Peri-operative analgesia for robot assisted laparoscopic prostatectomy—comparison of spinal plus general anaesthesia vs usual practice. 2022. 2022. (accessed 12 April 2022)

Boochever SS. HIS/RIS/PACS integration: getting to the gold standard. Radiol Manage. 2004; 26:(3)16-24

Bowman S. Coordinating SNOMED-CT and ICD-10. J AHIMA. 2005; 76:(7)60-61

Chouchou F, Khoury S, Chauny JM, Denis R, Lavigne GJ. Postoperative sleep disruptions: a potential catalyst of acute pain?. Sleep Med Rev. 2014; 18:(3)273-282

Cimino JJ, Patel VL, Kushniruk AW. Studying the human-computer-terminology interface. J Am Med Inform Assoc. 2001; 8:(2)163-173

Correia MDL, Duran ECM. Conceptual and operational definitions of the components of the nursing diagnosis. Acute pain (00132). Rev Lat Am Enfermagem. 2017; 25:(0)

Clinical audit of adult pain management in Derriford Hospital emergency department. 2016. (accessed 12 April 2022)

Dansie EJ, Turk DC. Assessment of patients with chronic pain. Br J Anaesth. 2013; 111:(1)19-25

Darnall BD, Scheman J, Davin S, Burns JW, Murphy JL, Wilson AC, Kerns RD, Mackey SC. Pain psychology: a global needs assessment and national call to action. Pain Med. 2016; 17:(2)250-263

Faculty of Pain Medicine. cCore standards for pain management services in the UK. 2021. (accessed 16 April 2022)

Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013; 14:(12)1539-1552

Fletcher D, Stamer UM, Pogatzki-Zahn E Chronic postsurgical pain in Europe: an observational study. Eur J Anaesthesiol. 2015; 32:(10)725-734

Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014; 30:(1)149-160

Glare P, Aubrey KR, Myles PS. Transition from acute to chronic pain after surgery. Lancet. 2019; 393:(10180)1537-1546

Hah JM, Bateman BT, Ratliff J, Curtin C, Sun E. Chronic opioid use after surgery: implications for perioperative management in the face of the opioid epidemic. Anesth Analg. 2017; 125:(5)1733-1740

Lavand'homme P. Transition from acute to chronic pain after surgery. Pain. 2017; 158 1:S50-S54

Lichtner V, Dowding D, Esterhuizen P Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools. BMC Geriatr. 2014; 14

Lichtner V, Dowding D, Allcock N The assessment and management of pain in patients with dementia in hospital settings: a multi-case exploratory study from a decision making perspective. BMC Health Serv Res. 2016; 16:(1)

Mac Neela P, Scott PA, Treacy MP, Hyde A. Nursing minimum data sets: a conceptual analysis and review. Nurs Inq. 2006; 13:(1)44-51

Mehl-Madrona L, Mainguy B, Plummer J. Integration of complementary and alternative medicine therapies into primary-care pain management for opiate reduction in a rural setting. J Altern Complement Med. 2016; 22:(8)621-626

NANDA International. The structure of the nursing diagnosis statement when included in a care plan. Position statment. 2010. (accessed 12 April 2022)

National Information Board and Department of Health and Social Care. Personalised health and care 2020. 2014. (accessed 12 April 2022)

National Pain Audit. National Pain Audit final report—November 2011. 2011. (accessed 12 April 2022)

NHS Digital. SCCI0034: SNOMED CT. 2020. (accessed 12 April 2022)

NHS Digital. The NHS Digital SNOMED CT browser. 2021. (accessed 19 April 2022)

The code: professional standards of practice and behaviour for nurses, midwives, and nursing associates.London: NMC; 2018

Pickering G, Marcoux M, Chapiro S An algorithm for neuropathic pain management in older people. Drugs Aging. 2016; 33:(8)575-583

