Purpose: Although effective pain management methods are available, they are not consistently used for infants in the hospital setting. This may be due to the challenge of pain assessment in the pre-verbal infant. Many pain assessment tools have been developed for use in the pediatric population. The purpose of this clinical study was to identify a valid, reliable pain assessment tool for use with infants.

Methods: A panel of expert nurses in pediatrics, pain, and research reviewed the literature for all valid, reliable pediatric pain assessment tools. Three tools met panel-developed criteria. Using a Latin square design, the FLAAC (Merkel, et. al, 1997), POPS (Attia, 1997) and OPS (Hannallah, et al., 1987) were tested using video vignettes.

Results: Pain ratings among and between staff nurses and a panel of experts were compared. No significant differences were found among the three tools for pain rating. However, significant differences were found among staff nurses' preference scores, with the FLAAC rated highest. No significant differences were found in nurse demographic characteristics.

Implications: Testing existing pain tools using video vignettes provided additional support for the validity and reliability of the tools. Staff nurse preference may provide direction in the selection of the tool to utilize in practice.