Interview with SGH Department of Infection Prevention & Epidemiology Director

A peek at Singapore General Hospital’s effective infection control strategies before and during COVID-19

Singapore General Hospital (SGH) plays a key role in Singapore’s pandemic response. With it comes the responsibility to carry out infection control strategies to protect both patients and healthcare workers.

Even though SGH just has a small percentage of COVID-19 patients, the hospital has kicked off a series of infection control measures which have actually been in place even before the pandemic.

To date, SGH registers zero COVID-19-associated infection on its hospital staff, which ultimately shows the efficiency of its programs. Dr Ling Moi Lin, Director of the Department of Infection Prevention and Epidemiology at SGH, answers our questions about their hospital’s success in curbing the spread of the infection within their hospital premises.

What were the infection control measures at SGH prior to COVID-19?

Dr Ling Moi Lin

Vertical strategies, aimed at targeting a single organism, include the following: use of bundles for multi-drug resistant organisms (MDROs), central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, and Clostridioides difficile infections; prophylaxis for methicillin-resistant Staphylococcus aureus carriers prior to orthopaedic surgeries; audit and cycle of improvement to close identified gaps; and infection prevention and control champions at all areas of the hospital. Meanwhile, the horizontal infection prevention measures at SGH include the enforcement of good hand hygiene practices, environment hygiene, antiseptic baths for all inpatients, and active surveillance screening for MDROs.

Infection control is a huge part of every hospital’s pandemic response. What are the infection control strategies at SGH during COVID-19?

When the pandemic hit, the hospital strengthened these programs in an effort to control the spread of the infection. SGH did triage and screening, rapid identification and isolation of confirmed cases, use of appropriate personal protective equipment (PPE) for staff, and new hospital policies, such as wearing of masks at all times, ‘no visitors’ rule for ‘hot’ zones like isolation wards and acute respiratory infection wards, limiting the number of visitors for areas such as wards, shifting to remote work arrangements for some of the staff, safe distancing measures, and enhancing environment hygiene.

Did you use technology as part of your hospital’s infection prevention measures?

Environmental surfaces are one of the most common sources of transmission, and since the COVID-19 virus is still new, hospitals cannot take chances with just a manually cleaned and disinfected environment. Knowing this, SGH leveraged on the use of technology to improve its environment hygiene that also adds a level of protection to the staff, especially because the global supply chain for PPE, alcohol-based hand rub agents, and ICU drugs and equipment has been disrupted.

Singapore General Hospital

We use robots and UV-C for room decontamination. Not only does the technology disinfect the hospital, but it also addresses manpower shortage due to social distancing and lockdown restrictions. SGH also has an innovative swab booth to reduce contact between healthcare workers and patients. Moreover, we have designed portable negative pressure rooms to ensure that no viral particles can escape whenever the door is opened. The hospital likewise tapped into social media and online tools to communicate and teach. We have Workplace@Facebook, emails, and daily e-newsletters.

How effective are the above-mentioned measures? What is the feedback from the hospital staff?

Thus far, SGH sees positive results from its strict implementation of infection prevention strategies. The hospital’s hand hygiene compliance, for example, is more than 95%. To date, no doctors or nurses at SGH has caught the infection, too. In fact, the staff acknowledge the support they receive during this difficult time. We made sure we have timely refresher training programs, close buddy help, and daily audit feedback.