Background Pain assessment in cognitive impaired patients can be complicated by the fact that many cannot communicate verbally. Individuals with cognitive impairment are at risk of developing drug related side effects, and treatment approaches effective for other populations may exacerbate pain in those with cognitive impairment (Barney, Anderson, Defrin, et al. Pain Rep 2020;5(4):e821). Observing behaviour is imperative and tools can assist with this. Evidence is promising regarding the incorporation of tools for the assessment and management of pain that can aid in overcoming the communication barriers in individuals with cognitive impairment (El- Tallaway, Ahmed, Nagiub. Pain Ther. 2023;12(4):939–961). It was acknowledged that whilst various tools were being used in Milton Keynes, it would be better to have a consistent, streamlined approach and develop a locally agreed tool to promote the best possible outcomes for this population of patients.

Aim To develop a pain assessment tool that can support an adult who is cognitively impaired, to disclose the features of pain more reliably and promote more effective management of the symptom.

Method As part of the Learning Disability Champion Group, a group of different nurses that specialise in Learning Disability and Dementia met monthly and developed the tool by looking at other tools and assessment guidance for people with cognitive impairment and brought them together to develop one streamlined tool that we can use across Milton Keynes at Willen Hospice, Milton Keynes Hospital and by the Learning Disability Community Team.

Results The Milton Keynes Cognitive Impairment Pain Communication Toolkit has been developed and ratified for implementation.

Future Actions To develop an educational program to educate clinical teams across Milton Keynes in the use of the toolkit. To develop an audit tool to evaluate its use and feedback to the Learning Disability Champion Group.