01. Edit your pqrst pain assessment online
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Pain Assessment Tool - University of Pennsylvania School of NursingGenesis Eldercare Used to record pain assessments interventions and outcomes for patients enrolled in the ElderCare palliative care program 2026
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02. Sign it in a few clicks
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03. Share your form with others
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How to use or fill out Pain Assessment Tool - University of Pennsylvania School of NursingGenesis Eldercare
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the patient's name, date, ID number, and room number at the top of the form.
- Indicate whether the patient has a diagnosis likely to cause pain by selecting 'Yes' or 'No'.
- Check any applicable conditions from the provided list that may contribute to pain.
- Specify if the patient is currently receiving pain medications by selecting 'Yes' or 'No'.
- Mark the location of pain on the drawing provided and indicate any radiation direction with an arrow.
- Assess and record the severity of pain using the Pain Severity Scale for both present and worst experiences over the last 24 hours.
- Document frequency of pain complaints per day and note whether onset was chronic, acute, sudden, gradual, or trauma-related.
- Evaluate how pain affects daily activities and quality of life by circling relevant descriptors.
- Complete sections on pain quality description and non-verbal expressions for comprehensive assessment.
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