NSW Standardised Pain Charts (adult)


Development and implementation of statewide charts to be used at the bedside when delivering Patient Controlled Analgesia (PCA), ketamine infusions and neuraxial opioid administration. To standardise practice and reduce error relating to documentation, monitoring and prescription across NSW.


Benefits include improved safety and quality of care for patients.


The initiative involved an extensive consultancy phase with a group of interested Clinical Nurse Consultants (CNCs) and anaesthetists, as well as discussions with the Clinical Excellence Commission (CEC), State Forms Committee and Medication Safety Expert Advisory Committee (MSEAC).

Draft charts were developed and piloted in four NSW hospitals. Much effort was taken to ensure alignment with existing protocols in the Standard Adult General Observation (SAGO) chart.

One thousand charts of each type were audited and analysed, with several changes made as a result of the pilot.

In response, an education package was developed in collaboration with the CEC. This package has been placed on the ACI website, together with an implementation package.


The ACI, together with the Pain Interest Group - Nursing Issues (PIGNI) and expert clinicians in the field of pain management have standardised three pain charts for use in NSW hospitals.

These new pain charts aim:

  • To provide a consistent framework and format for prescribing, recording and monitoring adult patients receiving opioid medications via a Patient Controlled Analgesia (PCA),a neuraxial route, or patient receiving a ketamine infusion
  • To provide ’track and trigger’ principles consistent with ’Between the Flags’ documentation which recognises the deteriorating adult patient associated with the administration of opioids

To improve safety by reducing the incidence of adverse events associated with PCA, ketamine infusions and neuraxial opioid administration.


  • Clinical Excellence Commission (CEC)
  • Health Education and Training Institute (HETI)
  • Local Health Districts
  • NSW Therapeutic Advisory Group (NSW TAG)
  • Pain Interest Group Nursing Issues (PIGNI)

Key Dates

March 2013Full implementation achieved
March 2014One year review
October 2014

Revised forms posted

Pilot Sites

Central Coast Local Health DistrictGosford Hospital
Hunter New England Local Health DistrictTamworth Rural Referral Hospital
South Eastern Sydney Local Health DistrictPrince of Wales Hospital
Western Sydney Local Health DistrictWestmead Hospital

Implementation Sites

Central Coast Local Health DistrictCentral Coast Local Health District
Far West Local Health DistrictFar West Local Health District
Hunter New England Local Health DistrictHunter New England Local Health District
Illawarra Shoalhaven Local Health DistrictIllawarra Shoalhaven Local Health District
Justice Health and Forensic Mental Health NetworkJustice Health and Forensic Mental Health Network
Mid North Coast Local Health DistrictMid North Coast Local Health District
Murrumbidgee Local Health DistrictMurrumbidgee Local Health District
Nepean Blue Mountains Local Health DistrictNepean Blue Mountains Local Health District
Northern NSW Local Health DistrictNorthern NSW Local Health District
Northern Sydney Local Health DistrictNorthern Sydney Local Health District
South Eastern Sydney Local Health DistrictSouth Eastern Sydney Local Health District
South Western Sydney Local Health DistrictSouth Western Sydney Local Health District
Southern NSW Local Health DistrictSouthern NSW Local Health District
St Vincent's Health NetworkSt Vincent's Health Network
Sydney Local Health DistrictSydney Local Health District
Western NSW Local Health DistrictWestern NSW Local Health District
Western Sydney Local Health DistrictWestern Sydney Local Health District


Formal Evaluation has occurred in 2014. Revised forms are now available on the ACI website.

Related Initiatives

This project is related to the NSW Pain Clinic Referral Form and Process.

Further Details

For more information go to NSW Standardised Pain Charts (adult) on the ACI website.


Jenni Johnson
Manager, Pain Management Network
02 9464 4636

Chris Shipway
Director, Primary Care and Chronic Services
02 9464 4603

Page Top | Added: 7 November 2013 | Last modified: 15 December 2014

Jenni Johnson
Manager, Pain Management Network
02 9464 4636