Long-Term Care / Geriatrics

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.

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.

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.

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.

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.

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.

Key takeaways

• Meta-analysis of 16 hospital studies found sensor-based fall systems overall did not significantly reduce fall rates (IRR 0.77) or injuries (IRR 0.98).
• Machine learning-based sensor systems significantly cut inpatient fall rates by 50% (IRR 0.50, 95% CI 0.32–0.79).
• Traditional rule-based pressure sensors showed no significant benefit on fall incidence.
• Mandatory unit-wide sensor implementation was associated with a significant fall rate reduction (IRR 0.51, 95% CI 0.37–0.70), but not fewer fallers.

Nursing implications

• Do not rely on standard pressure sensor alarms as standalone fall prevention; pair technology with intentional rounding, assisted toileting, and environmental safety checks. When modern predictive or machine-learning sensors are deployed, adhere strictly to unit operational protocols to realize preventative benefits.

Limitations & cautions

• High statistical heterogeneity among included trials (I² up to 92%); only seven studies eligible for statistical pooling; overall certainty of evidence rated very low to low under GRADE criteria.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Multicenter cluster-randomized trial enrolled 1,260 older adults with atrial fibrillation and multiple chronic conditions across six European nations.
• Baseline anticoagulation adherence was exceptionally high at 97.3%, and comprehensive geriatric assessment revealed high baseline functional independence.
• Unplanned hospitalizations did not differ significantly between the mHealth integrated care group and usual guideline care (17.1% vs 18.2%, P = 0.84).
• Digital intervention engagement was suboptimal, with over two-thirds of older participants actively using the mobile app for only one-third of follow-up.

Nursing implications

• Emphasize reliable adherence to evidence-based oral anticoagulation and rhythm/rate medications during cardiac nursing discharge education, rather than relying on unproven digital health apps, and directly assess older patients for device usability and digital literacy before recommending mobile tracking.

Limitations & cautions

• Open-label cluster design; baseline guideline adherence was extraordinarily high (97.3%), creating an event floor; suboptimal patient adoption of the smartphone application limited potential intervention impact.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Comprehensive network meta-analysis analyzed 45 randomized controlled trials comprising 16,240 older adults across five exercise categories.
• Mind-body exercise (OR 0.62) and multicomponent training (OR 0.78) significantly reduced overall faller incidence compared with usual care.
• Mind-body exercise was the only modality demonstrating a significant decrease in recurrent fallers (OR 0.57, 95% CI 0.38 to 0.85).
• Risk of fall-related physical injury was significantly attenuated by both mind-body exercise (OR 0.68) and balance training (OR 0.76).

Nursing implications

• Integrate tailored balance and mind-body movement activities into inpatient mobility pathways and multidisciplinary discharge care plans for older patients identified as moderate-to-high fall risks, emphasizing injury reduction over generalized ambulation alone.

Limitations & cautions

• Certainty of evidence varied from moderate to very low across distinct outcomes; interventions differed in duration and intensity; exercise modalities did not demonstrate a statistically significant reduction in fall-related fractures.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Systematic review synthesized 14 clinical studies evaluating nurse-led predictive symptom management protocols in oncology palliative care.
• Laboratory biomarkers including CRP, neutrophil-lymphocyte ratio (NLR), albumin, ferritin, and electrolytes reliably heralded impending clinical decline.
• Nurse-coordinated integration of biomarker trends with structured clinical assessment shifted care from reactive firefighting to proactive symptom stabilization.
• Predictive nursing models were associated with reduced emergency department admissions and improved symptom-related quality of life.

Nursing implications

• Review trending laboratory indicators (such as rising CRP, worsening NLR, or falling albumin) during oncology and palliative encounters as early alert signals for impending symptom crisis or disease progression, adjusting supportive care plans and symptom titration before severe functional decline develops.

Limitations & cautions

• Heterogeneity in study designs, biomarker panels, and tumor types across the 14 included studies; algorithms and predictive models require standardized electronic health record integration before universal bedside adoption.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Randomized controlled trial enrolled 214 older adults undergoing elective major abdominal (visceral) surgery.
• Participants were randomized to traditional nurse-led preoperative education alone or nurse education plus an interactive chatbot (PreventCombot).
• Chatbot group experienced significantly fewer postoperative complications at 24 hours, 48 hours, and 30 days (p < 0.05).
• Patients receiving chatbot education had significantly reduced anxiety (p < 0.001) and higher physical and mental quality-of-life scores (p < 0.001).

Nursing implications

• Integrate interactive teach-back methods and multimedia or digital reinforcement when preparing older adults for major surgery. Ensure preoperative teaching clearly reviews incentive spirometry, splinted coughing, and early post-op ambulation milestones, offering family members access to written or digital instructions to reinforce adherence.

Limitations & cautions

• Single-center trial in elective abdominal surgery; results may not generalize to emergent procedures or patients with severe cognitive impairment unable to interact with digital interfaces.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Randomized trial enrolled 95 acute ischemic stroke patients with dysphagia admitted to an inpatient neurology department.
• Intervention patients received 4 mL of room-temperature lemon juice prior to breakfast, lunch, and dinner for 7 days versus 4 mL water in controls.
• Swallowing function on the Gugging Swallowing Screen (GUSS) improved significantly more in the sour taste group at 7 and 30 days.
• Between-group difference in total GUSS scores demonstrated a large effect size at day 30 (r = 0.54, p < 0.001), while NIHSS scores improved equally.

Nursing implications

• Prior to initiating oral intake or swallowing trials, ensure a formal bedside dysphagia screening (such as GUSS) is completed. In stroke patients cleared for oral trials by speech-language pathology, collaborate on incorporating sensory stimulation techniques such as sour boluses while maintaining aspiration precautions (upright 90-degree positioning, small bolus size, and suction readiness).

