Connectivity and Results The GeneXpert®

systems were networked using Synapse software (Systelab Technologies S.A., Barcelona, Spain). This allowed real-time monitoring of test results and errors on all GeneXpert® systems. The analyzers were not interfaced directly with either the Laboratory Information Management System or the Electronic Patient Record. The GeneXpert® analyzers were connected to printers, which automatically printed HSP990 cost out individual patient results upon test completion. Staff members on older persons’ wards were instructed to insert this into the patient’s clinical notes; staff in ICU manually transferred the result to the Electronic Patient Record. Additionally, whenever any sample tested positive, an immediate automated email alert was sent to the study team and service infection control nurses from NU7026 molecular weight 9 am to 5 pm, Monday to Friday. Outside of these hours, infection control advice was provided by an infectious diseases/microbiology physician. This allowed immediate notification of a case and subsequent infection control interventions to be implemented before

the centralized laboratory testing result became available. Clinical staff were instructed to act upon the results as they would have had the sample been processed in the centralized laboratory. Clinical Utility JQ-EZ-05 order patients who underwent testing with the POCT were age and sex matched with patients tested for CDI on non-study wards (older persons’ ward or ICU) where POCT testing was not available. These groups were compared to determine any differences in length of stay, 30-day all-cause mortality and requesting of certain ancillary

investigations e.g., stool culture, norovirus testing, radiological investigations etc. Acceptability and Ease of Use A questionnaire was designed to gauge users’ experience and opinions on the POCT. A five-point scale was used to assess level of agreement with five statements covering ease of use, acceptability, turnaround time, and effect on bed management. Results The study period lasted for 22 months (March 2011 to January 2013). During this time, a total of 330 patients were tested by the POCT; 97 (29%) POCTs were performed on the older persons’ wards and 233 (71%) on ICU. A total of 335 POCTs were performed; 100 tests on the 97 elderly patients and 235 tests were oxyclozanide performed on the 233 ICU patients. A total of 76 older persons’ staff were trained, comprising of 17 healthcare assistants with no formal qualifications, 46 junior or student nurses and 13 senior nurses. Each older persons’ staff member processed an average of 1.3 tests. A total of 15 ICU laboratory technicians were trained, each processing an average of 18 tests. The majority of POCTs performed on older persons’ wards were undertaken between the hours of midday and 9 pm (82%). This figure was lower for those performed in ICU (61%). Figure 1 shows times of sample testing on the older persons’ wards and ICUs. Fig.