Universal screening for meticillin resistant Staphyloccus aureus (MRSA) is controversial. The implementation of screening for all elective admissions, and more recently emergency admissions, has a major financial impact on NHS trusts across England. Decolonisation of those patients who screen positive and in the case of emergency admissions isolation or cohorting of patients also creates pressure in the care system. Many infection prevention practitioners question the cost-effectiveness of the current strategy in England and colleagues are heard in heated discussions about the perceived waste of resources when faced with the potential loss of members of the infection prevention team and laboratory services. Following a Health Technology Assessment (Ritchie et al, 2007) NHS Scotland chose to test the features of universal MRSA screening against the requirements for public health screening programmes prior to its wholesale implementation. A prospective impact assessment designated as the MRSA Screening Pathfinder Programme was commenced in August 2008 and interim findings were published in spring 2009, with the completed programme scheduled to report in December 2009. The one-year programme of prospective linked projects aimed to:
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