Limitations & cautions

• Conducted at a single university hospital with a modest sample size (n = 95); longer-term aspiration pneumonia incidence and hard clinical outcomes beyond 30 days were not evaluated.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Across 18 studies (~20,000 patients), nurse-led telemonitoring significantly reduced all-cause and heart failure readmissions compared to usual care.
• Programs combined daily remote tracking of weight, blood pressure, heart rate, and symptoms with active nurse triage and escalation.
• Randomized trials showed a nonsignificant trend toward lower mortality, while large observational cohorts showed significantly lower 1-year mortality.
• Interventions featuring timely nurse response to biometric alerts and active patient engagement demonstrated the strongest clinical benefit.

Nursing implications

• Reinforce discharge education on daily weight tracking, symptom logging, and reporting red-flag thresholds such as sudden weight gain or worsening orthopnea. In outpatient and remote monitoring workflows, ensure rapid assessment and escalation when biometric alerts occur, following validated unit heart failure titration protocols.

Limitations & cautions

• Risk of bias across included studies was low to moderate, with performance bias common due to the unblinded nature of telemonitoring. Heterogeneity in monitored parameters and intervention components was present across trials.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Early ambulation within 24 to 48 hours following hip fracture surgery was associated with substantial reductions in both 30-day (RR 0.40) and 1-year mortality (RR 0.57).
• Postoperative complications dropped by 21% overall (RR 0.79; 95% CI 0.74-0.84), driven by lower incidences of postoperative pneumonia and venous thromboembolism.
• Patients achieved higher Barthel Index and Functional Independence Measure scores, along with increased rates of direct discharge to home.
• Hospital readmission rates did not differ significantly between early and delayed mobilization groups.

Nursing implications

• Collaborate with physical therapy and providers to initiate weight-bearing or out-of-bed ambulation within the first 24 to 48 hours after hip surgery. Premedicate for pain prior to scheduled transfers, monitor for orthostatic intolerance, and communicate the survival and functional benefits to hesitant patients and families.

Limitations & cautions

• The meta-analysis synthesized 26 studies with substantial heterogeneity, predominantly relying on observational cohort designs alongside randomized trials. Mobilization definitions and assistance levels varied across institutional protocols.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The pooled risk ratio for delirium incidence was 0.64 with no measured between-study heterogeneity for that outcome.
• Hospital Elder Life Program-based protocols had the largest subgroup estimate, with a risk ratio of 0.58.
• Subgroup and meta-regression analyses did not identify statistically significant moderators of the intervention effect.

Nursing implications

• Use the facility's approved delirium-prevention bundle, screen and document risk or new cognitive change, and coordinate ordered mobility, hydration, sleep, orientation, and sensory-support measures. Escalate acute changes and follow local fall, medication, and provider-order protocols.

Limitations & cautions

• The synthesis combined randomized and quasi-experimental designs and multicomponent programs that may differ by setting. The abstract reports moderate certainty and does not show that every component or implementation model has the same effect.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Molecular testing, particularly PCR, showed greater sensitivity than standard urine culture but lacked specificity.
• The two randomized trials included 773 patients and reported improvement in baseline UTI symptoms over 28 days with PCR-guided antibiotic therapy.
• Both randomized trials and five of ten prospective studies were funded by companies that developed the molecular tests.

Nursing implications

• Collect specimens according to facility protocol, document urinary and systemic symptoms clearly, and report results in clinical context. Reinforce the prescribed antibiotic plan and avoid presenting a positive molecular result alone as proof of symptomatic UTI.

Limitations & cautions

• Only 12 studies met inclusion criteria, clinical outcome evidence was limited, the randomized trials were industry funded, and the review excluded studies involving only men or children. The abstract does not establish a preferred molecular platform or testing protocol.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Dyspnea, cough, and fatigue were the most common presenting symptoms.
• Longer diagnostic time was associated with more advanced disease, worse survival and quality of life, and more hospitalizations.
• Reported contributors included comorbidities, prior misdiagnosis or treatment, and absence of early imaging or multidisciplinary evaluation.

Nursing implications

• Document the onset, trajectory, exertional impact, oxygenation, and prior treatment response for persistent dyspnea, cough, or fatigue. Escalate unexplained deterioration and help close ordered imaging, pulmonary referral, and follow-up loops according to local policy.

Limitations & cautions

• The included evidence was observational and heterogeneous, so the associations do not prove that delay caused worse outcomes. Time-to-diagnosis definitions and estimates varied, and direct economic effects were poorly studied.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Most intervention participants attended at least six of eight sessions, and mean delivery fidelity was 94.1%.
• Six possibly or probably related events were mild or moderate, with no related serious event.
• Staff and family interviews emphasized non-deceptive introductions, respect for refusal, training, and recognition that some residents had no response or an adverse response.

Nursing implications

• Use doll therapy only within an approved individualized care plan, introduce it without deception, observe the resident's verbal and nonverbal response, and stop when the resident refuses or becomes distressed. Continue assessment for unmet physical, environmental, and psychosocial needs under facility protocol.

Limitations & cautions

• This exploratory study involved only six nursing homes, lacked an attention-control condition, and was not designed as definitive effectiveness evidence. Medication effects were imprecise, functional improvement was not sustained, and findings may not generalize beyond the studied care setting.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Visual impairment functioned as a prognostic marker across diverse adult populations and settings.
• The adjusted analysis still showed substantial between-study heterogeneity, and the certainty of evidence was rated low.
• The review did not test whether correcting visual impairment reduces delirium incidence.

