Implementing and sustaining evidence-based practices in long-term care.

Pain Assessment and Management

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  • Abbey Pain Scale
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    The Abbey Pain Scale is an instrument designed to assist in the assessment of pain in patients who are unable to clearly articulate their needs, for example, patients with dementia, cognition or communication issues. The scale does not differentiate between distress and pain, so measuring the effectiveness of pain-relieving interventions is essential.

    Abbey, J; De Bellis, A; Piller, N; Esterman, A; Giles, L; Parker, D and Lowcay, B. Funded by the JH & JD Gunn Medical Research Foundation 1998 – 2002. This document may be reproduced with this acknowledgment retained.

    https://www.apsoc.org.au/PDF/Publications/Abbey_Pain_Scale.pdf

     

     

     

     

     

     

     

     

     

  • Brief Pain Inventory (BPI)
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    Purpose of the BPI tool is to assess the severity of pain and the impact of pain on daily functions. The tool can be used for patients with pain from chronic diseases or conditions such as cancer, osteoarthritis and low back pain, or with pain from acute conditions such as postoperative pain.

    Assessment areas included are severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours or the past week.

    The BPI copyright is held by Dr Charles S. Cleeland (1991). The copyright applies to the BPI and all it's derivatives in any language.

    Retrieved from http://www.npcrc.org/files/news/briefpain_short.pdf 

  • Checklist of Nonverbal Pain Indicators (CNPI)
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    The Checklist of Nonverbal Pain Indicators (CNPI), was designed to observe and measure pain behaviors in cognitively impaired elders.

    Retrieved from: https://www.caltcm.org/assets/Pain-file/checklist%20nonverbal%20pain%20indicators.pdf

    Feldt KS. The checklist of nonverbal pain indicators (CNPI). Pain Manag Nurs. 2000 Mar;1(1):13-21. Horgas AL. Assessing pain in persons with dementia. In: Boltz M, series ed. Try This: Best Practices in Nursing Care for Hospitalized Older Adults with Dementia. 2003 Fall;1(2). The Hartford Institute for Geriatric Nursing. www.hartfordign.org

  • Comprehensive pain assessment mnemonic (OPQRSTUV): Appendix C
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    This tool demonstrates how the mnemonic OPQRSTUV, can be used to conduct a comprehensive pain assessment. Note that this assessment may not be the most appropriate tool for all presentations of pain.

    Reference: Registered Nurses’ Association of Ontario. (2025). Appendix C of Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author. pp. 81. 

    Source: Adapted from: Fraser Health. Hospice palliative care program: symptom guidelines [Internet]. Surrey (BC): Fraser Health; 2019. Available from: https://www.fraserhealth.ca/-/media/Project/FraserHealth/FraserHealth/Health-Professionals/Professionals-Resources/Hospice-palliative-care/SectionsPDFs-for-FH-Aug31/9524-01-05-FH---Sym_Guide-Intro-v05FINAL.pd

  • Numeric Pain Scale (NRS)
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    A pain rating scale used to determine a persons level of pain.

    • Scored 0-10 with the anchors of 0 being ‘no pain’ and 10 being ‘pain as bad as it can be’ Used in adults, older adults, and adolescents and children over age 8.
    • Well established evidence of reliability, validity, and ability to detect change
    • No equipment is needed to administer this measure
    • High feasibility (quick and easy to use)

    Reference: McCaffery, M., Beebe, A., et al. (1989). Pain: Clinical manual for nursing practice, Mosby St. Louis, MO

  • Opioid Manager
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    The Opiod Manager condenses key elements from the Canadian Opiate Guideline into a workable format for prescribing opiates for persons with chronic, non-cancer pain.

    Reference: National Opiod Use Guidelines Group (2010), Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain Practice Toolkit, Opioid Manager. Retrieved from http://nationalpaincentre.mcmaster.ca/opioidmanager/

    © 2016 McMaster University

  • Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC)
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    PACSLAC is a tool to observe and assess both common and subtle pain behaviours. Copyright © Shannon Fuchs-Lacelle and Thomas Hadjistavropoulos. The PACSLAC may not be reproduced without permission. For permission to reproduce the PACSLAC, please contact the copyright holders (Thomas.Hadjistavropoulos@uregina.ca).

    Retrieved from: https://gerocentral.org/wp-content/uploads/2013/12/Pain-Assessment-Checklist-for-Seniors-with-Limited-Ability-to-Communicate-PASLAC.pdf

  • Pain Assessment in Advanced Dementia (PAINAD) Scale
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    This resource from Interior Health, is a pain assessment tool useful for scoring pain levels of people with dementia who are unable to verbally express their pain. It focuses on assessing behaviours and provides a score rating of mild, moderate or severe pain levels.

    Retrieved from: https://www.interiorhealth.ca/sites/default/files/PDFS/810310-pain-assessment-advance-dementia-scale.pdf

    Warden, V., Hurley, A. & Volicer. L. (2003). Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. JAMDA, 4(1), 9 -15. Horgas, A., & Miller, L. (2008). Pain assessment in people with dementia. American Journal of Nursing, 108(7), 62-70.

     

  • Symptom Management Algorithm- Pain in Adults with Cancer
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    Symptom Management Algorithm for pain in adults with cancer developed by Cancer Care Ontario.

    Cancer Care Ontario (2018) Symptom Management Algorithm- Pain in Adults with Cancer retrieved from https://www.cancercareontario.ca/en/symptom-management