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Improving the Rate of Sufficient Sweat Collected in Infants Referred for Sweat Testing in Michigan
Ibrahim Abdulhamid1, Mary Kleyn2, Carrie Langbo2
1Children's Hospital of Michigan Cystic Fibrosis Center, Detroit, MI, USA.
Insights
Michigan cystic fibrosis (CF) centers reduced sweat testing quantity not sufficient (QNS) rates in infants by implementing standardized procedures and collaborative reviews. This quality improvement project successfully lowered QNS rates, enhancing diagnostic accuracy for newborns.
Area of Science:
- Medical Diagnostics
- Pediatric Healthcare
- Quality Improvement in Healthcare
Background:
- The target for quantity not sufficient (QNS) sweat testing in infants under 3 months is ≤10%.
- Michigan cystic fibrosis (CF) centers reported QNS rates between 12% and 25% in 2009.
- A project was initiated to address and reduce high QNS rates in Michigan.
Purpose of the Study:
- To decrease the rate of insufficient sweat sample collection for cystic fibrosis testing in infants.
- To improve the quality of diagnostic procedures for newborn screening.
Main Methods:
- Consultant review of individual center sweat testing protocols.
- Dissemination of tailored recommendations to participating centers.
- Peer-to-peer observation of sweat testing procedures among technicians.
Main Results:
- Over a 2-year period, 778 infants screened positive for CF.
- The mean age for sweat testing was 23.2 days (SD ± 13.0).
- Overall QNS rates decreased significantly from 14.4% to 9.5% (P = .04).
Conclusions:
- A collaborative, project-based approach effectively reduced sweat test QNS rates.
- The initiative provided a platform for addressing a common challenge in CF diagnostics.
- Improvements in sweat testing procedures led to enhanced quality of care for newborns.
Abstract:
Objective. Sweat collected for testing should have quantity not sufficient (QNS) rate of ≤10% in babies ≤3 months of age. Michigan (MI) cystic fibrosis (CF) centers' QNS rates were 12% to 25% in 2009. This project was initiated to reduce sweat QNS rates in MI. Methods/Steps. (a) Each center's sweat testing procedures were reviewed by a consultant. (b) Each center received a report with recommendations to improve QNS rates. (c) Technicians visited other participating centers to observe their procedures. Results. A total of 778 infants were identified as positive via CF newborn screening over a 2-year period. The mean age at time of sweat test was 23.2 days (SD ± 13.0 days). The overall QNS percent decreased from 14.4% to 9.5% (P = .04) during the study. Conclusion. This project and teamwork approach led to a decrease of sweat test QNS rates, opportunities to solve a common problem, and improved quality of care.
