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A multicomponent control programme in nursing homes in Singapore.

Louisa Sun^1,2, Nares Smitasin^1,3, Brenda Mae Alferez Salada¹

¹Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore.

Annals of the Academy of Medicine, Singapore

|June 2, 2026

Summary

A multicomponent intervention in nursing homes reduced infections and unnecessary hospital transfers. This program improved infection control, vaccination rates, and clinical decision-making for safer long-term care.

Keywords:

antimicrobial stewardship hospital transfers infection prevention and control nursing homes vaccination

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Area of Science:

Gerontology
Infectious Diseases
Public Health

Background:

Nursing home residents face high risks of infections and preventable hospitalizations.
Effective infection prevention and control (IPC) are crucial for this vulnerable population.

Purpose of the Study:

To evaluate a multicomponent intervention program aimed at enhancing IPC, vaccination uptake, and clinical decision-making in nursing homes.
To reduce avoidable hospital transfers from nursing homes.

Main Methods:

A retrospective cohort study was conducted in six Singaporean nursing homes.
The intervention included IPC training, policy reviews, vaccination support, antimicrobial guidance, and a structured fever/desaturation pathway.
Data from 2045 fever-related admissions were analyzed pre- and post-intervention.

Main Results:

New methicillin-resistant Staphylococcus aureus (MRSA) acquisitions decreased by 33.6%.
Inappropriate fever-related transfers reduced by 39.2%.
Influenza vaccination coverage exceeded 90%, and 84% of staff regularly used the new pathway.

Conclusions:

A collaborative model integrating acute hospital expertise with nursing home teams improved IPC outcomes.
The intervention led to increased vaccination coverage and reduced inappropriate transfers.
This approach supports safer care delivery in long-term care settings.