Research ArticleResearchWorkflowQuality Improvement

A tailored nursing program was associated with fewer falls during chemotherapy for older adults with lymphoma

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (PubMed)Jul 18, 2026

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AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

In a single-center randomized trial of 210 adults aged 65 or older receiving chemotherapy for non-Hodgkin lymphoma, a multifactorial nursing program was associated with fewer falls over 12 weeks than standard oncology nursing (7.1% versus 19.8% among 194 participants who completed follow-up).

What NurseJet pulled from the source

This prospective randomized trial assigned 210 older adults with newly diagnosed or relapsed non-Hodgkin lymphoma to individualized fall-risk assessment plus a multifactorial preventive nursing program or standard oncology nursing. Of 194 participants who completed 12 weeks of follow-up, fall incidence was 7.1% in the intervention group and 19.8% in the control group. The intervention group also had fewer severe injuries, better Timed Up and Go performance, higher chemotherapy completion, and higher quality-of-life scores. Because the study was conducted at one center and reports outcomes among completers, the results support structured fall-prevention assessment without establishing that one protocol will work in every oncology setting.

Why this matters for nurses

Oncology nurses repeatedly assess mobility, neuropathy, anemia, treatment effects, and environmental risks that can change throughout chemotherapy. This trial directly tests a nursing-led approach for a high-risk older population.

Bedside takeaway

A multifactorial nursing program was associated with fewer falls in older adults receiving lymphoma chemotherapy, but the single-center protocol needs local review.

How This Applies in Practice

Use this when: Assessing an older adult's fall risk before or during chemotherapy for non-Hodgkin lymphoma.

On your shift

Reassess mobility and treatment-related fall risks at clinically relevant visits and after any fall, near-fall, or functional change.
Match prevention measures to the documented risks and communicate new weakness, neuropathy, dizziness, or injury to the oncology team.

Keep in mind: Do not import the study protocol without local review. Follow the oncology fall-prevention pathway, facility policy, and patient-specific provider orders.

Key takeaways

The single-center randomized trial enrolled 210 adults aged 65 or older receiving chemotherapy for non-Hodgkin lymphoma.
Fall incidence among 194 follow-up completers was 7.1% with the preventive nursing program and 19.8% with standard care.
The intervention group also had better functional-mobility, chemotherapy-completion, and quality-of-life outcomes.
The 12-week, single-center design and completer analysis limit generalizability.

Practice implications

Use the facility's oncology fall-risk process to reassess mobility and treatment-related risks across chemotherapy visits, then individualize prevention measures and document changes. Escalate new weakness, neuropathy, dizziness, falls, or injuries through the oncology team rather than adopting the study protocol without local review.

Limitations & cautions

The trial was conducted at one center, followed patients for 12 weeks, and reports results for 194 of 210 enrolled participants who completed follow-up. The abstract does not describe allocation concealment, blinding, or every component of the intervention, and the authors call for multicenter, longer-term validation.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (PubMed)

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (PubMed). A clinical study on fall risk assessment and preventive nursing in older adults with non-Hodgkin's lymphoma undergoing chemotherapy-a randomized controlled trial.

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https://pubmed.ncbi.nlm.nih.gov/42470465/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Asia-Pacific journal of oncology nursing (PubMed)Sep 21, 2026Systematic Review

A systematic review and meta-analysis of 11 randomized controlled trials found sensorimotor training significantly improved patient-reported neuropathy symptoms, balance function, lower-limb strength, and quality of life in adults receiving neurotoxic chemotherapy.

Oncology Med-SurgAI summaryReview source

Systematic ReviewResearchPatient EducationQuality ImprovementAI summary · original source linked below

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating adverse effect of neurotoxic antineoplastic agents that frequently impairs postural stability and increases fall risk. In a PRISMA-guided systematic review and meta-analysis registered in PROSPERO (CRD42024615574), investigators searched 11 databases and two clinical trial registries through March 2026. Across 11 randomized controlled trials enrolling 548 adult cancer patients (seven studies providing quantitative meta-analytic data), sensorimotor training (SMT) was associated with significant improvements in patient-reported CIPN symptoms (standardized mean difference [SMD] = 0.54; 95% CI, 0.18-0.89) and clinician-rated neuropathy scores (SMD = 0.50; 95% CI, 0.08-0.92). SMT also produced notable improvements in balance performance (SMD = 0.79; 95% CI, 0.43-1.15), lower-extremity strength (SMD = 0.67; 95% CI, 0.30-1.04), and overall quality of life (SMD = 0.64; 95% CI, 0.34-0.94). Subgroup analysis found no significant difference between standalone SMT and multimodal exercise programs.

