Point-of-care testing and recognizing and preventing errors.

Jenny, the practice nurse of a busy GP surgery, was asked to carry out a commercially available test to exclude a diagnosis of infectious mononucleosis. The test was negative. The patient was prescribed amoxycillin and later developed a severe rash. However, the blood tests from the local pathology laboratory showed that the patient did have infectious mononucleosis. The GP discovered from colleagues that over the last few weeks other patients as the surgery had been recorded as having negative tests but positive laboratory results had later followed.