Impact of Implementing a Structured Nurse-led Pain Reassessment Protocol on Pain Outcomes among Hospitalized Cancer Patients: A Before-and-after Interventional Study

Abstract Background: Pain reassessment after analgesic administration is essential for effective cancer pain management, yet reassessment practices remain inconsistent in routine clinical settings. Nurses are well positioned to facilitate timely pain reassessment and appropriate escalation of care. Objectives: To evaluate the impact of implementing a structured nurse-led pain reassessment protocol on pain outcomes among hospitalized cancer patients. Methods: A quasi-experimental before-and-after interventional study was conducted among 100 hospitalized adult cancer patients receiving analgesics for cancer-related pain. Fifty patients were enrolled during the pre-intervention phase and 50 during the post-intervention phase. The intervention comprised a structured nurse-led pain reassessment protocol supported by nursing education and standardized documentation. Pain intensity was assessed using the Numerical Rating Scale (NRS) before analgesic administration and during reassessment. Secondary outcomes included frequency and timeliness of pain reassessment, rescue analgesic utilization, and patient satisfaction. Results: Baseline characteristics were comparable between groups. Reassessment NRS scores were lower in the post-intervention group than in the pre-intervention group (3.9 ± 1.5 vs. 5.8 ± 1.7; P < 0.001). Mean reduction in NRS scores was greater following intervention (3.0 ± 1.2 vs. 1.3 ± 0.9; P < 0.001), and more patients achieved a clinically meaningful pain reduction (80.0% vs. 38.0%; P < 0.001). Documented pain reassessment, timely reassessment, rescue analgesic utilization, and patient satisfaction also improved significantly (all P < 0.05). Conclusion: Implementation of a structured nurse-led pain reassessment protocol was associated with improved pain reassessment practices and favorable pain-related outcomes among hospitalized cancer patients.