Triaging symptom calls with and without practice guides: A case exemplar

Barbara Ballantyne, Dawn Stacey


This case exemplar demonstrates use of COSTaRS symptom practice guides for enhancing quality of telephone-based nursing services. The case is based on findings from an audit of nurse-led telephone consultation documentation from 299 patients’ health records in ambulatory oncology programs. Phone calls between a 49-year-old woman with metastatic colon cancer and three registered nurses (RNs) are described herein. The patient received chemotherapy intravenously (day 1) and orally (days 1–14). On days three, five and six she telephoned her RN to report nausea and vomiting. The first two RNs advised her to take her antiemetics with no assessment documented. The third RN used a COSTaRS symptom guide to conduct a thorough assessment, medication review, and discussed strategies for self-management.

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