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Rate the following statements:
Strongly Disagree Disagree Agree Agree Stongly
Nurses and physicians work together to manage patient pain.
Other resources are used to manage patient pain when indicated. ex: consulting other physicians, use of hospice ect.
Nurses work with other nurses to help manage patient pain
 
 
Rate the following about patient rounding
Always Often Sometimes Not Often Never
Staff works as a team to do hourly rounding
During hourly rounding I ask my patients about their pain.
After pain medication/treatment is given I re-assess my patient during rounds.
Pain is assessed during physician rounding
 
 
Rate the following statements:
Always Often Sometimes Not often Never
Your patients are medicated prior to painful treatments/procedures.
During your assessments you find that the previous nurse asked about pain and/or medicated prior to leaving for their shift
In your practice you ask about pain and/or medicate prior to leaving for your shift.
 
 
To what extent would you agree that the following are barriers to the effective management of patient's pain
Strongly Disagree Disagree Agree Agree Strongly
Patient reluctance to take analgesics
Medical staff reluctance to prescribe analgesics
Nursing staff reluctance to administer analgesics
Inadequate staff assessment of pain and pain relief
Inadequate staff knowledge of pain management principles
Delayed staff response to patient's reports of pain
Inadequate patient knowledge/expectations about pain and or pain medications
 
 
 
During patient assessments about pain, how often are goals established?
 
Always
 
Sometimes
 
Never
 
Other
 
 
 
 
During report handoff how often are patient goals and pain regimens discussed among giving/receiving staff AND the patient?
 
Always
 
Sometimes
 
Never
 
Other
 
 
 
Rate the following:
Strongly Disagree Disagree Neutral Agree Agree strongly
I feel like I have a good understanding/knowledge base about pain medications/regimens.
I feel if I had more education about pain medications/regimens I could better care for my patients.
I feel as a hospital we could do a better job at treating patient pain.
 
 
How do the following patient responses influence your decision to initiate interventions for pain relief?
No Influence Small Influence Moderate Influence Great Influence
Facial expression
Sleeping
Vital Signs
Increased Movement
Decreased Movement
Patient report pain using a pain measurement tool
Family report of patient's discomfort
 
 
 
How often you do feel non-drug interventions are used in the practice of patient pain management
 
Used Often
 
Used Never
 
Used Sometimes
 
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