Pre-chemotherapy risk assessment is essential to proactive patient education and symptom management. When risks are assessed prechemotherapy and again before each subsequent treatment, side effects can be reduced or eliminated. A multi-symptom risk assessment tool allows clinicians to assess risks in one place and initiate supportive care guidelines that stem directly from the risk assessment. The adult Sarcoma patient population generally receives high doses of chemotherapy for extended periods of time. Implementing risk assessment leads to improved patient outcomes in this population. To describe the effects of the implementation of a multi-symptom chemotherapy risk assessment tool on patient outcomes in the adult Sarcoma patient population. The AIM Higher multi-symptom risk assessment tool was implemented by the Nurse Practitioner during the pre-chemotherapy visit for all new Sarcoma patients beginning in March 2005. AIM Higher is a national quality improvement program. An AIM Higher Risk Assessment task force created the tool based on best available evidence to date for each symptom. The symptoms include; neutropenia, anemia, nausea and vomiting, diarrhea, constipation, anxiety, depression, mucositis, peripheral neuropathy, cardiac toxicity and hand/foot syndrome. Patient education was initiated and proactive interventions such as growth factors and antiemetics were ordered based on the risk assessment. Supportive care guidelines were initiated based on the patient's risk for developing the symptom. Preliminary chart review suggests that the impact of many of the chemotherapy-related symptoms has been reduced or eliminated. Oncology nurses can use a multi-symptom chemotherapy risk assessment tool in a variety of settings before chemotherapy is initiated. The adult Sarcoma patient population is particularly vulnerable to treatment side effects due to the high doses of chemotherapy that are given. This group can receive great benefits from risk assessment. Identification of risks initiates proactive patient teaching and guidelines for the prevention and management of the symptom that the patient is at risk for developing. Proactive management of chemotherapy-related symptoms leads to improved quality of life and improved quality of care for the patient. [ABSTRACT FROM AUTHOR]