26 Chapter 2 Figure 1. Conceptual graphic of the cascade of care in MRSA decolonization. Legend: The first column addresses the total number of MRSA carriers in the Netherlands. The second column represents the proportion of carriers that is diagnosed. The third column addresses the MRSA carriers that are diagnosed and undergo eradication treatment. The last column represents the success rate of complicated MRSA eradication treatment. In every step of this conceptual cascade of care, there is the potential for leakage. As this figure represents a conceptual model, the columns are not quantified. Methods The questionnaire study was executed in primary care as GPs hold a central position in the Dutch healthcare system. All Dutch citizens are registered with a general practitioner (GP), who is the first point of contact in case of illness and acts as a gatekeeper to secondary care. With regard to MRSA carriership, the GPs are often the first healthcare professionals to be in contact with patients at risk or to detect MRSA carriership. Questionnaire development and distribution The regional MRSA Network developed a questionnaire that was reviewed by a panel consisting of a general practice specialist and an infectious disease specialist (Supplementary File S1). The questionnaire included 14 questions on the ‘search and destroy’ policy, the screening of risk patients, the difference between complicated
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