Enhancing Self-Reported Pain Assessments for Post-Sedated Patients: A Needs Assessment

Background: Effective pain management is essential for post-sedated patients in Post-Anesthesia Care Units (PACUs). any adult centers rely solely on the Numeric Rating Scale (NRS) for self-reported pain assessment. However, evidence suggests it may inadequately capture pain experiences in post-sedated patients, particularly for vulnerable populations, leading to potential gaps in self-reported pain assessment and management. Local Problem: Nurses in the PACUs of an academic healthcare system expressed dissatisfaction with the pain assessment tool, noting that exclusive use of the NRS in PACUs failed to meet the pain management needs of post-sedated patients. They also noted challenges in accurately assessing patients, which could impact patient outcomes. These concerns highlighted the need for alternative or additional pain assessment tools. Methods: The project team conducted a needs assessment in three PACUs within an academic healthcare system to evaluate the feasibility and usability of adding the Verbal Rating Scale (VRS) to improve pain assessment accuracy and staff satisfaction. Interventions: The team reviewed current literature, engaged key stakeholders, benchmarked with other healthcare institutions, and conducted a SWOT analysis. Nurses participated in structured observations and discussion groups. A gap analysis compared current pain assessment practices with evidence-based best practices, leading to the proposal of the VRS as a complementary self-report tool to address the limitations of the NRS as a pain assessment tool in the PACUs. Results: Feedback from PACU nurses revealed strong support for introducing an alternative self-report pain assessment tool. Current literature identified the VRS as a feasible alternative due to its simplicity, validation in postoperative settings, and potential to improve pain assessment accuracy in post-sedated patients. Nurses described the limitations of the NRS, particularly in the immediate post-sedation phase, and emphasized that the VRS could enhance patient outcomes and staff satisfaction by enabling more accurate and responsive pain assessments. The SWOT analysis identified strong staff support and net-zero costs as strengths. Weaknesses included resistance to change and documentation barriers. Opportunities included improved patient outcomes and adherence to best practices. Threats included workflow integration and stakeholder hesitancy. A gap analysis confirmed that the NRS alone led to inconsistent pain assessments, reinforcing the need for the VRS to enhance accuracy and guide structured implementation. Conclusion: Integrating the VRS alongside the NRS may improve assessment accuracy, nursing satisfaction, and pain management in PACUs. Future efforts should focus on staff training, implementation strategies, and policy support for using multiple validated self-reported pain assessment tools.