Date of Conferral



Doctor of Nursing Practice (DNP)




Barbara Niedz


Pain is often seen as a primary complaint in the pediatric emergency department (ED). Assessment and documentation of pain are integral to effective pain management, and nurses are responsible for documenting pain assessment. Nursing documentation is essential for ensuring continuous, safe, high-quality care. Evidence shows nurses are inadequately documenting pain assessment and reassessment and not always using appropriate pain scales in a busy, cosmopolitan children's hospital ED. The practice-focused question that guided this project was: How does an educational module and change in electronic health record pain assessment flowsheet increase the nurses' compliance with initial documentation of pain? An educational module and minor change in the electronic health record was developed and implemented. Chart audits showed an improvement in pain documentation in triage from 16% to 84% with a chi-square value of 11.4, p = .001. Prior to the DNP project there were 24 of 71 charts (33.8%) with all 3 required elements properly documented; after the educational module, this improved to 51 of 80 charts, 63.7%. The results of the chi square 13.4, p = < .001 demonstrate a statistically significant improvement. In the qualitative survey data collected before and after nurses completed the educational module, they cited short-staffing, electronic health records, lack of education, nursing experience, and time management as explanatory of documentation failures. Attention to accurate and timely pain assessment and documentation using the correct tools improves the care of the pediatric patient and contributes significantly to positive social change.

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Nursing Commons