An increase in the number of lower extremity venous duplex ultrasound exams performed at Hospital X prompted the question of implementing an ordering protocol and screening system to reduce the number of extraneous exams performed while also reducing the cost to the patient. Diagnosing deep vein thrombosis (DVT) among the inpatient population is a difficult process as patient presentation may appear as the presence of DVT, while another presentation could easily be diagnosed as a differential diagnosis like cellulitis. DVT is not a condition to be taken lightly, as a blood clot within the deep venous system is potentially life-threatening if left undiagnosed and untreated. Given the importance of diagnosing DVT, ordering users and physicians tend to take precaution and order lower extremity venous duplex ultrasound exams for any patient presenting with leg swelling, leg pain or edema; the most common presentations for DVT. A quantitative, prospective study was performed through the data collection of 150 inpatients admitted to Hospital X, located in Northern Nevada. The collected data included a Wells criteria for DVT score and lower extremity venous duplex ultrasound result. Upon completion of data collection, statistical analysis was performed using SAS 9.4 for Windows and Microsoft Excel 2013. Through use of SAS 9.4 for Windows, analysis performed included t-test, Chi-Square test and Fisher’s exact test for patient sex, ethnicity group, age when compared to the final ultrasound result, and the statistical significance of the Wells criteria questions. The results suggest an overuse of lower extremity venous duplex ultrasound exams resulting in excessive cost to the patient and depletion of hospital resources. There are several steps that Hospital X can take to combat this increase as mentioned in the discussion.