Nursing implications

• Assess and document baseline vision and available aids during delirium-risk screening, make prescribed visual aids accessible when safe, and evaluate acute cognitive change through the facility's delirium pathway rather than attributing it to sensory impairment alone.

Limitations & cautions

• The included evidence was observational, definitions of both visual impairment and delirium varied, heterogeneity was high, and residual confounding may remain. The analysis establishes association, not causation or treatment effectiveness.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Patients completed a structured adverse-effect profile that was shared with the practice pharmacist and repeated with a nurse researcher after 20 weeks.
• The study found more documented problems addressed in the intervention group, including medication-related referrals and reviews.
• The estimate was imprecise and came from one small practice group, so effectiveness and workflow burden need confirmation in larger settings.

Nursing implications

• During medication reconciliation, ask systematically about new or persistent symptoms, document timing and functional impact, and escalate suspected adverse effects to the pharmacist or prescriber. Do not stop or change long-term medicines outside provider orders and facility policy.

Limitations & cautions

• Only 60 patients from six practices within one general-practice group were enrolled, three were lost to follow-up, and the confidence interval around the primary estimate was wide. The abstract reports process and clinical-problem outcomes rather than hospitalization or mortality outcomes.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The pooled early-discontinuation estimate did not establish a reliable benefit because its confidence interval included no difference and heterogeneity was substantial.
• Complete discontinuation at the longest follow-up was highly uncertain, and dose-reduction results could not be pooled because definitions and time points varied.
• CBT-I-assisted interventions lowered post-treatment insomnia-severity scores in three small trials, but the evidence remained uncertain.

Nursing implications

• Reconcile benzodiazepine and Z-drug use, duration, and fall or cognitive concerns; avoid abrupt discontinuation; and route tapering and CBT-I questions to the prescribing and behavioral-health team. Reinforce the individualized plan and monitor for withdrawal or worsening insomnia according to local protocol.

Limitations & cautions

• The included trials were small and heterogeneous, long-term estimates were imprecise, dose-reduction definitions varied, and safety reporting was incomplete. The review does not establish a single CBT-I or tapering protocol.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review defined hospitalization-associated disability through declines in function reported across 46 studies.
• The wide prediction interval indicates that prevalence varies substantially across settings, populations, study designs, and assessment methods.
• The authors suggested early identification of high-risk patients and prospective standardized assessment anchored to preadmission function, while noting that these approaches need confirmation.

Nursing implications

• Establish and document the patient's preadmission functional baseline using the facility's approved assessment, trend mobility and self-care during the stay, and escalate new decline to the interprofessional team early. Follow local fall-prevention and mobilization protocols.

Limitations & cautions

• The pooled estimate had substantial between-study variation, with a 7% to 48% prediction interval. Prevalence depended on population, design, baseline definition, and measurement instrument, and the review did not establish that any specific nursing intervention prevents disability.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Risk assessment should be dynamic rather than limited to a single admission screen, according to the consensus.
• Prevention and management span oral care, dietary and postural measures, medication optimization, rehabilitation, and stratified nursing interventions.
• The document is intended for Chinese medical, community, long-term-care, and home-care settings and emphasizes multidisciplinary collaboration.

Nursing implications

• Follow the facility's aspiration and dysphagia protocol, repeat risk assessment when condition or function changes, and document oral care, positioning, diet or feeding precautions, and escalation of coughing, voice change, respiratory symptoms, or reduced alertness.

Limitations & cautions

• Abstract-only summary of an expert consensus published in Chinese with an English abstract. The abstract describes the scope and development process but does not provide the wording, strength, or supporting evidence for each of the 15 recommendations; applicability outside China requires local review.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Brisk walking or jogging was the only modality with a favorable total-hip bone-mineral-density estimate, based on low-certainty evidence.
• In 26 trials with 11,132 participants, mixed aerobic and mind-body exercise may have reduced fracture risk, but certainty was low.
• Dose-response relationships were nonlinear, and the authors estimated clinically meaningful bone-density benefits around 600 MET-minutes per week, roughly two to three hours of brisk walking or jogging.

Nursing implications

• Assess mobility and fall risk, reinforce the individualized activity plan, and help patients identify safe ways to meet prescribed exercise goals.

Limitations & cautions

• Abstract-only summary. Many estimates were supported by low-certainty evidence, fracture findings came from a subset of trials, and network and dose-response estimates do not establish one best program for every patient.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Critical-care trials also found lower glucose variability, but those estimates had substantial heterogeneity and low certainty.
• The mean-glucose estimate in critical care had moderate certainty and low statistical heterogeneity.
• Evidence for outcomes beyond glycemic measures was uncertain because of limited reporting, inconsistent findings, and small samples.

Nursing implications

• Track glucose trends, feed delivery and interruptions, and tolerance, then coordinate formula or insulin concerns with the prescribing and nutrition teams.

Limitations & cautions

• Abstract-only summary. The evidence comprised eight trials and 620 patients across two different care settings; several estimates were imprecise or highly heterogeneous, and broader clinical outcomes remained uncertain.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Short-term urinary symptom and quality-of-life differences were small and judged to represent little to no difference, with low-certainty evidence.
• Major adverse events and retreatment did not differ clearly between HoLEP and TURP.
• The trials did not provide ejaculatory-function data, and evidence was insufficient for people with very large prostates or those receiving anticoagulation.

Nursing implications

• Monitor bleeding, urinary output, catheter status, and postoperative symptoms according to the ordered pathway, and avoid promising broader superiority based on procedure type alone.

