AONE/NICHE Award: Bronson Methodist Hospital

In 2001, recognizing that 47 percent of its admissions were patients over age 65, the administration of Bronson Methodist Hospital in Kalamazoo, Michigan considered becoming a NICHE site. They sent staff members to the annual NICHE Leadership Conference and administered the Geriatric Institutional Assessment Profile (GIAP). Three years later, their efforts were so successful they received the inaugural AONE/NICHE Award.

"While the staff initially reported being confident in their ability to use treatments appropriately in older adults and to manage problems, the knowledge scores on the GIAP reflected a need for training," says Rita LaReau, MSN, GNP. The hospital adopted the Geriatric Resource Nurse model of the NICHE program and developed an inservice training curriculum based on the one recommended by the Hartford Institute for Geriatric Nursing.

Bronson Methodist Hospital embedded many of the evidence-based protocols and procedures of the Hartford Institute into their nursing documentation system, as well. For example, the nursing admission history incorporates assessment tools for activities of daily living and sensory deprivation.

Other assessment tools the hospital learned from the Try This series and incorporated into practice include the Hendrich II Fall Risk Model, Braden Pressure Ulcer Risk Assessment Scale, Confusion Assessment Method (CAM), and the Geriatric Depression Scale. The Mini-Cog (a brief dementia screening test) and the Foley Catheter Removal Protocol are two other evidence-based practice tools utilized. "One of our greatest achievements is using evidence-based tools in our nursing practice," says Ms. LaReau.

Once the potential for geriatric nursing was established, the hospital also decided to open a ward based on the Acute Care of the Elderly (ACE) concept. The unit has a community room, which encourages patients to walk about to encourage recovery and to spend time with family and friends. For patients not admitted to the ACE Unit, elder-focused protocols and procedures are in place throughout the hospital.

In addition to its own internal accomplishments, the hospital received a $200,000 grant from the federal Health Resources and Services Administration to make the NICHE program available to rural hospitals and nursing homes, through classroom instruction and teleconferencing. Bronson Methodist Hospital provided over $200,000 in funding to the project, as well. "One nice outcome was that many of these nurses pursued gerontological nurse certification, meaning that for the first time in some nursing homes there were staff who were certified as gerontological nurses," says Ms. LaReau.