The following resource is designed to assist Long-Term Care (LTC) homes with the implementation of the Assessment and Management of Pain Best Practice Guideline 3rd ed.. Documents found in this resource are evidence-based, but it is not a program plan. Each LTC home is unique and each home is in various stages of guideline implementation. LTC homes are advised to use the resource at their discretion. For those resources that have copyright notations, it is recommended that LTC homes obtain permission from the primary author prior to implementing them within their setting. The Toolkit is a dynamic resource, and is being updated and revised on a regular basis by the LTC Best Practices Program team. Visit this site often to see what's new!
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A tool to assist with comparing your organization’s current practice with evidence-based RNAO best practice recommendations.
Registered Nurses Association of Ontario (2025) Gap Analysis: Pain: Prevention, assessment & management, Fourth Ed. Toronto, ON.
This Best Practice Guideline (BPG) Pain: Prevention, assessment and management (Fourth Ed.), replaces the RNAO BPG Assessment and Management of Pain, Third Edition.
The purpose of this fourth edition guideline is to provide nurses and the interprofessional team with evidence-based guidance for the prevention, assessment and management of all types of pain across the lifespan. This BPG recognizes that people at risk of or experiencing any type of pain across the lifespan and their families are experts in their health and decision-making; collaboration among the interprofessional team, the person receiving care and their family (if applicable) is therefore essential to achieving improved health outcomes.
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Registered Nurses’ Association of Ontario. (2025). Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author. Retrieved from: https://rnao.ca/bpg/guidelines/assessment-and-management-pain |
This work is funded by the Ontario Ministry of Health and Long-Term Care.
The Leading Change Toolkit includes two frameworks- the Social Movement Action (SMA) Framework and the Knowledge-to-Action (KTA) Framework. Both frameworks outline the concept of implementation and its interrelated components. The toolkit is based on available evidence, theoretical perspectives and consensus. We recommend the Leading Change Toolkit for guiding the implementation of any BPG in health care or social service organizations, including academic centres.
Reference: Registered Nurses’ Association of Ontario, (2025). Appendix G of Pain: prevention, assessment and management. Fourth edition. Toronto, Canada: Author. pp. 98-99 .
A list of organization and resources for pain prevention, assessment and management.
Reference: Registered Nurses’ Association of Ontario. (2025). Appendix F of Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author. pp. 97.
A number of systematic reviews focused on non-pharmacological approaches (NPI) to pain management: Type of NPI and population.
Reference: Registered Nurses’ Association of Ontario. (2025). Appendix E of Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author. pp. 89-96
These pain screening and assessment tools can be self-reported (by the individual experiencing pain and/or their family) or observational (behaviours observed by a health provider in an individual who is unable to communicate or is unconscious). This is a list of validated tools that can be used to assess pain in various populations and contexts. However, this is not an exhaustive list. Please follow organizational policies for pain tool usage. Not all tools are validated for all populations and settings. RNAO does not endorse the use of any one specific pain screening and assessment tool.
Reference: Registered Nurses’ Association of Ontario. (2025). Appendix D of Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author.
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/He...PDFs-for-FH-Aug31/9524-01-05-FH---Sym_Guide-Intro-v05FINAL.pd
A list topics and suggested RNAO guidelines and resources from other organizations that align with Pain: Prevention, assessment and management. Fourth edition. Toronto, Canada: Author. pp. 76-78.
Reference: Registered Nurses’ Association of Ontario. (2025). Appendix B of Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author.
This resource is a glossary of terms used throughout the best practice guideline, Pain: Prevention, assessment and management. Fourth edition.
Reference: Registered Nurses’ Association of Ontario. (2025). Appendix A of Pain: Prevention, assessment and management. (Fourth Ed.). Toronto, ON: Author.
pp. 69-75.
The Canadian Journal of Pain is an open access journal that publishes research from all disciplines involved in the study of pain, including the clinical and basic sciences, epidemiology, and health policy and health systems. The Canadian Journal of Pain is the Official Journal of the Canadian Pain Society.
The journal aims to advance the understanding and treatment of pain by providing clinicians, scientists and other health care professionals with an interdisciplinary forum in which to share cutting-edge information about new developments in the field of pain, including chronic and neuropathic pain.
Retrieved from: https://www.tandfonline.com/journals/ucjp20
The journal operates a single anonymized peer review policy. Source: Canadian Journal of Pain. Copyright © 2025 Inform UK Limited
