Problem: Accurate pain assessment is necessary for adequate pain management, yet zero of the 93 mechanically ventilated adults requiring ground transport were assessed using a validated pain tool between January and October 2023. Recognizing this gap, departmental leadership prioritized improving pain assessment, which is supported by current literature. Purpose: This QI project aimed to standardize pain assessment among mechanically ventilated adults requiring ground transport by integrating the Critical-care Pain Observation Tool (CPOT), a validated pain assessment tool, into the pain and sedation management protocol. Methods: After thorough literature review, approval for CPOT integration was obtained from the program’s medical director and departmental leadership. The updated protocol was distributed to staff, and the electronic health record was modified to include the CPOT for documentation. Education was provided to staff regarding the usage and documentation of the CPOT, which was tracked via a REDCap survey. Weekly audits were performed to monitor adherence to the updated policy, and results were tracked in a separate REDCap survey. Results: Staff education reached 81% by the end of the second week. Staff expressed the ease of usability and documentation of the tool, and the applicability to practice the tool has for the target population in their REDCap survey responses. During the 15-week implementation period, over 95% of mechanically ventilated adults requiring ground transport were assessed using the updated protocol (n=42/44). Conclusions: Incorporating a validated pain assessment tool into the pain and sedation management protocol for patients with an advanced airway was an effective strategy to improve pain assessment in this vulnerable population.