Survey of methods used to determine if a patient has a deep vein thrombosis: An exploratory research report

ABSTRACT

Background: The use of evidence-based practice (EBP) is encouraged in the physical therapy profession, but integrating evidence into practice can be difficult for clinicians because of lack of time and other constraints. Objective: To survey physical therapy clinical instructors and determine the methods they use for screening for deep vein thrombosis (DVT), a type of venous thromboembolism (VTE) in the lower extremities. Design: Exploratory survey. Methods: Twelve survey questions written specifically for this study were sent to a convenience sample of clinical instructors associated with seven universities across 43 states. Results: Eight hundred fifty clinical instructors (22.4% response rate) completed the survey. Of those who responded, 80.5% were taught to use Homans sign to screen for a possible DVT in their entry-level education and 67.9% continued to use Homans sign in clinical practice. Regardless of post-graduate education, respondents were more likely to choose Homans sign than a clinical decision rule (CDR) to screen for a suspected DVT. Additionally, nearly two-thirds of respondents failed to correctly identify one or more of the major risk factors for developing a DVT/VTE. Limitations: The response rate was 22.4% and therefore may not fully represent the population of physical therapy clinical instructors in the United States. Conclusions: Results from this exploratory survey indicated that approximately two-thirds of physical therapy clinical instructors used outdated DVT/VTE screening methods that they were taught in their entry-level education and nearly two-thirds did not identify the major risk factors associated with DVT/VTE. These results suggest that change is necessary in physical therapy education, clinical practice, and continuing professional development to ensure a more evidenced-based identification of DVT and VTE.

KEYWORDS:

• Clinical decision rule
• deep vein thrombosis
• evidence based practice
• homans sign
• venous thromboembolism

Acknowledgments

The authors would like to acknowledge the clinical directors of the seven universities for the distribution of the survey and Deborah Goggin, MA, for assistance in editing this paper and Vanessa Pazdernik, MS, for assistance with statistical analyses. There was no grant funding for the current study.

Declaration of interest

There are no conflicts of interest that the authors are aware of in this manuscript.