Nurses as caregivers, leaders, and champions for equity: A recap of the 2021 NICHE virtual conference

After a two-year hiatus, our team was thrilled to welcome the NICHE members to the 2021 NICHE Conference, a three-day virtual event. Although we had hoped to meet in person this year, the continuing demands of the COVID-19 pandemic did not allow us to do so. In this month's column, we share the highlights of the conference program.

Drawing on our overarching conference theme of Driving Geriatric Nursing Excellence, this year's conference explored themes of family caregiving, clinical leadership, and nurses’ roles to advance health equity for older adults. The conference included keynote addresses and plenary panel presentations by leading experts and presentations by NICHE members about a range of quality improvement initiatives and innovative solutions aimed at enhancing the care experience for older adults and their family caregivers. The final day of the event provided a set of master classes hosted by our colleagues at the NYU Rory Meyers College of Nursing examining disparities in care and strategies that nurses can use to close the gaps through changes in shared governance and scope of practice. Our colleagues also shared how nurses can use focused health education to address healthy aging in diverse populations, including by working more closely with older adults in their communities to support their unique health needs during the COVID-19 pandemic and beyond.

NICHE Conference attendees spent two “mindful mornings” with Deborah Shields, PhD, RN, AHN-BC®, QTTT, CCRN engaging in self-care activities, and they recognized their peers’ accomplishments and connected with each other during a virtual recognition ceremony and happy hour. Collectively, the conference programming was insightful, wide ranging, and energizing. In the remainder of this column, we describe a few of the highlights of the event.

Keynote addresses

We welcomed four keynote speakers to this year's conference. Expanding our partnership with the AARP Home Alone Alliance and the National League for Nursing's Advancing Care Excellence for Elders program, we kicked off the conference with Dr. Terri Harvath's presentation titled Enhancing Family Caregiving Preparedness: Competencies for Health Professionals. Our colleagues at the National Alliance for Caregiving at AARP estimated 53 million Americans are caregivers, up from an estimated 43.5 million caregivers in 2015. Additionally, 26% of Americans are caring for someone with Alzheimer's disease or dementia. And more Americans say caregiving has made their own health worse.^{1 , 2} Dr. Harvath discussed the importance of seeing family caregivers as core members of an older adults’ care team. She also shared new work about the domains of family caregiver preparedness for both lay caregivers and healthcare professionals that her team at the UC Davis Betty and Irene Moore School of Nursing's Family Caregiving Institute has developed to ensure that invisible workforce of family caregivers are competent and confident in their roles to support their loved ones at home.

During our second keynote, Julie Battilana, PhD of the Harvard Business School and the Harvard Kennedy School of Public Service shared insights from her groundbreaking research on best practices for leading organizational change. Professor Battilana discussed the process of change with a specific focus on how effective change makers can identify and harness their power. She discussed common myths about power in organizations and challenged all NICHE nurses to seize the opportunity to garner their power in service of social change to create age-friendly care for older adults.

On the third day of the conference, we welcomed Dr. Linda Schwartz of the Vietnam Veteran's Association of America Inc. who offered a poignant presentation about older veterans and the common health conditions that are a function of military service. Dr. Schwartz shared the results of a recent study that she and her colleagues led examining the quality of care in the nation's State Veterans Homes during the COVID-19 pandemic. She concluded with a call to action for the NICHE members to integrate the American Academy of Nursing's “Have You Ever Served” assessment framework and pocket card into their work to identify military veterans and to design effective interventions that address Veterans’ unique health needs.

In our closing keynote address, Policy, Pandemics, Potential: Finding Better Pathways for Health of Older Adults, Eileen M. Sullivan-Marx, Ph.D., RN, FAAN, Dean of NYU Rory Meyers College of Nursing and President of American Academy of Nursing, challenged NICHE members to look to the future. She suggested that they reflect back on the last year, understand what they have learned, and move forward to what new worlds might exist as they care for older adults. She discussed how the concept of VUCA - that is volatility, uncertainty, complexity, and ambiguity - has shaped nursing care during the pandemic.³ She shared how nurses have combated this with the antidote VUCA consisting of vision (e.g., our nursing staff will remain resilient and well, we will deliver quality care), understanding (e.g., the facts, emotions, dynamics), clarity (e.g., through assessment and the nursing process), and agility (e.g., regulators rapidly moving to allow nurse practitioners to practice to the full scope of practice). Dean Sullivan-Marx congratulated NICHE nurses for their strength and resilience as well as thanked them for the excellent care that they continue to provide to older adults, including during the COVID-19 pandemic.