Limitations & cautions

• Abstract-only summary. The main comparison focused on outcomes within 12 months, several critical outcomes had low-certainty evidence, and evidence was insufficient for very large prostates, anticoagulation, long-term sexual function, and urinary incontinence.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Seven randomized controlled trials were included.
• Benefits for recurrence and reoperation were consistent across the review's timing, age, and follow-up subgroup analyses.
• Hematoma resorption was not significantly different, and longer follow-up is needed to define durability and optimal use.

Nursing implications

• For patients receiving embolization plus standard care, continue ordered neurologic checks and post-procedure monitoring and escalate changes according to local neurovascular and antithrombotic protocols.

Limitations & cautions

• Abstract-only summary. The analysis pooled seven trials with varying treatment timing and follow-up; no mortality or functional-outcome benefit was detected, and longer-term outcomes remain uncertain.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• SARS-CoV-2, influenza A, rhinovirus or enterovirus, and RSV were the most frequently identified viruses.
• hMPV and RSV tended to have higher odds of moderate or severe disease.
• Virus-specific patterns were associations from a cohort, not randomized comparisons.

Nursing implications

• During outbreaks or suspected infection, trend oxygen needs, mobility and time in bed, recovery, and signs of bacterial pneumonia according to facility protocols.

Limitations & cautions

• Abstract-only summary. Data came from 15 Dutch nursing homes, the overall suspected-infection risk estimate was imprecise, and virus-outcome comparisons may be affected by confounding and small subgroup counts.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Shortness of breath, abdominal pain, chest pain, weakness or fatigue, and extremity symptoms accounted for 59% of presentations.
• Age 85 or older, geriatric risk factors, polypharmacy, and shortness of breath were associated with admission.
• The authors called for structured evaluation, staff training, and geriatric-specific care pathways.

Nursing implications

• Pair the chief complaint with structured geriatric, medication, cognitive, functional, and physiologic assessment using local emergency protocols.

Limitations & cautions

• Abstract-only summary. This was a secondary observational analysis of seven-day samples collected during the 2020 COVID-19 pandemic; associations do not prove causation and may not generalize to all emergency settings.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The between-group difference did not meet the prespecified 12-point target for clinical importance.
• Robotic-assisted replacement was more costly as delivered in routine practice.
• Sixteen participants in each group experienced one serious adverse event.

Nursing implications

• Use the same ordered postoperative assessment, mobility, pain, and complication-prevention pathway regardless of the instrument system used.

Limitations & cautions

• Abstract-only summary. Findings apply to the Mako system as delivered in this trial; 36-month follow-up is ongoing.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• ReacStep improved maximum step length and choice stepping reaction time compared with the control condition.
• The groups did not differ significantly in laboratory-assessed reactive-balance falls or daily-life falls.
• Adherence to ReacStep sessions was 90%, and the program was described as well tolerated.

Nursing implications

• Keep using the facility's multifactorial fall-prevention bundle; this trial does not support substituting ReacStep for established precautions.

Limitations & cautions

• Abstract-only summary. The trial included 88 participants, and the intervention did not improve the fall outcomes assessed over 12 months.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Fifteen randomized trials with 7,995 community-dwelling older adults were included.
• Evidence for institutionalization, hospital admissions, and mortality was very low certainty.
• Nurse-led case management probably produced a slight improvement in physical quality of life.
• The authors recommend evaluating patient-reported outcomes alongside healthcare utilization.

Nursing implications

• When participating in community case management, document the patient's own goals, function, quality of life, access barriers, and continuity needs in addition to emergency visits and admissions. Do not promise that coordination alone will prevent hospitalization or institutionalization.

Limitations & cautions

• Certainty was very low for the major utilization and mortality outcomes, and the physical quality-of-life improvement was small with uncertain clinical importance. Programs and populations varied, so the review does not identify one case-management model that should be adopted universally.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The quantitative synthesis included 49 studies using standardized subjective-cognitive-decline criteria.
• Pooled APOE ε4 carrier prevalence was 28.3% with subjective cognitive decline and 22.0% with normal cognition.
• APOE ε4 carriage was more prevalent in mild cognitive impairment than in subjective cognitive decline.
• Age and education contributed to heterogeneity, so genotype alone does not establish an individual's diagnosis or trajectory.

Nursing implications

• Document the patient's reported cognitive change, onset, functional effects, medication concerns, mood, sleep, and collateral history when available. Escalate acute change urgently and route persistent concerns through the approved cognitive-evaluation pathway without treating APOE status as a diagnosis.

Limitations & cautions

• The analysis pooled heterogeneous cohorts, and age and education contributed to variation. Prevalence and association estimates do not show that APOE ε4 causes subjective decline or predict which individual will progress to mild cognitive impairment or dementia.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The study measured peak inspiratory flow in 273 clinically stable patients treated with a pMDI and spacer.
• At medium-high resistance, 96.0% reached at least 30 L/min and 61.9% reached at least 60 L/min.
• Lower inspiratory flow was associated with greater dyspnea and more severe airflow limitation in bivariate analyses.
• The findings support individualized assessment rather than assuming that spacer use reflects inadequate inspiratory capacity.

Nursing implications

• Ask the patient to demonstrate the prescribed inhaler and spacer, assess coordination and full exhalation, and document dyspnea and device barriers. If technique remains ineffective or the device is burdensome, request respiratory or prescribing-team review rather than switching devices independently.

