Initial Pain Assessment Tool Form – Fill Out and Use This PDF

The Initial Pain Assessment Tool Form is an invaluable tool in the assessment of individual patient needs. This form allows healthcare providers and other professionals to gain a comprehensive understanding of how an individual's pain is experienced on a short and long-term level. Through recognition of key symptoms, this form allows for a tailored plan for both physical and psychological treatment tailored to the specific situation. By encouraging communication from the individual being assessed, the effects – physical, emotional, cognitive and behavioral – derived from living with chronic or severe pain can be carefully taken into consideration. The Initial Pain Assessment Tool Form provides the ultimate opportunity to treat current issues as well as strategize for potential difficulties to come.

Initial Pain Assessment Tool Form PDF Details

Having an appropriate initial pain assessment tool form to evaluate a patient's level of pain is integral to ensure that they receive the proper care and treatment. Knowing how well or how poorly your patients can manage their acute and chronic pain not only helps with providing accurate diagnosis and effective treatments, but also serves as a key indicator in predicting post-surgical outcomes. Taking the time to accurately assess each patient’s individual situation - both physical and psychological - will ultimately yield better results across the board. This blog post will discuss what components should be included in an initial pain assessment tool form and why it's important for healthcare providers to use one when evaluating their patients' needs.

Question	Answer
Form Name	Initial Pain Assessment Tool Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	pain assessment, initial pain assessment tool, initial pain assessment form, form initial pain

Form Preview Example

FORM 1.1 INITIAL PAIN ASSESSMENT TOOL

Date ______________

Patient’s Name _______________________________________________________Age _________ Room ____________

Diagnosis__________________________________________ Physician______________________________________

Nurse ______________________________________

1. LOCATION: Patient or nurse mark drawing.

2.INTENSITY: Patient rates the pain. Scale used____________________________________________________________

Present pain: ________ Worst pain gets: _________ Best pain gets: __________ Acceptable level of pain: __________

3.IS THIS PAIN CONSTANT? _____ YES; ____ NO IF NOT, HOW OFTEN DOES IT OCCUR? ____________________

4.QUALITY: (For example: ache, deep, sharp, hot, cold, like sensitive skin, sharp, itchy) ________________________

5.ONSET, DURATION, VARIATIONS, RHYTHMS: ___________________________________________________________

_______________________________________________________________________________________________________

6.MANNER OF EXPRESSING PAIN: ______________________________________________________________________

_______________________________________________________________________________________________________

7.WHAT RELIEVES PAIN? _______________________________________________________________________________

_______________________________________________________________________________________________________

8.WHAT CAUSES OR INCREASES THE PAIN? _____________________________________________________________

_______________________________________________________________________________________________________

9.EFFECTS OF PAIN: (Note decreased function, decreased quality of life.)

Accompanying symptoms (e.g., nausea) __________________________________________________________________

Sleep _________________________________________________________________________________________________

Appetite _______________________________________________________________________________________________

Physical activity ________________________________________________________________________________________

Relationship with others (e.g., irritability) ___________________________________________________________________

Emotions (e.g., anger, suicidal, crying) ____________________________________________________________________

Concentration __________________________________________________________________________________________

Other__________________________________________________________________________________________________

10.OTHER COMMENTS: ________________________________________________________________________________

_______________________________________________________________________________________________________

11.PLAN:______________________________________________________________________________________________

_______________________________________________________________________________________________________

May be duplicated for use in clinical practice. Copyright Pasero C, McCaffery M, 2008. As appears in Pasero C, McCaffery M. Pain: Assessment and pharmacologic management, 2011, Mosby, Inc.

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Step 1: Just click on the "Get Form Button" above on this site to access our pdf file editor. There you'll find everything that is required to work with your document.

Step 2: With our advanced PDF editing tool, you could do more than merely complete blank form fields. Edit away and make your docs appear sublime with customized text incorporated, or adjust the original content to perfection - all comes along with the capability to add your own graphics and sign the PDF off.

This document will require you to enter specific information; in order to guarantee correctness, you should adhere to the guidelines listed below:

1. It's important to fill out the pain assessment forms properly, thus be attentive while filling out the segments containing all these fields:

Completing part 1 in universal pain assessment tool pdf

2. The third step would be to fill out these particular blanks: INTENSITY Patient rates the pain, Present pain Worst pain gets, IS THIS PAIN CONSTANT YES NO IF, QUALITY For example ache deep, ONSET DURATION VARIATIONS RHYTHMS, MANNER OF EXPRESSING PAIN, WHAT RELIEVES PAIN, WHAT CAUSES OR INCREASES THE PAIN, EFFECTS OF PAIN Note decreased, Accompanying symptoms eg nausea, and Sleep.

Writing segment 2 in universal pain assessment tool pdf

It is easy to make an error while filling in your WHAT CAUSES OR INCREASES THE PAIN, consequently make sure to take another look before you send it in.

3. In this part, look at Sleep, Appetite, Physical activity, Relationship with others eg, Emotions eg anger suicidal crying, Concentration, Other, OTHER COMMENTS, PLAN, and May be duplicated for use in. Each of these are required to be filled in with utmost precision.

Step # 3 in filling out universal pain assessment tool pdf

Step 3: Right after double-checking your entries, hit "Done" and you are good to go! Right after getting a7-day free trial account at FormsPal, you will be able to download pain assessment forms or send it via email promptly. The PDF form will also be easily accessible in your personal cabinet with your each change. FormsPal is focused on the personal privacy of all our users; we make sure that all personal data going through our tool continues to be secure.

Initial Pain Assessment Tool Form – Fill Out and Use This PDF

Initial Pain Assessment Tool Form PDF Details

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