title: Performance of a nurse-led paediatric point of care service for respiratory syncytial virus testing in secondary care.
abstract: OBJECTIVE
  To evaluate respiratory syncytial virus (RSV)-point-of-care-testing (POCT) performance among paediatric patients with respiratory symptoms, using the BinaxNOW(®) RSV assay performed by trained nurses on the paediatric ward, and compare results with those obtained by real-time polymerase chain reaction (PCR).
  
  
  METHODS
  Four paediatric nurses were trained and certified in using RSV-POCT. Between October 2008 and March 2009, all hospitalised children below 5 years of age presenting with a suspected RSV infection had nasopharyngeal swabs (NPS) tested by RSV-POCT by the nurses and a real-time PCR targeting common respiratory viruses by laboratory staff.
  
  
  RESULTS
  Among 159 NPS, 21 (13.2%) were RSV-POCT positive and 138 (86.8%) negative. All 21 RSV-POCT positive samples were positive by PCR, yielding a specificity of 100% (95% CI 95.7%, 100.0%). Of 138 RSV-POCT negative samples, 30 (21.7%) were RSV positive by PCR (sensitivity 41.2%; 95% CI: 27.9%, 55.8%). The positive and negative predictive values for RSV-POCT were 100% (95% CI 80.8%, 100.0%) and 78.3% (95% CI 70.3%, 84.6%) respectively. Other respiratory viruses were detected in 52/138 (39.9%) NPS.
  
  
  CONCLUSIONS
  A POCT for RSV run by trained nurses can be used reliably as a first screening step in symptomatic children. Negative samples should be analysed for RSV and other respiratory pathogens by real-time PCR.
authors.affiliation: Dept. of Virology, Royal Free Hampstead NHS Trust & UCL Medical School, Pond Street, London, UK.
authors.forename: Aysha Begum
authors.initials: AB
authors.lastname: Khanom
authors.forename: Charlotte
authors.initials: C
authors.lastname: Velvin
authors.forename: Khidir
authors.initials: K
authors.lastname: Hawrami
authors.forename: Martin
authors.initials: M
authors.lastname: Schutten
authors.forename: Mauli
authors.initials: M
authors.lastname: Patel
authors.forename: Michael V
authors.initials: MV
authors.lastname: Holmes
authors.forename: Claire
authors.initials: C
authors.lastname: Atkinson
authors.forename: Judith
authors.initials: J
authors.lastname: Breuer
authors.forename: John
authors.initials: J
authors.lastname: Fitzsimons
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Geretti
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007223:Infant; D008297:Male; D010371:Pediatric Nursing; D019095:Point-of-Care Systems / Q000592:standards; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000451:nursing; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity