Penggunaan alat-alat khusus di ICU seperti ventilasi mekanik dapat mengakibatkan beberapa komplikasi seperti aspirasi, VentilatorAcquired Pneumonia (VAP), cedera paru-paru, hiperventilasi, hipoventilasi, masalah gastrointestinal, imobilitas, ketidaknyamanan dan nyeri. Nyeri merupakan masalah penting di ICU, hampir 5 juta pasien yang dirawat di ruang ICU setiap tahunnya, 71% mengalami rasa sakit selama masa perawatan. Pasien dengan status kritis di ICU tidak mampu menyampaikan rasa nyeri secara verbal. Ketepatan penggunaan pengkajian nyeri comfort scale pada pasien kritis sangat dibutuhkan untuk menentukan skala nyeri dan intervensi yang akan diberikan. Tujuan penelitian yaitu mengidentifikasi gambaran pelaksanaan penggunaan pengkajian skala nyeri comfort scale di ICU Rumah Sakit Siloam Denpasar. Metode penelitian yang digunakan adalah deskriptif kuantitatif. Pengambilan sampel menggunakan teknik total sampling. Hasil penelitian menunjukan bahwa mayoritas tahapan-tahapan pengkajian nyeri comfort scale dilakukan sesuai prosedur. Sebanyak 78,27% tahapan dari pengkajian nyeri comfort scale di ICU Rumah Sakit Siloam Denpasar dilakukan sesuai prosedur dan 21,73% tahapan tidak dilakukan sesuai prosedur. Berdasarkan hasil penelitian dan pengalaman dari penelitian ini, maka peneliti ingin memberikan saran bagi pelayanan keperawatan dan penelitian selanjutnya untuk lebih meningkatkan pelayanan mutu pengkajian nyeri di ICU serta penerapan evaluasi dan pendokumentasian hasil pengkajian nyeri setiap pasien agar mendapatkan pelayanan dan tindakan keperawatan dengan baik / Background: The use of special tools in icu as ventilation mechanical can result in some major complications as aspirations, ventilatoracquired pneumonia ( vap ), injury the lungs, hyperventilation, hipoventilation, gastrointestinal problem, imobilitas, discomfort and pain. Pain is a problem important in ICU , almost 5 million patients in the ICU every year , 71 % have been pain during the treatment. Patients with critical status in ICU unable to convey pain verbally. The accuracy of the use of assessment pain comfort scale in patients critical is needed to determine scale pain and intervention to be given. Objective to identify the implementation of nurse in the use of study scale pain comfort scale in ICU of Siloam Hospital Denpasar. Method the research used is descriptive quantitative. Sampling using total sampling technique. Results the majority of comfort scale scale assessment measures were performed according to the procedure. A total of 78.27% stages of the comfort scale pain assessment in ICU Hospital Siloam Denpasar performed according to the procedure and 21.73% stages are not performed according to the procedure. Suggestion based on research result and experience from this research, hence researcher wish to give suggestion for service of nursing and subsequent research to further improve quality service of pain assessment in ICU and implementation of evaluation and documenting result of pain assessment every patient to get service and action good of nursing.