What is the PQRST Pain Assessment? Tool, Method, Questions, Examples, and Nursing Use in Australia

Content:

• What is PQRST Pain Assessment?
• Tool
• Method
• Questions
• Examples
• Nursing Use in Australia

What is PQRST Pain Assessment?

• PQRST is a systematic pain assessment tool used by nurses and healthcare professionals.
• The acronym stands for Provocation/Palliation, Quality, Region/Radiation, Severity, and Timing.
• Each component helps identify different aspects of a patient's pain experience.
• It ensures thorough evaluation of both acute and chronic pain conditions.
• Pain being subjective, the PQRST approach helps patients describe it clearly and consistently.
• It is widely used in Australian healthcare settings, including hospitals, clinics, and aged care.
• This method promotes better communication, documentation, and clinical decision-making.
• PQRST aligns with evidence-based practice and supports patient-centered care.

Tool

• The PQRST tool is a guide—not a physical tool—used to assess pain comprehensively.
• It structures the conversation between patient and clinician during assessments.
• Each letter in the acronym prompts specific questions about the pain.
• The five components are:
  • Provocation/Palliation – What causes or relieves the pain?
  • Quality – What does the pain feel like?
  • Region/Radiation – Where is the pain? Does it move?
  • Severity – How intense is the pain (0–10 scale)?
  • Timing – When did it start? How long does it last?
• Integrated into both paper-based and digital documentation systems in Australia.
• Ensures consistency and thoroughness in clinical pain assessments.

Method

• Use of PQRST follows a step-by-step, conversational approach with the patient.
• Each component is addressed in sequence to ensure no information is missed.
• Typical steps:
  • P – Provocation/Palliation: Ask what starts the pain or what makes it better or worse.
  • Q – Quality: Ask the patient to describe the pain (e.g., dull, sharp, burning).
  • R – Region/Radiation: Identify the pain’s exact location and whether it spreads.
  • S – Severity: Request a pain score from 0 to 10.
  • T – Timing: Ask about the onset, duration, and pattern of the pain.
• Encourages open-ended responses and deeper understanding of the pain condition.
• Commonly used during triage, bedside assessments, and follow-up evaluations.

Questions

• Each PQRST letter guides specific, focused questions for effective pain assessment.
• Sample questions include:
  • Provocation: What were you doing when the pain started?
  • Palliation: Does anything make it better or worse?
  • Quality: Can you describe what the pain feels like?
  • Region: Where exactly do you feel the pain?
  • Radiation: Does the pain move to other parts of your body?
  • Severity: How would you rate your pain on a scale of 0 to 10?
  • Timing: When did the pain begin? Is it constant or intermittent?
• These questions help in making informed clinical decisions based on patient feedback.
• Used in Australia across hospitals, GP practices, and community healthcare settings.

Examples

• Example 1: Emergency Department (Chest Pain)
  • Provocation: Pain began while walking up stairs.
  • Palliation: Slight relief with rest.
  • Quality: Tight, crushing sensation.
  • Region/Radiation: Central chest, radiates to left arm.
  • Severity: 8 out of 10.
  • Timing: Sudden onset, 20 minutes ago.
• Example 2: Aged Care (Chronic Back Pain)
  • Provocation: Worse after sitting long periods.
  • Palliation: Heat pack provides relief.
  • Quality: Dull and aching.
  • Region/Radiation: Lower back, no radiation.
  • Severity: 4–7 out of 10 depending on activity.
  • Timing: Ongoing for 6 months, worse in mornings.
• These examples show how PQRST helps tailor care to the individual patient's needs.

Nursing Use in Australia

• The PQRST Pain Assessment is part of standard nursing practice in Australia.
• It is taught in nursing education programs and reinforced in clinical training.
• Nurses use it in:
  • Hospitals (emergency, surgical, medical wards)
  • Aged care facilities
  • Community health and palliative care
• Supports accurate documentation, pain tracking, and treatment response.
• Facilitates communication between nurses, doctors, and other health staff.
• Promotes patient-centered care and meets national clinical guidelines.
• Endorsed by regulatory bodies like the Nursing and Midwifery Board of Australia (NMBA).