A RETROSPECTIVE EVALUATION OF THE NICHE (NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS) PROGRAMME IN SINGAPORE

Abstract

Aims and objective: The aim of the study was to evaluate the effectiveness of the NICHE program in improving nursing practice compliance and geriatric patients outcomes in Singapore. Background: Singapore’s healthcare needs to adapt and prepare for the ageing population. Research have shown the improved clinical outcomes of geriatric patients under the Nurses Improving Care for Healthsystem Elders (NICHE) programme. However, there were no studies done in Singapore‘s healthcare setting that explored the effects of NICHE programme. Method: A retrospective evaluation was conducted in a NICHE-trained medical geriatric ward. Data reflecting nursing practices and geriatric outcomes were extracted from patients 65 and above and admitted before and after the intervention implementation. Descriptive statistics was used to analyze the sociodemographic data. Other analysis was performed to test for statistical significance between the pre-intervention and post-intervention data. Results: Out of the 547 samples, there was no statistical significance found between the pre-intervention and post-intervention period. However, a marginal statistical significance of (p=0.06) was found for the length of stay variable. Based on frequency, there were improvements for variables such as incidence of behaviour issues, pressure injury, falls and length of stay. Conclusion: The NICHE programme should not be deemed as ineffective despite the statistical insignificance as other factors had to be considered. This includes the ward circumstances during the post-intervention period, multifactorial reasons that was not addressed by NICHE-implementation, study design, data extraction methods and method of intervention implementation. Implication: Future practice implications includes implementing multipronged interventions, and a data system for nurse-sensitive data. Recommendation for future research includes design and data extraction methods for future studies, exploring other nurse-sensitive variables, undertaking larger sample size, utilizing a longitudinal approach and exploring clinical and practical significance.