Nurses' knowledge and attitudes about pain affect their ability to manage patients' pain. A mechanism was sought to evaluate nursing competency in pain management at eight pediatric hospitals. Several pain survey tools were reviewed, considering the patient population around which they were designed, the basis for survey content, and format. A survey with established validity and reliability, the Pediatric Nurses' Knowledge and Attitude Survey Regarding Pain (PNKAS) (Manworren 1999) was chosen as the most appropriate for this group. The tool was modified for applicability to the nurses caring for pediatric populations that do not include oncology. Revisions were made with the concurrence of Manworren to assure that neither the content being tested, nor the integrity of the tool, was affected. Stability of the modified tool (PNKAS-Shriners Version 2002) was verified by retesting 6-8 weeks after initial survey.