Limitations & cautions

• This cross-sectional study involved clinically stable patients already using pMDIs with spacers and did not compare clinical outcomes after device changes. Thresholds depend on device resistance, and multiple authors reported industry relationships, including manuscript support from Orion.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The meta-analysis included 15 articles and 1,617 patients with major depressive disorder.
• Depression and anxiety scale scores decreased after ECT across age groups.
• Adults older than 60 appeared to have a greater improvement in depressive symptoms in some analyses.
• High heterogeneity, varied ECT protocols, and limited age-stratified data reduce confidence in the age comparison.

Nursing implications

• Record baseline and serial mood, anxiety, orientation, cognition, and reported memory concerns using the service's protocol. Communicate clinically important change promptly and provide treatment education without promising a response based on age.

Limitations & cautions

• Only 15 articles were included, age-stratified data were limited, heterogeneity was high, and ECT frequency, intensity, co-treatments, and cognitive-assessment timing varied. These factors limit causal and age-specific interpretation.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The prospective study included 9,697 eligible older ED patients, but only 3,039 underwent ISAR screening.
• Recent hospitalization within six months was associated with 3-day ED revisits and readmissions.
• The reported odds ratios were 1.852 for an ED revisit and 2.290 for readmission.
• The study supports risk flagging, not using one question as a substitute for clinical assessment or disposition planning.

Nursing implications

• Ask older patients or caregivers about hospital stays during the previous six months and verify the history when possible. If present, incorporate it into the full risk assessment and communicate unresolved symptoms, medication changes, support gaps, or follow-up barriers.

Limitations & cautions

• This was a single-community-hospital study in Taiwan, and fewer than one-third of eligible patients were screened. The observational association does not prove that recent hospitalization causes return visits or that acting on the item alone prevents them.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The consensus contains 39 statements covering assessment and stepwise management of chronic constipation.
• It emphasizes symptom severity, psychosocial impact, overlapping gastrointestinal symptoms, and possible pelvic-floor injury during assessment.
• Initial care includes lifestyle modification and conventional laxatives, with response assessed within four weeks.
• Anorectal physiologic testing and biofeedback are highlighted for functional defecatory disorders; surgery is reserved for selected patients after comprehensive evaluation.

Nursing implications

• Document the patient's usual bowel pattern, current symptoms, intake, mobility, medications, prior therapies, and response. Reinforce the prescribed plan and arrange reassessment rather than independently escalating laxatives or assuming all constipation has the same mechanism.

Limitations & cautions

• This is a regional consensus tailored to Asian healthcare settings and resource availability. The PubMed abstract does not provide each statement's evidence certainty, recommendation strength, drug doses, contraindications, or a complete red-flag pathway.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The study analyzed 916,904 acute-care visits among 372,140 adults across four Chicago health systems.
• Thirty-three clinically reportable diagnoses remained associated with extreme heat after the two-stage analysis.
• Associated categories included fluid-balance and renal disorders, dermatologic and pressure-related conditions, multiple sclerosis, and several injuries and external causes.
• The observed associations covered the day of heat exposure through the following three days and do not by themselves prove heat caused each diagnosis.

Nursing implications

• During and after extreme heat, ask about exposure, cooling access, hydration, medications, mobility, and symptom timing. Pair temperature and volume-status assessment with the presenting complaint, and escalate instability, altered mentation, severe hyperthermia, or organ dysfunction immediately.

Limitations & cautions

• This observational study used diagnosis codes and data from four Chicago health systems, so coding, local climate, and population differences limit generalizability. Associations cannot establish causation, and the abstract does not provide effect estimates for each retained diagnosis.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The updated review included 16 randomized trials and 2,261 adults with mild-to-moderate hearing loss.
• Hearing aids likely produced large improvements in listening ability and hearing-specific quality of life.
• General quality of life may improve slightly, while loneliness showed little or no difference.
• Evidence for working-memory benefit and pain-related harms was very uncertain.

Nursing implications

• Ask about usual hearing supports, make prescribed hearing aids available and functional, reduce background noise, face the patient, and confirm understanding with teach-back. Refer unresolved hearing or device concerns through the local pathway.

Limitations & cautions

• Blinding was inadequate or absent in nearly all trials, follow-up ranged from four weeks to three years, and certainty varied by outcome. The review did not demonstrate improvement in loneliness or working memory and could not fully define uncommon harms.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The target-trial emulation included 28,920 veterans with influenza diagnosed in Veterans Health Administration emergency departments.
• Oseltamivir treatment within six hours of a positive test was associated with lower 10-day hospitalization risk.
• ICU admission was also less frequent in the treated group, while 30-day mortality was similar.
• The largest absolute hospitalization-risk reductions were observed in adults aged 65 years or older and when treatment was prescribed within three hours of diagnosis.

Nursing implications

• For a patient with confirmed influenza, communicate the result promptly, complete ordered antiviral screening and administration without avoidable delay, and reinforce dosing and return precautions. Escalate respiratory compromise or other signs of severe illness immediately.

Limitations & cautions

• This was an observational target-trial emulation rather than a randomized trial, so residual confounding is possible. The cohort was predominantly male and drawn from the Veterans Health Administration, limiting generalizability; mortality did not differ between groups.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review included 33 studies of nurse-delivered ED interventions for adults aged 65 years or older.
• Evaluated approaches included geriatric screening and assessment, specialist nurses, multidisciplinary teams, pathway changes, and discharge planning.
• Combining geriatric nurse specialists with multidisciplinary teams produced the most consistent benefits.
• Evidence for reducing ED revisits or hospital length of stay was inconsistent, and overall evidence quality was modest.

Nursing implications

• Use the approved geriatric screening and assessment pathway, identify functional or cognitive concerns and discharge risks, and communicate findings to the multidisciplinary team. Avoid assuming that one intervention will reliably prevent revisits or shorten hospitalization.

