To explore Ghanaian nurses' knowledge of invasive procedural pain in children who are in hospital and to identify the effect of unrelieved pain on children, parents and nurses.

An exploratory, descriptive and qualitative design was adopted. A purposive sampling technique was used and individual face-to-face, semi-structured interviews were conducted with 16 registered nurses from four children's units at a hospital in the Eastern Region of Ghana. Thematic and content analyses were performed.

Four themes emerged: types of invasive procedure; pain expression; pain assessment; and effects of unrelieved pain. Participants had adequate knowledge of painful invasive procedures, however, they were not aware of the range of available validated pain assessment tools, using observations and body language instead to assess pain.

Ghanaian nurses require education on the use of validated rating scales to assess procedural pain in children. The inclusion of pain assessment and management in pre-registration curricula could improve knowledge.