Table 4

The subcategories of ‘Our current testing practice distracts from care for our patients’ with a sample of corresponding quotes

The temptation of POCTs disrupts our clinical reasoningWe are inadequately informed about our POCTsNon-standardised use of POCTsPOCTs are not ‘all good’POCTs cannot always be trusted
I can sometimes feel it is unjustified if it is a very alert child who is eating, peeing, is afebrile, and feels well, and then we take samples, like ‘do a CRP on that’. But they don’t have a fever, they haven’t anything … they have been running around for 2–3 hours.
(Nurse assistant group)
No, but I don’t even know how to do a proper RS [POCT for RS virus] test so that you know this is a positive RS. I haven’t had an introduction or instructions on how to take it [the sample].
(Junior doctor group 2)
I think that I probably do it differently every day, that I’m not consistent myself either… *laughter*. And it can be that the week before you had a patient who became very ill and had to go to the intensive care unit – and then maybe I take that extra CRP the week after, because I remembered that case. So, it affects your decisions.
(Consultant group)
If it is a child who is extremely afraid of hospitals and needles, then even a stick in the nose is painful.
(Consultant group)
I like the CRP because it is reliable … However, my interpretation of it is not reliable. So, the test result feels reliable, but I don’t feel reliable in my interpretation of it all the time.
(Junior doctor group 2)
Unfortunately, yes. And again, it is probably meant to help, but it can turn into a hindrance if it doesn’t show what one hopes.
(Resident group)
I have no clue how much these tests cost.
(Consultant group)
No, but I think that the talk goes so differently, depending on, it’s probably always what is so difficult with our job. That everybody always thinks so differently, that some consultants think so differently about what you should do.
(Resident group)
And then we found out the cost … Since then, I probably have never used it [POCT] for several years now!
(Resident group)
But I think that it is often that I get a negative result and then you have done a new test which has been positive. So that I don’t really dare to trust it.
(Junior doctor group 2)
The clinical picture [acumen], the clinical picture, it is the clinic picture you act on.
(Resident group)
… the validation of these devices, I don’t always know how it has been conducted. So that, I don’t know about as an individual doctor, like, how good is this device really, now that we have it. That I don’t know.
(Consultant group)
But I think that a lot is at an individual level… Some doctors don’t want any samples at all and some want samples of practically everything.
(Nurse group)
But we don’t consider the staff time required, because we think that the nurses are already there. But on the other hand, they could be managing other patients if they weren’t standing there working on the reagent.
(Consultant group)
But it is also somewhat how the sample is taken and how much secretion you have got.
(Nurse group)
  • CRP, C-reactive protein; POCTs, point-of-care tests; RS, Respiratory Syncytial Virus.