Quinte Health Care is proud to announce that it is now officially NICHE designated. NICHE (Nurses Improving Care for Healthsystem Elders) provides elder-care education and support for health care providers to help hospitals improve the care of older adults. The NICHE vision is “…for all patients 65 and over to be given sensitive and exemplary care”. http://www.nicheprogram.org/
Elderly patients accounted for 66% of acute medical admissions to QHC hospitals in 2014/15. In the area served by QHC hospitals, 21% of the population is over 65 years of age compared to the provincial average of 16%. In the past couple years, QHC has experienced a 7% growth in the number of patients over 90 years of age. That population has an increased total length of stay of 20 days versus 5 days for patients under 60. In addition, the number of patients requiring home care support when they are discharged from hospital has grown from 15% to 31%.
QHC will open a 30-bed Acute Care for the Elderly (ACE) and Alternative Level of Care (ALC) unit in April on Quinte 4 at Belleville General Hospital (20 beds are allocated for ACE and 10 ALC beds). A focused implementation of ACE principles of care is planned to begin in April at Prince Edward County Memorial Hospital’s inpatient unit. QHC Program Director of Medicine Christine Wilkinson, stresses that while this philosophy of care for older patients will be the basis for care on the new unit and in the PECMH inpatient unit, it’s important education for staff in all areas throughout the organization.
“We wanted to look at a comprehensive and sensitive plan of care for our elderly patients throughout our organization,” explained Wilkinson. “Considering the increasing age of our community and the patients we are seeing, it’s the right thing to do to embed it into the care we provide today and into the future.”
Wilkinson was among three members of the QHC team to complete the Niche Leadership Training Program in which they developed an action plan in order to successfully attain the designation. “We know that hospitalization can create further decline for frail, elderly patients,” Wilkinson explained. “They are more at risk for worsening functional status, delirium, falls, medication toxicity, dehydration, malnutrition and ulcers. It’s a more complex hospitalization as 40% of patients we treat over 65 years of age have at least three other illnesses or conditions.”
According to Wilkinson, the training provided through our NICHE designation will provide staff with the tools to better meet the specialized needs of the elderly in hospital, for example focusing on preventing the decline of mobility, watching for falls, getting them up to a social dining setting and working with the patients and families to make sure they have the supports they need.
QHC NICHE Coordinator, Registered Nurse Kim Bender agrees, “NICHE will provide nurses at QHC with practical, evidence based geriatric education in several different areas of the healthcare continuum; such as caring for seniors in emergency departments, oncology departments and in a primary care setting,” she explains. “This knowledge will allow nurses to help seniors maintain their functional and cognitive abilities, while being admitted in the hospital, and ensuring they have the best quality of life in hospital and outside of the hospital setting.”
Clinical managers have identified 5-10 front line staff members from each inpatient unit at QHC to complete geriatric training and the education resources and supports related to NICHE are available to everyone at Quinte Health Care.