Limitations & cautions

• Evidence quality was modest, interventions and outcomes differed across 33 studies, and improvements in revisits and length of stay were inconsistent. The abstract does not support selecting one universal geriatric ED model.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review included 16 randomized trials and 5,668 participants across trial cohorts.
• Galantamine and memantine showed small short-term improvements on selected cognitive scales.
• Functional, global, and other patient-important outcomes did not show consistent benefit.
• Most evidence was old, and support for several other medications came from single trials or very low-certainty findings.

Nursing implications

• Document baseline cognition and daily function, verify the indication and monitoring plan for prescribed therapy, watch for medication-specific adverse effects, and include patient and caregiver observations when evaluating whether treatment goals are being met.

Limitations & cautions

• Trials used different drugs and outcome scales, most were published in 2012 or earlier, and evidence for many interventions was sparse or non-poolable. Cognitive-score changes were short term and did not establish consistent functional or global benefit.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review included 26 observational studies of adverse childhood experiences and later-life outcomes.
• Adverse childhood experiences were associated with about twice the odds of frailty.
• They were also associated with objective cognitive impairment and subjective cognitive decline.
• Substantial measurement heterogeneity and observational designs prevent causal conclusions.

Nursing implications

• Use validated frailty and cognitive assessments when indicated, approach sensitive history with permission and privacy, and connect identified needs to the interdisciplinary care plan without assuming childhood adversity caused the patient’s current condition.

Limitations & cautions

• All included evidence was observational, only subsets of studies contributed to each meta-analysis, and adverse experiences, frailty, and cognitive outcomes were measured inconsistently. Residual confounding and recall bias may affect the associations.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The population-based cohort included 9,066 community-dwelling adults with a mean age of 53.3 years.
• Over a mean 7.8 years, 23.1% had at least one hospital admission and 12.1% of those admitted had a readmission.
• MMSE-defined cognitive impairment was associated with a 40% higher hospital-admission rate, but readmission rates did not differ.
• Results varied by screening instrument, and chronic conditions and overall disease burden may be more important drivers of hospital use.

Nursing implications

• At admission and discharge, identify documented cognitive or communication needs, assess the support available for medication and follow-up tasks, and use teach-back with the patient and caregiver when appropriate. Pair cognitive findings with chronic-disease and functional assessment rather than using a screening score alone.

Limitations & cautions

• This observational cohort cannot establish that cognitive impairment causes hospitalization. Results differed between the MMSE and ACE-R, the cohort was from one region of Chile, and participants were ages 38 to 74 rather than an exclusively geriatric population.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The prospective trial followed 24 nursing homes through eight three-month periods as clusters crossed from control to intervention.
• The analysis included 1,151 participants in control periods and 1,271 in intervention periods.
• About two-thirds of 1,260 model specifications favored the intervention directionally, but none showed a statistically significant effect.
• The authors concluded that the results did not support the hypothesized reduction in hospitalization.

Nursing implications

• Use the approved deterioration and escalation pathway for each resident rather than assuming telemedicine should replace hospital evaluation. If a telemedicine service is available, document when it was activated, whether it changed the plan, and why transfer or on-site care was selected so program performance can be assessed meaningfully.

Limitations & cautions

• The COVID-19 pandemic and a regional flood disrupted implementation, and estimated effects changed with modeling choices, datasets, and outcome definitions. The study was conducted in one German region and may not generalize to other staffing, payment, or emergency-care systems.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The synthesis integrated four studies: two sources of direct evidence from older Indian adults and two reviews providing contextual implementation evidence.
• In the six-city study of 600 older adults, one-third had polypharmacy, while inappropriate medicines, prescribing omissions, and self-medication were common.
• Medication-safety risks were higher with multimorbidity, recent hospitalization, care transitions, or living alone.
• The deprescribing review found no significant increase in major adverse outcomes, but its evidence certainty was low to very low.

Nursing implications

• At admission, transfer, and discharge, reconcile prescribed, over-the-counter, and self-selected medicines and identify who helps manage them at home. Escalate discrepancies, anticholinergic burden concerns, and possible omissions for pharmacist or prescriber review rather than initiating deprescribing independently.

Limitations & cautions

• This article integrates heterogeneous direct and contextual evidence, and some implementation findings were not specific to older adults in India. The deprescribing evidence was low to very low certainty, residual confounding affected observational findings, and prospective evaluation is still needed.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The trial randomized 147 adults aged 70 or older undergoing laparoscopic transabdominal preperitoneal hernia repair into three equal groups.
• Compared with no block, 48-hour morphine-equivalent use was 5.53 mg lower with standard bupivacaine blocks and 7.24 mg lower with liposomal bupivacaine blocks.
• Mean ambulation time was 14.1 hours with liposomal bupivacaine, 16.7 hours with standard bupivacaine, and 20.0 hours without a block.
• Hospital stay was a median three days in both block groups versus four days without a block, and adverse-event rates did not differ.

Nursing implications

• When a regional block is part of the operative plan, document pain at rest and movement, opioid rescue use, sedation, respiratory status, lower-extremity function, and readiness for assisted mobility. Coordinate first ambulation with fall precautions and escalate unexpected weakness, uncontrolled pain, local-anesthetic toxicity concerns, or delayed recovery.

Limitations & cautions

• This was a single-center trial limited to adults aged 70 or older having one laparoscopic procedure. The abstract reports short-term recovery outcomes only and does not establish whether the findings transfer to other operations, block techniques, or younger patients.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Sixteen studies met the review criteria, including seven randomized controlled trials and nine pre-post studies.
• Fifteen studies reported potential improvement in at least one dimension of social interaction.
• Reported outcomes included communication, interaction frequency or quality, smiling or laughter, and activity participation.
• Effectiveness varied with participant characteristics, intervention design, and context, and long-term outcomes remain uncertain.

