Patti, we simply added this to our nurses notes..
I use the 0-10 scale for pain assessment, unless the pt can't answer, or language barrier, then I have a faces pain chart. For anyone who has pain, you must assess if their current regimen is effective. So if I have a pt who has chronic back pain, I write
Pain Chronic/back/arthrtic relieved w current pain med regimen
Pain Chronic/back/arthritic; client does not take pain meds as rx.
Then I document pain management and med instruction and write to assess pain on the next visit.
Pain 5 (0-10 scale) abd inc site, has not taken pain med yet
Or, if they did take pain med, I would call the doc if pain is unrelieved, and/or document any other pain mngmnt measures I did like guided imagery, ice (to a TKR after a PT session for ex), or splinting techniques.
If you make it a parameter to eval on your notes, then nurses should write an entry every visit, so it won't be missed. An inservice on pain assessment and management, and how to document this info is really what you need. Having a form doesn't mean people will use it, better to teach them how to assess and manage pain.