The processing errors could be related to the low volumes of tests being performed by any

one individual staff member (particularly for the older persons’ staff who processed an average of just one test each for the duration of the study). A higher throughput of tests may have helped staff members to confidently recall how to perform the procedure. A more successful model of testing may be to make use of staff that are more familiar with laboratory procedures in a dedicated satellite POC laboratory [7]. Cohen-Bacrie and colleagues Vismodegib describe this model in their Marseilles hospitals and were able to achieve turnaround times between 0.5 and 3.5 h for a range of 23 POCTs of varying complexity [7]. Gray and colleagues found that assigning responsibility for Group B Streptococcus testing in laboring women to a relatively small group of staff ensured that each tester undertook enough testing to maintain competency [12]. With any POCT, there is a need for staff performing the test to be trained and competent in appropriate documentation, sample collection, performing the test and result interpretation. Failure to do this can have adverse outcomes in terms of assay performance [9]. Most tests were performed during the afternoon or early

evening on the older persons’ wards, whereas tests were performed throughout the day and night on the ICU. The numbers of nursing staff on the older persons’ LY294002 wards was lower through the night shift, but remained stable on the ICU. Patients

may also be less willing to report diarrhea during the night and many patients on ICU were fitted with bowel managers making access to stool samples easier. In a study of POC testing for Group B Streptococcus Glutathione peroxidase in a UK delivery suite, Gray and colleagues found that testing increasingly became confined to normal working hours, when laboratory staff were available to assist [12]. The turnaround time of the POCT was significantly faster compared with laboratory-based testing (1.85 vs. 18 h, respectively). Sample transportation caused a significant delay in our institution, batching of samples testing in the centralized laboratory also added on additional time, even when samples were tested twice per day. Although the turnaround time was significantly reduced, there were no discernable effects of the POCT on clinical utility other than a reduction in ancillary bacterial culture testing. This is likely to be a minimal cost saving and does not offset the significant costs of running the POCT. The numbers in this study were modest and the study may be insufficiently powered to detect any changes in clinical outcomes between those tested with POCT compared with those tested by laboratory-based testing. Future studies should look at other outcomes such as severity of disease, time to anti-C.