1. Capezuti, Liz PhD, RN, APRN-BC, FAAN

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The Atlantic Philanthropies has awarded the Hartford Institute for Geriatric Nursing, part of New York University's College of Nursing, a $5 million, five-year grant to expand its NICHE (Nurses Improving Care for Health System Elders) program. Since 1996, the Hartford Institute has administered NICHE, which has as its vision that all patients ages 65 and older be given sensitive and exemplary care. NICHE is a national geriatric nursing program that helps hospitals achieve systematic nursing change to benefit older patients. It is currently implemented in 225 hospitals in more than 40 states and parts of Canada.


Many nurses are unaware of the ways in which older adults differ from younger patients in terms of symptoms and appropriate treatment. Hospitals are recognizing that such teaching is necessary to prepare their organizations for the future. The Atlantic Philanthropies grant will help NICHE build its internal capacity, dramatically improve the program's "tool kit"-particularly its measurement and reporting capacity-and initiate outreach to accelerate adoption of the program by additional hospitals.


When hospitals first join the NICHE program, they send a team to a conference where they learn about the various elements of the NICHE tool kit. NICHE is a modular program that offers hospitals an array of options to improve their nursing resources for older adults. The most frequently used component, the Geriatric Resource Nurse model, helps hospitals train interested and motivated nurses in best practices for the care of older adults. These nurses then become resources for their colleagues, and many go on to become certified in gerontologic nursing. Some hospitals have adopted the Acute Care of the Elderly model, and others have instituted hospital-wide programs to address specific issues such as falls prevention, skin care, incontinence, and delirium.


The NICHE program aims to expand to 600 or more hospitals during the five-year grant period. The project's current plan includes regional and audio conferences and a new Web site for NICHE members that will offer interactive, Wikipedia-type technology, enabling users to share information about best practices in the care of older adults. For more information, go to


Liz Capezuti, PhD, RN, APRN-BC, FAAN


Associate professor and codirector, John A. Hartford Foundation Institute for Geriatric Nursing, New York University College of Nursing, New York City: