Table 6.

Pain Chart Audit Items Based on NCCN Pain Guideline Recommendations

NCCN Recommendations	Chart Audit Items
Quantify pain intensity	Was screening for pain documented routinely at visit?
Pain intensity rating	Was pain rating documented?
Characterize quality of pain	Was the quality of the pain documented (i.e. sharp, stabbing, dull)?
Management of patients with no pain	Was re-assessment documented at subsequent visits?
Managing mild to moderate (1–6) pain	Was NSAIDs used? Were opioids initiated? Was re-assessment documented after initial dosing?
Management of severe (7–10) pain	Rapid titration initiated? Was continuation of long-acting plus short-acting opioids documented? Was re-assessment documented at the subsequent visits? Was the use of adjuvant analgesics documented?
Managing side effects of opioids	Was a bowel regimen documented? Was bowel status documented?
Patient and family education	Was a list of potential side effects of pain medication given to patient and family? Was patient and family educated and counseled on managing side effects of pain medications?
Supportive care consultations	Were consultations to supportive care services (pain specialist, physical therapy, psychology/psychiatry, social work, pastoral care) initiated?