Results of a Quality Improvement Program for Sweat Testing to Diagnose Cystic Fibrosis

Obtaining an adequate volume of sweat to measure chloride is a challenge for many cystic fibrosis centers. The standard for patients older than 3 months is a less than 5% quantity not sufficient (QNS) rate; the suggested goal for patients aged 3 months or younger is a less than 10% QNS rate. St. Alexius Medical Center (SAMC) began performing sweat chloride testing in 2008. After an initial period of testing, a quality improvement (QI) program for sweat testing was instituted to improve QNS rates. Quantity not sufficient rates were evaluated before and after implementation for patients aged 3 months or younger and those older than 3 months. The QNS rates for each technician performing the tests were also evaluated. Improvement was observed in QNS rates after implementation of the QI initiative regardless of patient age. After QI was implemented, QNS rates improved for most technicians. This study demonstrates how a QI improvement initiative can significantly improve QNS rates in sweat testing of infants, especially under 3 months of age.