Date of Graduation

Summer 8-11-2026

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

Kaiser cohort MSN capstone

First Advisor

Liesel Buchner

Second Advisor

David Ainsworth

Third Advisor

Sara Horton-Deutsch

Abstract

Abstract

Problem: Timely reassessment of pain is often missed or inconsistently documented, creating a gap between evidence-based standards and actual nursing practice. This inconsistency prevents evaluation of intervention effectiveness and contributes to unmanaged pain, reduced patient satisfaction, and safety concerns.

Context:  Pain reassessment is a critical component of evidence-based pain management, ensuring that nurses evaluate the effectiveness of interventions and adjust care accordingly.  Competing priorities and documentation challenges often lead to inconsistent reassessment, affecting patient comfort, safety, and overall quality of care.

Interventions: Guided by a Plan-Do-Study-Act framework, the intervention included documentation of a safety round, purposeful hourly rounding, and a pain assessment. Additional interventions included staff education, reinforcement of existing protocols, positive and constructive feedback, and leader audits.

Measures: Outcome measures included compliance with documenting pain reassessments within one hour of pain medication administration. Process measures included staff education completion, purposeful hourly rounding, leadership audits, and timely electronic health record documentation. Balancing measures assessed the interventions' impact on nursing workflow and workload. Following implementation, pain reassessment compliance increased from 81% to 94%, demonstrating improved adherence to evidence-based pain management practices without significant disruption to routine nursing care.

Results: Following implementation, pain reassessment compliance increased from 81% to 94%, demonstrating improved adherence to evidence-based pain management practices without significant disruption to routine nursing care.

This increase reflects more consistent follow-up after pain interventions and strengthens the overall quality of patient-centered pain management.

Conclusion: These findings suggest that combining purposeful hourly rounding with hourly pain assessment, following staff education and leader audits, yields favorable results. Consistent emphasis on reminders, patient safety, and workload-sensitive strategies will help sustain these improvements.   

Keywords: pain, assessment, documentation, purposeful, hourly, rounding

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