Non-Verbal Pain Scale
Learn how to evaluate non-verbal patients with our free Non-Verbal Pain Scale template. Download a free PDF and example here.
Fact Checked by Nate Lacson.
Evaluating pain for non-verbal patients
Pain is a subjective experience and can be challenging to assess, especially in patients who are unable to communicate verbally. In critical care settings, it is essential to accurately determine pain in non-verbal patients as they may be unable to express their discomfort or distress.
Moreover, non-verbal patients may have underlying conditions that affect their ability to convey pain, such as neurological impairments or sedation. This makes it even more challenging to determine the level of pain they are experiencing.
Medical professionals must rely on observational tools and subjective evaluations to address this challenge. For example, observing facial expressions, body movements, and changes in vital signs can provide valuable clues about a patient's pain level. Communication with caregivers or family members who may be familiar with the patient's behavior and responses can also help evaluate pain.
Printable Non-Verbal Pain Scale
Download this Non-Verbal Pain Scale to determine pain in non-verbal patients accurately.
Using the Non-Verbal Pain Scale
The non-verbal Pain Scale (NVPS) assesses pain in patients who cannot communicate verbally. The NVPS was initially developed to evaluate pain in adult patients on a burn trauma unit and was patterned after the Face, Legs, Activity, Cry, Controllability Scale but modified for use in non-verbal patients (McGuire et al., 2016).
The scale uses a 0-2 scoring system, with 0 being no pain and 2 being the most severe pain (University of Rochester Medical Center, n.d.). The NVPS evaluates five categories: face, activity or movement, guarding, vital signs, and respiratory.
Each category is scored based on specific behaviors and physiological responses. The total score ranges from 0-10, with higher scores indicating more severe pain.
Studies have shown that the NVSP is a reliable and valid tool for assessing pain in non-verbal patients (Ghayem et al., 2023), including intubated patients, unconscious patients, and those with cognitive impairment or sedation (McGuire et al., 2016). This tool can be used in various settings, including intensive care units and medical-surgical nursing units, to evaluate pain in critically ill adults effectively.
How to use Carepatron's free Non-Verbal Pain Scale template
This free template is based on the Non-Verbal Pain Scale assessment by the University of Rochester for patients unable to self-report pain. Our team added text fields and created a digital format, making it easier and more efficient. Follow the steps below to get started:
Step 1: Download the scale template
Access the free Non-Verbal Pain Scale form via the link on this page or the Carepatron app. You can also get it from our resources library.
Step 2: Use the printed or digital copy
Print or complete the form digitally using a tablet, laptop, or phone. Make sure to have a pen and paper handy using the print version.
Step 3: Gather information
Find the patient's medical records, including notes from previous pain assessments. Speak with the patient's caregivers or family members for additional insight.
Step 4: Observe and assess
Observe the patient closely while performing care tasks. Look for non-verbal cues such as facial expressions, body movements, and behavioral changes that may indicate pain. Use the NVSP to assess pain intensity on a scale of 0-2.
Step 5: Record vital signs
In addition to using the NVSP, record vital signs such as blood pressure, heart rate, respiratory rate, and temperature. These can also help evaluate pain levels.
Non-verbal Pain Scale example (sample)
Our team has completed a sample NVPS form to illustrate how it should be filled out. You can review the example to understand better how to use this tool.
Download this free Non-Verbal Pain Scale example here:
Scoring and interpreting the results
Each of the five areas on the NVPS form is assigned a score ranging from 0-2. A total score of 0 indicates no signs of pain, while a score of 10 indicates severe pain (University of Rochester Medical Center, n.d.):
Scoring
- Non-verbal patients who are awake: For non-verbal patients who are awake, observe them for at least 1-3 minutes. During this time, assess their legs and body for any signs of pain. They may exhibit increased muscle tension, restlessness, or facial grimacing.
- Non-verbal patients who are asleep: For non-verbal patients who are asleep, observe them for at least five minutes or longer. Pay attention to any changes in their breathing pattern or facial expressions. Repositioning the patient or performing care tasks may also elicit non-verbal pain cues.
Interpretation
Interpret the total score as follows:
- 0: Relaxed and comfortable
- 1-3: Mild discomfort
- 4-6: Moderate pain
- 7-10: Severe discomfort/pain
Remember that this is just one assessment tool and should be used with other pain assessment methods. Consider the patient's medical history, current condition, and any underlying factors that may affect their pain experience.
Why use Carepatron as your nursing software?
Don't let your pain management nursing tasks become a burden. Allow Carepatron to streamline your entire workflow so you can focus more on what truly matters - providing excellent patient care.
Our cutting-edge practice management software offers a comprehensive suite of features designed specifically to meet the needs of pain management nursing professionals.
Enjoy a user-friendly interface, secure and HIPAA-compliant data management, real-time communication tools for better patient interaction, and efficient scheduling options to avoid double booking.
Carepatron also offers robust reporting tools that track patients' progress and outcomes, ensuring quality care and improved patient satisfaction. Furthermore, our software supports telehealth functionality, providing you with the flexibility to conduct virtual consultations.
Harness the power of Carepatron - your one-stop solution for seamless nursing practice management.
Start your journey today!
.png)
References
McGuire, D. B., Kaiser, K. S., Haisfield-Wolfe, M. E., & Iyamu, F. (2016). Pain Assessment in Noncommunicative Adult Palliative Care Patients. Nursing Clinics of North America, 51(3), 397-431. https://doi.org/10.1016/j.cnur.2016.05.009
Ghayem, H., Heidari, M. R., Aghaei, B., & Norouzadeh, R. (2023). The Effect of Training the Nonverbal Pain Scale (NVPS) on the Ability of Nurses to Monitor the Pain of Patients in the Intensive Care Unit. Indian Journal of Critical Care Medicine, 27(3), 195-200. doi: 10.5005/jp-journals-10071-24425
University of Rochester Medical Center. (n.d.). Adult Nonverbal Pain Scale. ttps://com-jax-emergency-pami.sites.medinfo.ufl.edu/files/2015/02/Adult-nonverbal-pain-scale-University-of-Rochester-Medical-Center.pdf
Commonly asked questions
Pain assessment in non-verbal patients can be challenging, but various tools and methods are available. Some examples include the Behavioral Pain Scale, Critical-Care Pain Observation Tool, and Non-Verbal Pain Scale. These scales use behavioral cues such as facial expressions, body movements, and vocalizations to assess pain levels in non-verbal patients.
Patient pain can significantly impact nonverbal patients' well-being and recovery. Adequate pain management starts with proper pain assessment. It helps healthcare providers determine the appropriate treatment plan and evaluate its effectiveness.
Various clinical practice guidelines provide evidence-based recommendations for managing acute pain in intensive care units. Some examples include the American Society for Pain Management Nursing guidelines and the Society of Critical Care Medicine pain, agitation, and delirium guidelines.
