A streamlined laboratory process for obtaining band counts in hospitalized neonates

Abstract

Objective: Band neutrophil counts are helpful for the detection of neonatal sepsis. Our goal was to optimize our laboratory process to detect elevated band neutrophils whenever present, without performing unnecessary manual differential counts. Methods: We retrospectively tracked consecutive complete blood count with differential (CBCD) orders from neonatal intensive care unit (NICU) specimens according to the level of manual review. We identified specimens for which manual differential counts were performed due to telephone request and categorized them according to band percentage. Results: Our laboratory routinely performed manual scans on 96% of NICU specimens, but only 87% of specimens required manual differential counts. Abnormal band counts were present in 5 of 70 specimens for which manual differential counts were requested because of clinically suspected sepsis. We elected to perform universal manual scans on all NICU specimens. Conclusion: The revised laboratory process could be useful for other hospitals treating neonatal patients at risk of sepsis.