Date of Award
Summer 2026
Abstract
Background: Effective pain management requires nurses to complete and document an entire pain assessment cycle, including the initial assessment, intervention, and reassessment (Wolters Kluwer, paragraph 5, 2020). Timely reassessments are essential for determining whether interventions were effective or if additional actions need to be taken to improve patient pain and comfort. Despite established hospital policies and guidelines, inconsistencies in timeliness of pain reassessments and associated documentation are a common challenge faced.
Local Problem: Baseline chart audits on a 22-bed combined pediatric and adult medical-surgical unit identified opportunities to improve adherence to timely pain assessments and documentation. With only 65% percent of pain reassessments being completed within the defined timeframe, a quality improvement initiative using a multifaceted educational and reminder-based approach was implemented to improve adherence to the hospital's pain reassessment policy.
Methods: A quality improvement (QI) project guided by the Plan-Do-Study-Act (PDSA) framework was conducted over a 3-week period with the goal of improving the timeliness of pain reassessments within the microsystem. The combined interventional approach used an asynchronous educational presentation on pain reassessment guidelines and their importance, as well as laminated visual reminders placed throughout the unit. Post-intervention chart audits were completed on pain reassessment documentation to compare the percentage of timely pain reassessments to pre-interventions data. Additionally, post-interventions feedback questions were used to collect information from the nurses on their perceptions of the interventions.
Results: Following the interventions, timely pain reassessment completion and documentation increased from a baseline of 65% to 70%, demonstrating a modest 5 percentage point increase. Although the primary specific aim of achieving at least 85% timely completion and documentation, the microsystem nurses reported increased confidence and perceived ability to complete and document timely pain assessments. Qualitative data from the post-intervention feedback questions also indicated that the nurses found the visual reminders to be more impactful than the educational presentation due to their ability to provide constant reminders throughout shifts. Barriers were also identified, including competing clinical priorities, patient acuity and workload, and staffing ratios.
Conclusions: The use of a multifaceted interventional approach containing nurse education and visual reminders produced a modest improvement in the percentage pain reassessments completed and documented on time, as well as enhanced nurses' perceived ability to carry out changes in practice. With this said, refinement through future PDSA cycles and further support from leadership may allow these interventions to make further improvements, increased sustainable changes, and be applied to other inpatient microsystems.
Keywords: Quality Improvement, Pain reassessments, Documentation, Visual reminders, Nurse education, Timely, PDSA
Document Type
Master's Thesis
First Advisor
Elizabeth Evans
Second Advisor
Pamela Kallmerten
College or School
CHHS
Department or Program
Direct Entry Master's in Nursing
Degree Name
Master of Science
Recommended Citation
Grace, Madison, "Improving Timely Pain Reassessments and Documentation using Nurse Education and Visual Reminders: A Quality Improvement Project" (2026). Master's Theses and Capstones. 2097.
https://scholars.unh.edu/thesis/2097