Radnovich R, Chapman CR, Gudin JA, Panchal SJ, Webster LR, Pergolizzi JV Acute pain: effective management requires comprehensive assessment. Postgrad Med. 2014; 126:(4)59-72

Richebé P, Capdevila X, Rivat C. Persistent postsurgical pain: pathophysiology and preventative pharmacologic considerations. Anesthesiology. 2018; 129:(3)590-607

Sawilowsky S. New effect size rules of thumb. J Mod Appl Stat Methods. 2009; (8)

Schug S, Palmer G, Scott D, Halliwell R, Trinca J. Acute pain management: scientific evidence.Melbourne: ANZCA and FPM; 2015

Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med (Zagreb). 2021; 31:(1)27-53

SNOMED International. User interface In: Example EMR EHR requirements guide. 2022a. (accessed 16 April 2022)

SNOMED International. Using statistical classifications. 2022b. (accessed 16 April 2022)

SNOMED International. Enhancing EHR design with SNOMED CT. 2022c. (accessed 12 April 2022)

Stinson JN, Jibb LA, Nguyen C Development and testing of a multidimensional iPhone pain assessment application for adolescents with cancer. J Med Internet Res. 2013; 15:(3)

Tan G, Craine MH, Bair MJ Efficacy of selected complementary and alternative medicine interventions for chronic pain. J Rehabil Res Dev. 2007; 44:(2)195-222

Van Vleck TT, Wilcox A, Stetson PD, Johnson SB, Elhadad N. Content and structure of clinical problem lists: a corpus analysis. AMIA Annu Symp Proc. 2008; 2008:753-757

Velazquez Cardona C, Rajah C, Mzoneli YN An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital. Pain Rep. 2019; 4:(6)

Wall P, McMahon S, Koltzenburg M. Wall and Melzack's textbook of pain, 6th Edition. Philadelphia (PA): Elsevier/Churchill Livingstone; 2006

Zarean E, Azadeh A, Pirali H Association between depression, anxiety, and insomnia with musculoskeletal pain source: a multi-center study. Middle East Curr Psychiatry. 2021; 28

Acute pain assessments and records: a pilot study of digital transformation

26 May 2022
13 min read
Volume 31 · Issue 10



Pain is a leading cause of disability worldwide. Pain assessments are an essential part of evidence-based care and management. Among comparable care providers, there is variation in how nurses document assessments as well as the content in them, and there is a notable associated administrative burden.


This study evaluated the impact and significance of a new, structured, digitised pain assessment form from quality, safety and efficiency standpoints.


Samples of pain assessments were examined at three consecutive stages: first, the pre-existing form was used, then the new structured form was introduced and, finally, the structured form was taken away and nurses went back to completing the original form. Assessments were scored by two clinical analysts against 18 clinically defined pain-related characteristics and factors. The time taken to extract and interpret the assessments was also recorded. Statistically significant changes were assessed using Welch's t-tests and Fisher's exact tests.


There was a significant improvement in data quality using the new structured form compared with the pre-existing template, including an increase in the capture of five safety-related variables. Less time was needed to extract and interpret data with the new form.


Intelligent structured forms are highly effective for documenting pain assessments, and offer notable benefits in quality, safety, and efficiency.

Pain is an almost universally experienced phenomenon (Wall et al, 2006). As a physiological sensation, it serves to protect an organism from harm and limit damage. The influence of psychological factors on the perception of pain is well recognised (Darnall et al, 2016). Acute post-surgical pain can persist well beyond 3 months (Richebé et al, 2018). This chronic post-surgical pain can affect up to one in 10 surgical patients (Glare et al, 2019), with one in 100 experiencing intolerable pain (Fletcher et al, 2015).

While there are many risk factors for developing chronic post-surgical pain including mood, pre-existing pain and the use of pre-operative analgesia, the trajectory of the acute pain course in the days following surgery as well as the amount of time spent in severe pain seem to be important factors (Lavand'homme, 2017). This provides an opportunity for careful in-hospital monitor ing, which could potentially impact outcomes.

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