the geriatric resource nurse role, and associated nursing clinical protocols.2 NICHE expands nursing expertise in geriatrics, positioning nurses to lead from the bedside and equipping nurse leaders with skills to ensure nursing evidence-based practices reach each older adult.

Why Now? Older adults will outnumber those under the age of 18 within the next decade.3 NICHE provides nurses with specialized knowledge, recognition of this expertise, and role enrichment through engagement in care improvement to meet the needs of this expanding population.

The next steps for the NICHE community, led by the national program office team, seek to build on the strength of our community of geriatric nurses, deepen its integration with established geriatric quality programs and nursing professional organization partners, and increase the adoption of the NICHE practice model.

One of the key benefits and value for NICHE members is access to a network of like-minded nurse leaders who are focused on developing and sustaining clinical practice excellence in the care of older adults. The extended community of NICHE Coordinators and Geriatric Resource Nurses (GRNs) are central to NICHE's mission to advance the adoption of evidence-based practices to proactively manage the geriatric syndromes and common nursing problems that older adults are likely to experience during periods of acute illness. The NICHE national program office team has created new opportunities to engage the extended member network to fulfill the program's mission and vision for exemplary nursing care of older adults. The new volunteer opportunities through the NICHE national program office for NICHE Coordinators, GRNs, and staff nurses include:

NICHE Coordinator Community (NCC) Google Group: A new list-serve type service for NICHE Coordinators for information exchange and sharing of best practices. NICHE Coordinators may request enrollment by emailing [email protected]. At NCC enrollment, the NICHE Coordinator receives a guide to the community content guidelines and the Google Group application. The NCC Google group is moderated by the NICHE Program team.

Volunteer Opportunities:

NCPD Reviewers and Planners- We invite volunteers to contribute to NICHE's continuing professional development activities by overseeing the annual member learning needs assessments, and ongoing program evaluation and continuous quality improvement initiatives.

Curriculum Development- We welcome submissions from the members highlighting innovative approaches to teaching complex concepts to busy front-line clinicians. We would like to create a curriculum development workgroup of representatives from across the member network to inform the development of new educational resources to enhance GRN and Geriatric Patient Care Associate/ Geriatric Certified Nursing Assistant (GPCA/GCNA) clinical skills and competencies aligned with national quality improvement needs.

Webinar Series Focusing on Practice Model Implementation and Outcomes- We invite members who have successfully implemented the NICHE practice model and have documented outcomes to develop a presentation for the bi-monthly webinar series. These one-hour presentations are broadcast to a live audience and recorded for future viewing. The webinars award 1.0 nursing continuing professional development contact hour for license renewal or to fulfill the ongoing continuing education requirements needed to maintain specialty practice certification in the NICHE Member Recognition program. For teams interested in publishing the results of their evidence-based practice projects, the webinar series is a great first step to achieving this goal.

NICHE is an evidence-based practice model that supports front-line nurses to work to the full scope of their licenses and contribute their expertise to improve patient, nurse, and organizational outcomes focusing on the care of older adults. The four components of the NICHE practice model are: 1). clinical leadership and practice specialization through the Geriatric Resource Nurse (GRN) unit-based leadership role; 2). the consistent and reliable use of evidence-based clinical practice guidelines guided by the comprehensive geriatric assessment model4; 3). an environment of care, guided by the Acute Care for Elders and functional-care models, to promote older adults’ self-determination in guiding their care and to reduce the harmful effects of hospitalization5,6 and; 4). nurse-led transitions of care that support older adults and their family caregivers throughout the 30-day post-hospitalization period.7

NICHE can be viewed as a nurse-led quality and safety program, and therefore, the practice model can be integrated with other national programs focusing on the unique healthcare needs of older adults. NICHE supports and advances measurable changes in clinical outcomes, care coordination, and patient experience. NICHE promotes nursing leadership and integration in the interprofessional practice that is foundational to the specialty practice of geriatrics.1,8 NICHE offers members a proven practice model that enhances professional practice, supports nurses as leaders in their units, and provides continuing education and evidence-based practice resources to meet or exceed national quality standards.

As a professional nursing practice model, NICHE and the American Nurses Credentialing Center's (ANCC's) Magnet® and Pathway to Excellence® Programs share a common set of values and criteria for organizational systems, structures, and processes known to enhance the nurse practice environment. The NICHE practice model can be used as a springboard to enhance the nurse practice environment and meet professional practice standards in the Magnet® and Pathway® designation programs.9

As a geriatric care model, NICHE optimizes the contributions of the front-line nursing workforce to improve organizational capacity and capabilities to effectively care for older adults. NICHE shares common criteria and goals with the following national geriatric programs:

IHI Age-Friendly Health System Movement and the Implementation of the 4 M Geriatric Assessment Model

American College of Surgeons Geriatric Surgery Verification (GSV) Program

American College Emergency Physicians (ACEP) Geriatric Emergency Department Accreditation (GEDA) and the Geriatric Emergency Department Collaborative (GEDC).

American Geriatric Society (AGS) CoCare®: HELP Program and HELP ENHANCE Trial Dissemination Partner

UCLA Alzheimer's and Dementia Care Program

American Delirium Society (ADS) Evidence-Based Practice Guidelines

Alzheimer's Association Health System Regional Programs

The third priority for the NICHE national program office is to support the broader adoption of evidence-based practices to improve health outcomes for older adults. As healthcare delivery organizations recover from the pressures of the COVID-19 pandemic there is an opportunity to reimage the power and potential of clinical nursing excellence.

Partnerships: Over the next year, NICHE seeks to enhance existing and cultivate new partnerships with other professional nursing organizations to align priorities to address the health, wellness, and healthcare needs of the growing population of older adults.

Regional Conferences: To expand opportunities for more NICHE members to attend conferences, network with peers, and present their work to promote the use of evidence-based practices, we are discontinuing the annual national conference and moving to a regional conference model.

The regional conferences will be jointly sponsored by a NICHE member hospital and the national program office. The planning committee comprised of members from the host site and NICHE will develop the conference theme and program, including accepting abstracts from the membership. The goal is to host one or one-and-a-half-day events to build regional networks of leaders and organizations engaged in advancing age-friendly care while also serving as responsible stewards of our resources. More information about upcoming regional conferences will be available on the NICHE website and social media pages in the coming weeks.

Speaking Engagements: The NICHE national program faculty, including Dr. Mack, the Leadership Training Program (LTP) mentors, and the NYU Meyers College of Nursing faculty are available for keynote presentations, virtual grand rounds, or webinars focusing on evidence-based practices, program implementation strategies, or workforce development tactics to support geriatric nursing excellence that the NICHE members may be hosting.

Conclusion. This is an exciting time for NICHE as Dr. Mack assumes the role of the Executive Director to lead the program and the membership into the future to shape clinical practice and achieve the full potential of the nursing workforce to achieve age-friendly care. Thank you for your continuing dedication to our mission.

For more information about the NICHE program see our website at www.nicheprogram.org or call the national program office based at NYU Rory Meyers College of Nursing at 212–998–5445. We invite you to explore our proven practice model and evidence-based approach to transform nursing care for older adults.