Nursing implications

• If an approved program uses a social robot, establish the person's preferences and communication baseline, introduce the device gradually, observe engagement or distress, and document whether interaction generalizes beyond the device. Stop or modify use when it conflicts with comfort, dignity, consent, or the care plan.

Limitations & cautions

• The evidence combined seven randomized trials with nine uncontrolled pre-post studies, used varied interventions and outcome measures, and was not pooled into a single effect estimate. The abstract does not establish durability, comparative effectiveness, or which residents are most likely to benefit.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The guideline addresses sarcopenia case-finding, screening, diagnosis, prevention, treatment-related risks, nutrition, exercise, and pharmacotherapy in adults with multimorbidity.
• Proactive case-finding is emphasized for adults 65 and older and for younger adults with multimorbidity who have specified risk factors.
• Muscle strength, assessed with handgrip or chair-stand testing, is the recommended entry point to assessment.
• Management should be individualized, and nearly half of the adapted recommendations were supported by low-quality evidence or consensus statements.

Nursing implications

• Within an approved pathway, identify loss of strength or function, perform or arrange the specified strength screen, document baseline mobility and nutrition concerns, and refer positive findings for diagnostic and interdisciplinary assessment. Monitor tolerance when exercise or nutrition plans begin.

Limitations & cautions

• This is an adapted guideline rather than a new de novo evidence review. Of 37 recommendations, eight were supported by high-quality evidence, 12 by moderate-quality evidence, and 17 by low-quality evidence or consensus; direct evidence in multimorbid populations was limited.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Eight studies with a combined 341 participants were included in the systematic review.
• Most systems were nonimmersive, screen-based platforms that supplied real-time visual feedback.
• The studies consistently reported improvement in postural sway, mediolateral stability, and functional-mobility measures.
• The evidence was narratively synthesized and does not establish that virtual-reality rehabilitation prevents actual falls.

Nursing implications

• Screen for neuropathy-related sensation, vision, balance, orthostasis, footwear, cognition, and device tolerance before technology-assisted rehabilitation. Coordinate progression with rehabilitation professionals, use appropriate guarding and equipment, and track real falls and near-falls alongside mobility scores.

Limitations & cautions

• The review included only eight heterogeneous studies and 341 participants, used narrative synthesis without a pooled effect estimate, and covered adults whose mean ages extended below older-adult ranges. Consistent mobility improvements do not establish fewer falls, long-term benefit, or superiority over conventional rehabilitation.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• Sixteen comparative observational studies included 31,543 emergency patients aged 65 years or older.
• Pooled delirium prevalence was approximately 10%.
• Baseline cognitive impairment or dementia was associated with delirium, with a pooled odds ratio of 1.90.
• Advanced age and medication-related exposures were also associated, but several pooled domains had substantial heterogeneity.

Nursing implications

• Obtain collateral baseline cognition and function when possible, complete the approved delirium assessment, and review medication exposure and acute contributors when an older patient changes. Escalate acute or fluctuating findings while maintaining safety, orientation, sensory support, and observation needs.

Limitations & cautions

• All included studies were observational, adjusted estimates were not available for every factor, and substantial heterogeneity affected several domains. Functional dependence and emergency-process factors were not statistically significant in pooled analyses, and associations cannot establish that a risk marker caused delirium.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The multicenter trial randomized 834 older adults receiving spinal anesthesia for hip-fracture repair.
• Postoperative delirium within 72 hours occurred in 4.0% of the dexmedetomidine group and 7.8% of the propofol group.
• The reported between-group difference met the study's statistical threshold with a P value of 0.021.
• The findings support close delirium surveillance and informed anesthesia planning, not independent substitution of one sedative for another.

Nursing implications

• Establish the patient's cognitive baseline when possible, use the approved delirium assessment at the required intervals, and trend sedation exposure with pain, oxygenation, sleep, mobility, hydration, and new confusion. Escalate an acute change through the postoperative pathway.

Limitations & cautions

• The trial compared specific intraoperative sedation regimens during spinal anesthesia with iliac fascia block, and delirium follow-up in the abstract was limited to 72 hours. Enrollment occurred from 2017 to 2020, and the abstract does not provide enough detail to determine applicability to every frail older adult, anesthesia plan, or postoperative setting.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The trial randomized 62 cognitively frail residents, with 31 participants in each group.
• Otago sessions lasted 30 minutes, three times weekly, for 12 weeks.
• Frailty severity and cognitive-function measures improved more in the exercise group.
• The study does not establish whether benefits persist or reduce falls and other clinical events.

Nursing implications

• Confirm mobility status, fall precautions, symptoms, and the approved activity plan before each session. Support safe footwear and assistive-device use, monitor tolerance, and communicate pain, dizziness, dyspnea, new weakness, or cognitive change to the responsible team.

Limitations & cautions

• This was a small trial in one nursing home, the abstract does not describe blinding or adverse events, and follow-up ended at 12 weeks. Changes in scale scores should not be assumed to reduce falls, disability, hospitalization, dementia, or mortality.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review included 30 articles evaluating interventions initiated after an emergency-department fall presentation.
• Interventions were associated with a lower fall rate, with a pooled rate ratio of 0.69.
• The pooled odds of being a recurrent faller were not significantly reduced.
• Interventions and outcomes varied considerably across studies.

Nursing implications

• Use the approved older-adult fall pathway to assess injury, mobility, cognition, medications, home risks, and support needs. Confirm referrals and follow-up before discharge, teach return precautions and prevention steps, and communicate unresolved risks to the receiving clinician or service.