Key takeaways

Meta-analysis synthesized 11 randomized controlled trials comprising 548 adult cancer patients undergoing neurotoxic chemotherapy.
Sensorimotor training was associated with significant reductions in patient-reported (SMD 0.54) and clinician-graded (SMD 0.50) neuropathy symptoms.
Interventions yielded substantial functional gains in postural balance (SMD 0.79) and lower-extremity muscle strength (SMD 0.67).
Overall evidence certainty was evaluated as low per GRADE criteria due to small sample sizes, study heterogeneity, and risk of bias.

Why this matters on shift

Oncology nurses frequently assess patients for sensory loss, numbness, and tingling during neurotoxic chemotherapy regimens. Because pharmacologic options for CIPN treatment remain limited, non-pharmacologic sensorimotor exercises that retrain proprioception and balance offer an actionable strategy to alleviate symptom distress, prevent falls, and preserve functional independence.

Bedside takeaway

A meta-analysis of 11 RCTs (548 adults with cancer) found sensorimotor training significantly improved neuropathy symptoms (SMD 0.54), balance function (SMD 0.79), and quality of life (SMD 0.64), though overall evidence certainty remains low.

Nursing implications

Screen patients receiving neurotoxic chemotherapy for numbness, paresthesias, and unsteady gait; provide early fall prevention education and collaborate with oncology physical therapy to initiate guided sensorimotor and balance exercises per facility care pathways.

Limitations & cautions

Low certainty of evidence across outcomes per GRADE; small sample sizes across primary studies; heterogeneous training protocols and variable chemotherapy regimens precluded definitive dosing recommendations.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Asia-Pacific journal of oncology nursing (PubMed). Effects of sensorimotor training on chemotherapy-induced peripheral neuropathy-related outcomes in adults with cancer: A systematic review and meta-analysis of randomized controlled trials.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Anesthesia and analgesia (PubMed)Oct 16, 2026Systematic Review

A meta-analysis of 25 randomized controlled trials with 3,344 surgical patients found perioperative ketamine and esketamine were associated with reduced postoperative delirium between days 2 and 7, but significantly increased postoperative dizziness.

Geriatrics Med-SurgAI summaryReview source

Systematic ReviewResearchMedication SafetyAI summary · original source linked below

Postoperative delirium (POD) is a common, distressing complication in older surgical patients, yet effective pharmacologic prevention options remain limited. This systematic review and meta-analysis of 25 randomized controlled trials (RCTs) involving 3,344 patients evaluated perioperative administration of ketamine (9 trials) and esketamine (16 trials) compared to placebo or standard care. Both agents were associated with reduced POD incidence (ketamine: risk ratio [RR] 0.69; 95% CI, 0.49–0.98; P = .04; esketamine: RR 0.58; 95% CI, 0.36–0.95; P = .03). Risk reductions were most evident with higher-dose regimens (single bolus: ketamine >0.5 mg/kg or esketamine >0.25 mg/kg; cumulative dose: ketamine >1.0 mg/kg or esketamine >0.5 mg/kg), bolus-plus-infusion administration, and in major surgical procedures. However, the preventative association was present only when delirium was assessed between postoperative days 2 and 7, not within the first 24 hours. Furthermore, ketamine/esketamine significantly increased the risk of postoperative dizziness (RR 1.45; 95% CI, 1.14–1.84; P = .002). Trial sequential analysis indicated that total evidence remains inconclusive due to insufficient overall sample size.

Key takeaways

Meta-analysis analyzed 25 RCTs with 3,344 patients receiving perioperative ketamine (9 trials) or esketamine (16 trials).
Both agents were associated with lower POD incidence versus control: ketamine RR 0.69 (P = .04) and esketamine RR 0.58 (P = .03).
Delirium reduction was apparent at postoperative days 2 to 7, but not during the initial 24 hours.
Dizziness risk was significantly elevated in treated patients (RR 1.45; 95% CI, 1.14–1.84; P = .002), and trial sequential analysis found cumulative sample size insufficient to draw definitive conclusions.

