Assessing the Knowledge Base and Comfort Level of Urgent Care Providers in Performing Risk Stratification of Deep Vein Thrombosis in the Urgent Care Setting

One of the most common complaints listed by patients who visit acute care providers in the emergency department and urgent care settings is concern for possible deep vein thrombosis (DVT). The current literature indicates that only 20-30% of patients that are presenting to the UC setting to be evaluated for possible DVT will have a confirmed DVT and require treatment (Boren, 2016). The traditional work-up for exclusion of DVT has been done primarily by emergency departments. With the expansion of more sophisticated urgent care centers (UCC) over the past 40 years, it may be possible for patients to be evaluated in UCC for exclusion of DVT. In order to proceed with a possible change in clinical pathway regarding DVT exclusion in UCC, research needs to be done regarding the comfort level and current practices of urgent care providers in evaluating risk for DVT in their practice. To evaluate this question, UCC providers in the Salt Lake valley were given a questionnaire assessing their current comfort level in assessing a patient for risk of a DVT as well as current clinical practice and policy for patients presenting with concern for possible DVT. Thirty nine respondents completed the pre-education module questionnaire. The same urgent care providers were presented with an educational intervention via an education module including instruction on assessing risk of DVT and how to safely exclude DVT in an acute care setting. After the education module was given the participants were given a questionnaire to assess for any changes in comfort level of assessing for risk of DVT in the urgent care patient and to evaluate whether the education would affect current practice in regards to excluding DVT without an emergency department referral. Twenty five of the respondents completed both the pre education and post education questionnaires and thus our analysis was performed using this number. The findings of the post-education questionnaire showed a statistically relevant change in knowledge and comfort level in performing risk assessment for DVT in the UCC setting. The hypothesis set forth in this study is this: If urgent care providers were comfortable, and had the knowledge base needed, they could craft policies allowing for exclusion of DVT in the UCC setting. Effectively performing risk stratification for DVT in the UCC could provide a safe and effective avenue to assess and manage DVT outside of the emergency department.