Development and introduction of a pain score documentation chart in the acute oncology setting

Background: Recommendations to improve cancer pain management include the introduction of routine and clearly visible documentation of pain scores. Whilst this practise has been adopted in many cancer and palliative care units, longitudinal evidence to support the view that the practise has provided improved analgesic outcomes for patients is limited. The aims of this study were threefold; (i) to collaboratively develop a locally acceptable pain documentation chart; (ii) to test this chart by comparing patient‐reported and nurse‐documented scores with pain scores collected by researchers using validated measures; and (iii) to examine whether or not pain scores and analgesia scores longitudinally improved over the study period. Methods: Using a multidisciplinary approach, a pain score documentation chart was developed for use on an acute hospital's oncology ward. Prior to the chart's introduction, the brief pain inventory (BPI) was administered to 45 in‐patients. The patients were then asked to report on a regular basis their numeric pain scores, which were documented on the chart. At the time of discharge or after 7 days, the BPI was repeated. The pain chart scores and the BPI item, ‘average pain experienced in the preceding 24 h’ were correlated. Results: The initial chart scores significantly correlated with the first BPI score (P = 0.001), and a similar relationship was found between scores collected at the end of the study period (P = 0.020). Analgesic scores improved, patients were satisfied with the approach taken to their analgesic management and the pain scores were charted with a similar frequency to vital signs (pulse, temperature, blood pressure). Conclusions: Pain score charting is feasible and acceptable to patients and nursing staff in an acute hospital. Most importantly, this process has the potential to improve the analgesic outcomes of cancer patients.