Grant: Operating Grant: Knowledge to Action

Patients undergoing cancer treatments experience many symptoms. Often these symptoms occur when they are at home and some can progress to be life-threatening. Our group conducted a study that showed that most cancer programs provide patients with access to nurses by telephone (or email) but current protocols to guide their symptom management are out of date. Next we established a Canadian panel representing 8 provinces and used a rigorous process to develop 13 symptom protocols that were based on the best available scientific evidence. When the protocols were reviewed by cancer nurses from across Canada, nurses described the protocols as comprehensive, user-friendly, and easy to complete. The purpose of this study is to implement and evaluate these 13 symptom protocols for remote support provided by nurses in three cancer programs in Canada. We specifically chose programs from different provinces (Ontario, Quebec, and Nova Scotia) and having different sizes. We plan to: a) assess factors influencing their use by nurses, b) adapt them for use in each of the three settings including French translations; c) provide nurses with training and other supports to implement them; d) test how they are used by nurses; and c) evaluate their impact on patients (e.g., satisfaction and how well their symptoms are controlled), nurses (e.g., satisfaction with using the protocols), and the healthcare system (e.g., appropriateness of advice provided, clinic visits, emergency visits and hospitalizations). Given the importance of providing safe patient care, this study will help us understand ways to ensure symptom protocols are being used in the manner for which they were designed when nurses provide remote symptom support in Canada.