Improving the assessment of acute pain in adult inpatients: a quality improvement project.

Adcock, C.; McMahon, R.; Duffy, K.; Peters, L.; Drury, N.; Thomas, C.

Improving the assessment of acute pain in adult inpatients: a quality improvement project.

All Authors

Adcock, C.

McMahon, R.

Duffy, K.

Peters, L.

Drury, N.

Thomas, C.

LTHT Author

Duffy, Katie
Peters, Leanne
Drury, Natalie
Thomas, Caroline

LTHT Department

Pain Team
Theatres & Anaesthetics
Anaesthetics

Non Medic

Clinical Nurse Specialist
Clinical Nurse Specialist

Publication Date

2025

Item Type

Journal Article

Abstract

Acute pain remains a significant issue for inpatients, for example, 20-40% of surgical inpatients report severe pain in the first 24 postoperative hours. Simple pain rating scales are widely used but have limitations. National guidelines recommend incorporating functional assessment to guide individualised pain management, though how best to do this remains unclear. This quality improvement project aimed to enhance the assessment of acute pain in adult inpatients at Leeds Teaching Hospitals by introducing functional assessment alongside standard pain scoring. Applying the Model for Improvement and Plan-Do-Study-Act cycles, we prototyped a Leeds Functional Activity Score and evaluated its usability across three cycles. Once the methodology of assessing functional pain was prototyped (cycle one), 79 adult inpatients' pain was assessed using both Leeds Functional Activity Score and the Numeric Rating Scale (cycle two). We found pain intensity patterns did not always predict functional impact. Functional assessment enabled conversations with patients about the need to manage function rather than targeting a pain score. Cycle three involved evaluation by 37 ward staff, with 73% rating it as 'easy' or 'very easy' to use. This cycle helped us to identify training needs. This report demonstrates that implementing functional assessment alongside traditional pain scoring is feasible, well received by staff and provides clinically meaningful context to guide analgesia. The Leeds Functional Activity Score has now been integrated into the hospital's electronic systems, alongside supporting training videos and communications.