Plenary sessions

We welcomed our colleagues from The John A. Hartford Foundation and the Institute for Health Improvement, Dr. Amy Berman and Dr. Alice Bonner, and the leadership team of Dr. Christine Waszynski and Dr. Robert Dicks from Hartford Hospital, a longtime NICHE member and exemplar site, who shared lessons learned and implementation strategies to integrate the Age-Friendly Health System's 4M model of – What Matters, Mobility, Mentation and Medications –into clinical practice as part of Hartford Hospitals’ work to become an Age-Friendly Health System. The panelist stressed the importance of integrating the 4Ms into standard workflows and aligning care improvement initiatives with health system strategic priorities and organizational mission and vision. Our colleagues at Hartford HealthCare also stressed that the Age-Friendly Health Systems movement supports and amplifies NICHE outcomes. In fact, a crosswalk available from the IHI illustrates the synergy between these two programs and is available via the following link: https://f.hubspotusercontent30.net/hubfs/241684/NICHE-AFHS%20Crosswalk%202018.pdf.

Member presentations

Approximately 100 NICHE members and other experts in gerontological care shared their great work via breakout, roundtable, and poster presentations. The innovation and expertise of NICHE members came through in these presentations. For example, in their breakout session, Baseline Mental Status: Removing the Confusion Through Documentation, Erica Yates, MSN, APRN, ACNS-BC, CRRN, GERO-BC, and Julie Simon, MSN, APRN, AGCNS-BC, CMSRN of Cleveland Clinic shared how they improved delirium detection by integrating a baseline delirium assessment into their electronic medical record. Similarly, during her breakout session, Dawn Hippensteel, MS, BSN, RN, GCNS-BC shared how interdisciplinary geriatric case conference is driving improved patient outcomes at UPMC Pinnacle Harrisburg. Collectively, the member presentations were impressive and proof of the NICHE membership's commitment to geriatric nursing excellence.

Member recognition

Wednesday evening, we had the opportunity to honor our members for a number of accomplishments. We recognized over 60 members that earned the NICHE-ABIM Foundation Choosing Wisely® Trailblazer Award in conjunction with the 2020 NICHE Virtual Conference session, Choosing Wisely® to Promote High-Value Care. The award recognizes organizations whose NICHE teams have implemented quality improvement projects focusing on following the American Academy of Nursing recommendations: mobility and fall reduction, delirium recognition and management, sleep hygiene, restraint reduction, urinary catheter management, and nutrition or hydration or one of three additional areas identified by NICHE: medication safety, care coordination or transitions of care, and advanced care planning. We look forward to honoring members again this fall with this annual award. During our member recognition event, we also honored our Legacy Members, who are those who joined NICHE between 1993 and 2010 and remain active members. We welcomed new members and those who achieved Senior-Friendly and Exemplar member recognition. We celebrated all the NICHE member organizations that have Accredited Geriatric Emergency Departments. Finally, we thanked NICHE Leadership Training Program mentors, the 2021 NICHE Virtual Conference Planning Committee, and this year's sponsors. We could not have hosted such a successful event without their support.

Conclusion

While we look forward to when we can gather in person, the 2021 NICHE Conference allowed us to connect virtually and learn about innovations in the field. Members highlighted their nurse-led initiatives to improve the care of older adults through their inspiring presentations. Our speakers challenged attendees to be powerful, resilient, self-aware, and compassionate in their continued work delivering age-friendly excellent care to older adults. Attendees left the event excited, ready to implement new things that they had learned, and looking forward to when we can be together again.

Box: To learn more about NICHE or to become a member contact us at: support@nicheprogram.org or by phone 212-992-5445.