MCN’s customizable template, Pain Management Program - Initial Pain Assessment Form, is taken from our Pain Management Policy and Procedure Manual. MCN Healthcare’s proven policy and procedure templates, competencies and compliance tools have assisted more than 20,000 health care organizations worldwide meet their regulatory compliance goals.

MCN provides more than 80 health care specific policy and procedure manuals for Acute Care Hospitals, Ambulatory Care, Behavioral Health, Home Health, Physician Practice, and Long Term Care. MCN’s policy and procedure manuals focus on the latest healthcare "hot topic" issues related to patient safety and prevention of medical healthcare errors.

Here is some sample content from Pain Management Program - Initial Pain Assessment Form:

	PAIN MANAGEMENT PROGRAM INITIAL PAIN ASSESSMENT FORM Patient Name: Age: Date: Physician: Diagnosis: Describe Location of Pain: Pain Scale Rating: Pain Currently Rated At: What is the Worst Pain Gets? What is the Best Pain Gets? What is an Acceptable Level of Pain? What is the Quality of the Pain? Have Patient Describe in Own Words: Onset: Duration: Variations: Manner the Patient Uses to Express Pain: What Relieves Patient's Pain? i.e., heat, rest, medication What Causes or Increases Patient's Pain? i.e., walking, standing, lifting, exercise What Effects Does Pain Have...
Second excerpt:
	... Concentration: Sleep: Other: Check the words that describe the patient's pain: q aching q intermittent q shooting Describe Any Previous or Ongoing Instances of Pain: What Previous Methods of Pain Control Have Been Helpful? What Previous Methods of Pain Control Have Not Been Helpful? How Does Patient Feel About the Use of Opioid, Anxiolytic or Other Medications? Does Patient Have History of Substance Abuse: Does Patient Have History of Psychiatric Disorders, i.e., Depression,...