Limitations & cautions

• Interventions, study designs, and outcome definitions varied, and heterogeneity for fall incidence was very high. Several secondary outcomes were not statistically significant, so the review does not identify one universally effective ED program.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review included 16 randomized controlled trials across different female life stages.
• Postpartum urinary-incontinence incidence was lower with online training, with a pooled risk ratio of 0.56.
• Symptom severity improved modestly postpartum but not significantly among older participants.
• Adherence improved in both subgroups, while quality-of-life differences were not significant.

Nursing implications

• Ask directly about leakage, urgency, pain, retention, and functional impact during postpartum care. For an approved pelvic-floor program, confirm that the patient understands the exercise technique and follow-up plan, and escalate red flags or persistent symptoms for evaluation.

Limitations & cautions

• Only 16 trials were included, interventions and participants varied, heterogeneity was moderate to high, and quality of life did not improve significantly. Findings in postpartum participants should not be generalized to older adults or every cause of incontinence.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The multicenter prospective study included 103 patients with expected deaths on acute geriatric wards.
• Doctors scored comfort 3.4 points higher than relatives on the 14-to-42-point EOLD-CAD scale.
• Agreement was weak even between nurses and doctors, with a maximum reported correlation of 0.25.
• Correlations between relatives and clinician raters were low and not statistically significant.

Nursing implications

• During expected dying, complete the approved comfort and pain assessments, invite relatives to describe observed symptoms and concerns, and document differences in perception. Escalate unresolved distress, new symptoms, or disagreement about the care plan through the palliative and medical team.

Limitations & cautions

• The study involved two Belgian university hospitals, relatives provided ratings for fewer than half of included patients, and observational ratings cannot determine why perceptions differed. The scale and timing may not capture every symptom or apply identically in other cultural or clinical settings.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The parallel randomized trial compared a staged nursing pathway with usual care in older adults with acute ischemic stroke, dysphagia, and post-pyloric tubes.
• Seven-day feeding intolerance was lower with the pathway (adjusted RR 0.61, 95% CI 0.47 to 0.81).
• Patients reached at least 80% of their energy target sooner, and aspiration-related pneumonia risk was lower (adjusted RR 0.54).
• The measured feeding and tube safety outcomes did not differ significantly between groups.

Nursing implications

• For eligible stroke patients receiving post-pyloric feeding, use the facility-approved tolerance and aspiration-risk assessments, document trends and delivered nutrition, and escalate intolerance or respiratory changes through the ordered pathway. Do not generalize the trial to other feeding routes or populations without local review.

Limitations & cautions

• This was a single-center trial limited to older adults with acute ischemic stroke, dysphagia, and post-pyloric tubes. The abstract does not report the enrollment size, blinding, longer-term outcomes, or whether the pathway transfers to other settings, ages, diagnoses, or feeding routes.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The nonblinded, single-center trial randomized 114 postmenopausal participants with laboratory-proven recurrent UTI.
• At six months, 50.9% of the periurethral group and 52.6% of the intravaginal group were UTI-free.
• Periurethral application met the prespecified noninferiority comparison, which used a 25-percentage-point margin.
• Participants were predominantly White and had a mean age of 71.1 years, limiting generalizability.

Nursing implications

• When vaginal estrogen is prescribed for recurrent UTI prevention, teach the ordered application technique using plain language and confirm understanding. Document adherence, recurrent symptoms, irritation, bleeding, or other adverse effects and route concerns to the prescribing clinician.

Limitations & cautions

• The trial was single-center and nonblinded, used a relatively wide 25-percentage-point noninferiority margin, enrolled predominantly White participants, and followed outcomes for six months. The abstract does not establish comparative effectiveness beyond the studied doses and techniques.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The review included 15 studies and 706 community-dwelling older adults with mild cognitive impairment.
• Montreal Cognitive Assessment scores improved compared with control interventions, while Mini-Mental State Examination scores did not.
• Instrumental activities of daily living, depressive symptoms, and walking performance did not improve significantly.
• Substantial heterogeneity limits certainty about which program or patient is most likely to benefit.

Nursing implications

• When virtual reality training is part of an established care plan, orient the patient and caregiver to the equipment, assess tolerance and safe participation, and document adherence or barriers. Do not present improved scores on one cognitive measure as evidence of greater independence or mobility.

Limitations & cautions

• The included studies differed substantially, and the benefit appeared on the Montreal Cognitive Assessment but not the Mini-Mental State Examination. The review did not establish meaningful improvement in daily function, mood, or walking performance.
• AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

• The study compared residents' periods of concomitant medication use with periods using clopidogrel, apixaban, rivaroxaban, or warfarin alone.
• Fourteen statistically adjusted signals remained, but only four were judged biologically plausible by an expert panel.
• The plausible pairs were clopidogrel with sertraline and warfarin with cephalexin, sulfamethoxazole-trimethoprim, or furosemide.
• Negative-control findings indicate that the signals are prompts for assessment, not proof that a medication pair caused bleeding.

Nursing implications

• During medication reconciliation or a change in therapy, identify concurrent antithrombotic and newly added medications, assess for bleeding or acute illness, and route concerns to the prescriber and pharmacist. Do not hold or discontinue therapy solely because a pair appeared in this screening study.

Limitations & cautions

• The analysis used US nursing-home and Medicare claims from 2013 through 2020 and screened associations rather than testing medication changes. Residual confounding was evident in negative-control results, and the abstract does not establish absolute risk, causality, or the benefit of acting on any individual signal.
• AI-summarized from the linked source. Review the original article before applying to practice.