Evaluation of a program providing operator training, quality assurance, and quality control for point-of-care testing for hepatitis C infection

C Markus, L Causer, D Silk, E Tu, S Comben, M Martinez, Shaw I, Cunningham E, J Williams, J Richards, TA Applegate, W Dimich, L Cabuang, O Dawson, Kerr S, R Guy, P Cunningham, M Shephard, J Grebely, S Matthews

Research output: Contribution to conferenceAbstractpeer-review


Background: Robust training and compliance with standard operating procedures underpin point-of-care (POC) testing quality, thus minimising patient harm. To date, the National Australian HCV POC Testing Program has delivered standardised training to 31 health services (of 89 planned). As part of continual quality improvement, this study evaluated HCV POC testing operator competence and error rates during initial program scale-up.

Methods: Standardized training for GeneXpert HCV Viral Load Fingerstick POC testing was developed and delivered to staff at enrolled services. Longitudinal POC operator competency was self-assessed with 5-part Likert scale surveys and categorised as below average (≤2) or average/above average (>3), after each training activity. HCV test error rates were determined from extracted connectivity data, with individual supplementary training session provided as required.

Results: Ninety-seven operators (64% nurses, 11% peer workers and 25% other health professionals) completed HCV POC training, with 23% having previous GeneXpert experience. Pre- and post- training competency improved for specimen collection (64% vs. 92%, P<0.01), quality control (57% vs. 100%, P<0.01), RNA testing (43% vs. 97%, P<0.01) and result interpretation (48% vs. 100%, P<0.01). After each training activity the proportion of average/above average competence increased (P<0.001).
Of 3,704 POC HCV RNA tests (January-October 2022), 3,593 (91%) were valid on first attempt. Unsuccessful tests (n=348), broadly related to poor quality sampling (“errors”; n=286), cartridge error (“invalid”; n=45) or device error (“no result”; n=17) and were proportionally lower in operators with prior GeneXpert experience (7.9% vs. 17.2%, P<0.001). Individual supplementary training was provided to one operator.

Conclusion: Staff performing HCV POC testing recognise the importance of robust training, standard operating procedure compliance and ongoing skill acquisition for GeneXpert competency. Supplementary training can further reduce test errors and cartridge wastage. Comprehensive training, supported bycompetency assessment, quality assurance and embedded continual quality improvement are essential for scale-up and delivery of high-quality POC testing.

Original languageEnglish
Number of pages2
Publication statusPublished - 14 Mar 2023
EventAustralasian Conference on Point of Care Testing for Infectious Diseases - Sheraton Grand Sydney Hyde Park, Sydney, Australia
Duration: 14 Mar 202315 Mar 2023
Conference number: 1st
https://www.kirby.unsw.edu.au/events/poc23-1st-australasian-conference-point-care-testing-infectious-disease (Conference link)


ConferenceAustralasian Conference on Point of Care Testing for Infectious Diseases
Abbreviated titlePOC23
OtherTo accelerate access to new point-of-care technology, we need research in all these areas to provide the most effective implementation pathways. To respond to this evolving challenge, ASHM and the RAPID Point of Care Research Consortium for infectious disease in the Asia Pacific made the decision to run this two-day conference.

The conference will collaborate with leading scientists, clinicians, and other stakeholders to develop a program on the ever-evolving landscape of point-of-care testing for infectious diseases and provide time to discuss challenges and solutions to scaling up point-of-care testing in this setting.
Internet address


  • hepatitis C virus (HCV)
  • point-of-care testing
  • training
  • quality assurance


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