Transcription of Daily Pain Assessment Chart - NHS Lanarkshire
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Daily Pain Assessment Chart - NHS Lanarkshire
Daily pain Assessment Chart Addressograph CHI No .. Hospital No .. Ward .. Name .. Consultant .. q Hairmyres q Monklands q Wishaw Once Daily - ask your patient: Overall, how would you rate your level of pain during the last 24 hours - none, mild, moderate, severe or very severe? Date Time Signature 4 very severe 4. 3 severe 3. 2 moderate 2. 1 mild 1. 0 none 0. q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q drowsiness q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion q confusion Please tick q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations q hallucinations appropriate box if signs of opioid q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking q jerking toxicity are present.
Daily Pain Assessment Chart Once daily - ask your patient: “Overall, how would you rate your level of pain during the last 24 hours - none, mild, moderate, severe or very severe? Date Time Signature 4 3 2 1 0 4 very severe 3 severe 2 moderate 1 mild 0 none Please tick appropriate box if signs of opioid
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