Avoiding Spurious Low Platelet Counts by Redrawing Specimens with First Time Low Platelet Counts.

Area of Science:

• Pediatric Hematology
• Clinical Pathology
• Hospital Quality Improvement

Background:

• Initial low platelet counts in pediatric patients often trigger repeat testing.
• The clinical significance and frequency of correction for these initial low counts are not always clear.

Purpose of the Study:

• To evaluate the effectiveness of a policy mandating redraws for pediatric patients with first-time platelet counts below 100 K/ml.
• To determine the frequency of corrected platelet counts after redraws and identify high-yield clinical areas for this policy.

Main Methods:

• A 25-month retrospective review was conducted at a children's hospital.
• Analyzed data from 99 pediatric patients who underwent automatic redraws for initial low platelet counts (<100 K/ml).
• Examined the origin of specimens and the results of repeat platelet counts.

Main Results:

• A significant 62% of redrawn specimens showed corrected platelet counts.
• Highest correction rates were observed in samples from the emergency department (74%), pediatric intensive care unit (71%), and operating room (67%).
• Lower correction rates were noted in cardiac intensive care (38%) and general hospital floors (44%).

Conclusions:

• The policy of redrawing pediatric patients with initial low platelet counts (<100 K/ml) is effective, with 62% correction rates.
• This approach successfully avoids unnecessary delays and additional costs associated with provider-ordered repeat testing.
• The findings support the continued implementation of this redrawing policy, particularly in high-acuity areas.