Rising to the Occasion: A National Nursing Home Study Documenting Attempts to Address Social Isolation During the COVID-19 Pandemic.

Objectives: COVID-19-related policies introduced extraordinary social disruption in nursing homes. In response, nursing facilities implemented strategies to alleviate their residents' loneliness. This study sought to describe interventions nursing homes used, document the perceived effectiveness of efforts, and determine barriers to implementing strategies to mitigate social isolation and loneliness.

Methodological Challenges for Epidemiologic Studies of Deprescribing at the End of Life.

Purpose Of Review: To describe approaches to measuring deprescribing and associated outcomes in studies of patients approaching end of life (EOL).

Recent Findings: We reviewed studies published through 2020 that evaluated deprescribing in patients with limited life expectancy and approaching EOL. Deprescribing includes reducing the number of medications, decreasing medication dose(s), and eliminating potentially inappropriate medications.

National Trends in Statin Use among the United States Nursing Home Population (2011-2016).

Background: Little is known about trends in statin use in United States (US) nursing homes.

Objectives: The aim of this study was to describe national trends in statin use in nursing homes and evaluate the impact of the introduction of generic statins, safety warnings, and guideline recommendations on statin use.

Methods: This study employed a repeated cross-sectional prevalence design to evaluate monthly statin use in long-stay US nursing home residents enrolled in Medicare fee-for-service using the Minimum Data Set 3.

Geographic Variation of Statin Use Among US Nursing Home Residents With Life-limiting Illness.

Background: Medically compromised nursing home residents continue to be prescribed statins, despite questionable benefits.

Objective: To describe regional variation in statin use among residents with life-limiting illness.

Research Design: Cross-sectional study using 2016 Minimum Data Set 3.

Statin Discontinuation and Life-Limiting Illness in Non-Skilled Stay Nursing Homes at Admission.

Objectives: To estimate 30-day statin discontinuation among newly admitted nursing home residents overall and within categories of life-limiting illness.

Design: Retrospective cohort using Minimum Data Set 3.0 nursing home admission assessments from 2015 to 2016 merged to Medicare administrative data files.

Prevalence of Pain on Admission by Level of Cognitive Impairment in Nursing Homes.

Purpose: To provide contemporary estimates of pain by level of cognitive impairment among US nursing home residents without cancer.

Methods: Newly admitted US nursing home residents without cancer assessed with the Minimum Data Set 3.0 at admission (2010-2016) were eligible (n=8,613,080).

Candida auris outbreak involving liver transplant recipients in a surgical intensive care unit.

Candida auris is a yeast that is difficult to eradicate and has caused outbreaks in health care facilities. We report a cluster of 5 patients in 1 intensive care unit who were colonized or infected in 2017. The initial 2 patients were recipients of liver transplants who had cultures that grew C auris within 3 days of each other in June 2017 (days 43 and 30 posttransplant).

Cancer Pain in Relation to Metropolitan Area Segregation and Nursing Home Racial and Ethnic Composition.

Objectives: To estimate pain reporting among residents with cancer in relation to metropolitan area segregation and NH racial and ethnic composition.

Design: Cross-sectional study.

Setting And Participants: 383,757 newly admitted black (B), Hispanic (H), or white (W) residents with cancer in 12,096 US NHs (2011-2013).

Prevalent Statin Use in Long-Stay Nursing Home Residents with Life-Limiting Illness.

Objectives: To evaluate the prevalence and factors associated with statin pharmacotherapy in long-stay nursing home residents with life-limiting illness.

Design: Cross-sectional.

Setting: US Medicare- and Medicaid-certified nursing home facilities.

Racial Segregation Across U.S. Nursing Homes: A Systematic Review of Measurement and Outcomes.

Background And Objectives: Nursing homes remain subjected to institutional racial segregation in the United States. However, a standardized approach to measure segregation in nursing homes does not appear to be established. A systematic review was conducted to identify all formal measurement approaches to evaluate racial segregation among nursing home facilities, and to then identify the association between segregation and quality of care in this context.

Improving Advanced Care Planning through Physician Orders for Life-Sustaining Treatment (POLST) Expansion across the United States: Lessons Learned from State-Based Developments.

Background: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm is an effective advance care planning tool. However, barriers to implementation persist. In the United States, POLST program development occurs at the state-level.

Integration of genomic and clinical data augments surveillance of healthcare-acquired infections.

Background: Determining infectious cross-transmission events in healthcare settings involves manual surveillance of case clusters by infection control personnel, followed by strain typing of clinical/environmental isolates suspected in said clusters. Recent advances in genomic sequencing and cloud computing now allow for the rapid molecular typing of infecting isolates.

Objective: To facilitate rapid recognition of transmission clusters, we aimed to assess infection control surveillance using whole-genome sequencing (WGS) of microbial pathogens to identify cross-transmission events for epidemiologic review.

Screening Mammography Among Older Women: A Review of United States Guidelines and Potential Harms.

In the United States, older women (aged ≥65 years) continue to receive routine screening mammography surveillance, despite limited evidence supporting the benefits to this subpopulation. This article reviews screening mammography guidelines and the potential harms of such screening for older women in the United States. Published guidelines and recommendations on screening mammography for older women from professional medical societies and organizations in the United States were reviewed from the mid-20th century to present.

Screening mammography among nursing home residents in the United States: Current guidelines and practice.

Objective: United States (US) guidelines regarding when to stop routine breast cancer screening remain unclear. No national studies to-date have evaluated the use of screening mammography among US long-stay nursing home residents. This cross-sectional study was designed to identify prevalence, predictors, and geographic variation of screening mammography among that population in the context of current US guidelines.

Non-Hispanic Black-White disparities in pain and pain management among newly admitted nursing home residents with cancer.

Background: Racial disparities in pain management persist across health care settings and likely extend into nursing homes. No recent studies have evaluated racial disparities in pain management among residents with cancer in nursing homes at time of admission.

Methods: Using a cross-sectional study design, we compared reported pain and pain management between non-Hispanic White and non-Hispanic Black newly admitted nursing home residents with cancer (n=342,920) using the de-identified Minimum Data Set version 3.

Cognitive Impairment and Pain Among Nursing Home Residents With Cancer.

Context: The prevalence of pain and its management has been shown to be inversely associated with greater levels of cognitive impairment.

Objectives: To evaluate whether the documentation and management of pain varies by level of cognitive impairment among nursing home residents with cancer.

Methods: Using a cross-sectional study, we identified all newly admitted U.

A 10-Year Review of Total Hospital-Onset ICU Bloodstream Infections at an Academic Medical Center.

Background: The rates of central line-associated bloodstream infections (CLABSIs) in U.S. ICUs have decreased significantly, and a parallel reduction in the rates of total hospital-onset bacteremias in these units should also be expected.

Potential bloodborne pathogen exposure from occult mattress damage.

A near-miss patient incident involving body fluid seeping from a mattress led to a visual inspection of 656 hospital bed mattresses of which 177 were contaminated because of occult damage to mattress covers.

The bundle "plus": the effect of a multidisciplinary team approach to eradicate central line-associated bloodstream infections.

Background: Central line-associated bloodstream infections (CLABSIs) have decreased significantly over the last decade. Further reductions in CLABSI rates should be possible. We describe a multidisciplinary approach to the reduction of CLABSIs.