Understanding barriers to implementing point-of-care tests in paediatric patients

The team at Aquarius Population Health investigated the experience of implementing point-of-care tests (POCTs) for paediatric patients during respiratory disease season (winter 2014 – spring 2015), in collaboration with colleagues from three large hospitals in South London (Guy’s and St. Thomas’, King’s College Hospital, and St. George’s University Hospital). Each centre independently evaluated one POCT test (Enigma® MiniLab™ FluAB-RSV PCR assay, BioMérieux BioFire Filmarray, and Luminex RVP Fast v2) on paediatric patients either in the Accident and Emergency department or admitted as an inpatient.

We explore the results of the acceptability and implementation issues of each test in our latest paper, “Point-of-care tests for infectious diseases: barriers to implementation across three London teaching hospitals”, published by Bustinduy et al in Acta Paediatrica. Our paper summarises staff concerns and perceived benefits regarding the use of POCTs. Overall, we found that having a test result was thought to improve bed management and cohorting sick patients appropriately, reassure parents about their child’s condition, reduce hospital transmission, and rationalise further tests and treatment. Concerns focused on confidence about the test’s performance – particularly around false negatives not receiving proper management, how to manage discrepant results (i.e. the laboratory assay gave a different answer to the POCT), and training enough staff to run the test at the point of care.

Bustinduy AL, Jeyaratnam D, Douthwaite S, et al. Point-of-care tests for infectious diseases: barriers to implementation across three London teaching hospitals. Acta Paediatrica, online first 4 Apr 2017. DOI: 10.1111/apa.13867

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