Why this matters on shift

Surgical and post-anesthesia nurses monitor older adults recovering from general anesthesia for confusion, agitation, and fall risk. While ketamine and esketamine show potential neurocognitive protective signals beyond day 1, their heightened dizziness profile increases post-op balance instability, requiring cautious bedside mobility precautions rather than unreserved clinical adoption.

Bedside takeaway

In a meta-analysis of 25 RCTs (3,344 patients), perioperative ketamine (RR 0.69) and esketamine (RR 0.58) reduced delirium at days 2–7 but significantly increased dizziness (RR 1.45).

Nursing implications

Screen surgical patients systematically for emergence and delayed delirium using validated tools (such as CAM or CAM-ICU) through postoperative day 7, implement strict fall and dizziness precautions when ketamine derivatives are administered, and avoid assuming early alertness guarantees absence of delayed delirium.

Limitations & cautions

Trial sequential analysis confirmed current evidence remains inconclusive due to inadequate total information size; dizziness was increased (RR 1.45); high heterogeneity in surgical populations and anesthesia protocols.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Anesthesia and analgesia (PubMed). Effects of Ketamine and Esketamine on Postoperative Delirium After General Anesthesia: A Meta-Analysis and Meta-Regression Analysis.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Stroke (PubMed)Oct 1, 2026Clinical Guideline

The American Heart Association and American Stroke Association released updated 2026 guidelines for adult stroke rehabilitation and recovery, updating guidance across medical comorbidities, bone health, fall risk, and technology-assisted therapy.

Emergency Med-SurgAI summaryReview source

Clinical GuidelineGuidelineQuality ImprovementWorkflowAI summary · original source linked below

Replacing the previous 2016 recommendations, the American Heart Association and American Stroke Association published the comprehensive 2026 Guideline for Adult Stroke Rehabilitation and Recovery following extensive systematic review of literature published through late 2025. Directed toward interprofessional care teams, rehabilitation nurses, therapists, and family caregivers, the updated guideline establishes evidence-based standards spanning the inpatient acute-to-community recovery continuum. Major updates focus on the comprehensive assessment and management of vascular and medical comorbidities, structured fracture risk assessment, protocolized inpatient and home fall prevention, technology-enabled rehabilitation modalities, dedicated caregiver psychosocial support, community participation, and standardized evaluations for safe return to driving and employment.

Key takeaways

AHA/ASA 2026 guideline replaces 2016 standards across the inpatient and outpatient stroke rehabilitation continuum.
Establishes new recommendations for managing post-stroke medical comorbidities, bone mineral density loss, and fracture prevention.
Prioritizes structured fall prevention protocols and evaluates technology-enabled rehabilitation systems.
Expands dedicated guidance on family caregiver support, functional community participation, and safe return to driving.

Why this matters on shift

Neuroscience and medical-surgical nurses manage acute stroke survivors during the highest-risk window for post-stroke complications, including immobility, deconditioning, and falls. Updated national guidance gives bedside nurses clear authority to initiate early mobility safety assessments, safeguard bone health, and prepare family caregivers for post-discharge recovery demands.

Bedside takeaway

AHA/ASA updated its adult stroke rehabilitation guideline, emphasizing comorbidity management, bone health, structured fall prevention, technology-enabled therapies, and caregiver support.

Nursing implications

Incorporate structured fall risk assessments and fracture prevention strategies into post-stroke care plans, assess family caregiver burden early in the hospital stay, and coordinate closely with physical and occupational therapy on mobility goals and discharge equipment needs.

Limitations & cautions

Comprehensive guideline covers broad multi-domain stroke rehabilitation; the authors emphasize that substantial gaps in high-certainty evidence remain for specific neuro-recovery interventions, underscoring the need for ongoing randomized trials.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Stroke (PubMed). 2026 Guideline for Adult Stroke Rehabilitation and Recovery: A Guideline From the American Heart Association and American Stroke Association.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

Meta-analysis of 11 randomized trials finds sensorimotor training improves neuropathy symptoms, balance, and quality of life in adults with cancer

Meta-analysis of 25 RCTs finds perioperative ketamine and esketamine reduce postoperative delirium risk but increase dizziness

AHA/ASA releases 2026 adult stroke rehabilitation and recovery guideline across medical comorbidities and fall prevention