title: Survey of policy for MRSA screening in English cataract surgical units and changes to practice after updated National guidelines.
abstract: BACKGROUND
  National guidelines on MRSA (methicillin-resistant Staphylococcus aureus) screening policy in England have changed on a number of occasions, but there is limited data on its influence at a local level. The aim of this study was to determine if changes in National policy influenced preoperative screening of cataract patients for MRSA.
  
  
  METHODS
  A structured telephone survey was conducted on all 133 ophthalmology units in England in 2004 and again in 2007 for the initial responders, after a change in national policy.
  
  
  RESULTS
  A total of 74 units (56%) responded in 2004 and 71 units (96% of initial respondents) in 2007. In 2004, 57% of units screened for MRSA. They screened groups at high risk of carriage, including patients with previous MRSA (93%) and patients from Nursing homes (21%). Swab sites included the nose (100%), eyes (31%) and perineum (62%). In 2007, there was no significant change in the number of units that screened for MRSA (57% vs 66%; p = 0.118; McNemar test). However, more units screened for MRSA in patients from nursing/residential homes (21% vs 51%; p = 0.004, McNemar test), and in patients who had recent admission to hospital (12% vs 36%; p = 0.003). In the second survey, 3 units (6%) now screened patients who were close relatives of MRSA carriers.
  
  
  CONCLUSIONS
  This survey has highlighted inconsistences in MRSA screening practice of day-case cataract surgery patients across England after 2 major national policy changes. A change in DoH policy only led to more units screening patients for MRSA from high risk groups.
authors.affiliation: Department of Clinical Ophthalmology, Institute of Ophthalmology, University College London, 11-43 Bath Street, London EC1V 9EL, UK. l.joshi@ucl.ac.uk.
authors.forename: Lavnish
authors.initials: L
authors.lastname: Joshi
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: West
authors.forename: Luke
authors.initials: L
authors.lastname: Herbert
mesh_terms: D002386:Cataract; D003428:Cross Infection / Q000517:prevention & control; D004739:England; D019983:Guideline Adherence / Q000592:standards; D019538:Health Care Surveys; D006291:Health Policy; D006801:Humans; D017053:Infection Control / Q000592:standards; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D017410:Practice Guidelines as Topic; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires