The study objective was to develop and evaluate a template for evidence-informed symptom protocols for use by nurses over the\ntelephone for the assessment, triage, and management of patients experiencing cancer treatment-related symptoms. Guided by the\nCAN-IMPLEMENT�© methodology, symptom protocols were developed by, conducting a systematic review of the literature to\nidentify clinical practice guidelines and systematic reviews, appraising their quality, reaching consensus on the protocol template,\nand evaluating the two symptomprotocols for acceptability and usability. After excluding one guideline due to poor overall quality,\nthe symptom protocols were developed using 12 clinical practice guidelines (8 for diarrhea and 4 for fever). AGREE Instrument\n(Appraisal of Guidelines for Research and Evaluation) rigour domain subscale ratings ranged from 8% to 86% (median 60.1\ndiarrhea; 40.5 fever). Included guidelines were used to informthe protocols along with the Edmonton SymptomAssessment System\nquestionnaire to assess symptomseverity. Acceptability and usability testing of the symptom populated template with 12 practicing\noncology nurses revealed high readability (?? = 12), just the right amount of information (?? = 10), appropriate terms (?? = 10),\nfit with clinical work flow (?? = 8), and being self-evident for how to complete (?? = 5). Five nurses made suggestions and 11\nrated patient self-management strategies the highest for usefulness. This new template for symptom protocols can be populated\nwith symptom-specific evidence that nurses can use when assessing, triaging, documenting, and guiding patients to manage theircancer\ntreatment-related symptoms.
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