Controlling respiratory infections in long-term care facilities: A systematic review.

In 30 seconds

This systematic review synthesized experimental and quasi-experimental studies of non-pharmacological strategies to prevent or control respiratory infections in long-term care facilities. Searches identified 18 eligible studies from 12,203 retrieved records; nine addressed respiratory tract infections broadly and five focused exclusively on COVID-19. Using the WHO Infection Prevention and Control Assessment Framework, the authors found that multimodal approaches combining environmental cleaning and education had the most consistently positive impact, while monitoring and feedback showed promising effectiveness in reducing infection incidence. Evidence was limited by variable study methods and outcomes, and no study covered all eight framework components.

Key findings

• Eighteen studies met inclusion criteria from 12,203 retrieved records; nine examined respiratory infections broadly and five focused exclusively on COVID-19.
• Multimodal strategies combining environmental cleaning and education showed the most positive impact.
• Monitoring and feedback showed promising effectiveness in reducing infection incidence.
• Guidelines, surveillance methods, staffing, workload, and bed occupancy were addressed by relatively few studies.

Why it matters

Long-term care residents are vulnerable to respiratory infections, but the evidence base for non-pharmacological prevention in these settings remains limited. The review highlights potentially useful combined approaches while showing that important system-level areas, including surveillance and staffing, have received little study. This helps frame priorities for developing and evaluating infection-control strategies suited to long-term care facilities.

What to keep in mind

The included studies had limited methodological quality and substantial variation in design, interventions, and outcome measures. No study addressed all eight framework components.