Charting pain assessments

Hello everyone,

I'm a clinical manager at my hospital attempting to revises the way we assess pain and pain control. Although I know mostly what I would like to see I'm also cognizant of the workload most of the staff have (anywhere from 6-9 pts each) and am trying to develop something that does not dramatically increase the workload (I find that the more you try to add on the less reliable the added work is).

So, to that end - this is currently how we assess pain:

Pain - present or absent
6 pain sections (only chart on the number of places pt has pain - ex if pain present in abd and legs you would chart on pain#1 and pain #2)
Pain Location
Pain intensity
Pain description
Accompanying symptoms
Reassess pain intensity
Consciousness Scale
Respiratory Scale
Motor Block for epidurals
PCA/epidural Med
Concentration
Dose
Lockout
Basal
Bolus
Attempt number
Number of doses given
Number of bolus
Total given ml
Total drug given (mg or mcg)
total remaining
Narcan given?
New syring hung
Tubing change
Intervention
Intervention response

All of this charting exists under our assessment portion (computer charting) as is usually charted on 1 time per shift. The medications (other than pca/epidural) are charted on another screen and do not flow across. So, for example if dilaudid is given it is charted on the electronic MAR and thenyou have to click on another screen to see what the pain score is and whether or not relief was achieved (often times not charted on or somehow charted at the same time as the original pain score was charted). This leads to a very fragmented system of pain assessment and I believe leads to inneffectual pain relief.

So to make a long story short (too late) this is what I would like to change. I like a lot of what the assessment asks for but I think realistically it is too much for the floor staff to do each time they give a pain med. What I would like to do is develop a new screen that could be charted on when a pain med is given - something relatively simple that pain relief can easily be gauged from. The assessment above can not even be viewed on the same screen at one time, you have to keep scrolling down.

So finally my question, what are the essential questions that need to be asked when documenting a pain med? These are my thoughts already:

Pain intensity
Pain med given / dose
or
Alternative Intervention tried
Did you receive adequate pain relief last time from this treatment?
Acute pain or Chronic pain
and if on a PCA at least every 2 hrs for 1st 24 or longer if pain not relieved
#attempts
Actual dose received

Any other ideas or suggestions - please remember I want to simultaneously achieve good pain relief and not overburden the floor staff with documentation. Also I would have them chart on the assessment located at the top q 4hrs until pain relief achieved and the q 8 hrs.

Thanks in advance

Pat