Problem: In the Post-Operative Care Unit (PACU) of a large, academic medical center, 70% of adult orthopedic surgery patients experience severe pain and anxiety per a chart audit that was performed on October 2-6, 2023. Anxiety leads to activation of the sympathetic nervous system and alters response to pain management. Currently, the PACU staff do not utilize non- pharmacological interventions as an adjunct, which is a requirement by The Joint Commission (TJC), to address post-operative pain and anxiety. Purpose: The purpose of this quality improvement (QI) project is to reduce post-operative anxiety and pain scores among adult post- orthopedic surgery patients and improve compliance with TJC’s requirement among nursing staff in the PACU by implementing and measuring the impact of recorded music therapy (MT) as an adjunct to pharmacological interventions. Methods: The addition of MT as an adjunct therapy was implemented over 15 weeks in the PACU. Two music channels were created for the purpose of this project. 100%(50/50) bedside nurses were educated regarding the intervention through nursing huddles and weekly emails. Electronic REDCap MT initiation surveys were completed by nursing staff during this period. Weekly chart audits were performed by using the electronic health record (EHR) to determine the MT initiation compliance, pain documentation compliance, average of pain scores and anxiety scores for each week. Results: Collected data showed that 34.4% (82/238) of the orthopedic patients received recorded MT as an adjunct therapy, pain documentation compliance was 98.7% (81/82), the average of pain scores for each week was 2- 5/10, and the average anxiety scores for each week were 0/4 in patients who received MT. Conclusion: Collected results suggest the addition of recorded relaxing music to pharmacological interventions improve postoperative pain and anxiety scores. Perhaps additional strategies need to be implemented to improve staff buy-in.