Moderate Sedation Guidlines for Alabama
Type of Guidance: Alabama Board of Nursing Administrative Code effective 12/2009
Impact: RNs
Source: Alabama Board of Nursing Administrative Code (12/09) "Administrative Code Chapter 610-X-6-.08(1): Standards of NursingPractice: Standardized Procedures (12-28-2009)"
ABN Definition of Moderate Sedation: (page 2)
(12) Moderate Sedation: the administration of pharmacological agent(s) for the purpose of a medically controlled state of depressed consciousness limited to short periods of time and used for diagnostic and therapeutic procedures that:
- Allow protective reflexes to be maintained.
- Retain the patient’s ability to maintain a patent airway, respiratory rate and rhythm.
- Permit expected responses by the patient to physical stimulation and verbal command.
Guidance: "The registered nurse may administer ordered medications for the purpose of moderate sedation that allows the patient to be aroused and to retain the reflexes for a short-term theraputic, or diagnostic procedures pursuant to facility policies , provided minimum requirements are met" (
page 10)
610-X-6-.08 Standards for Moderate Sedation
(1) After a patient assessment and verification of physician’s presence in the procedural area, the registered nurse may administer ordered medications for the purpose of moderate sedation that allows the patient to be aroused and to retain reflexes for short-term therapeutic, or diagnostic procedures pursuant to facility policies and procedures.
(2) The minimum requirements for a registered nurse to perform moderate
sedation and associated monitoring includes successful completion of an
organized program of study, supervised clinical practice and demonstrated
clinical competence.
(3) The minimum training for the registered nurse managing the care of
patients receiving moderate sedation shall include:
(a) Anatomy, physiology, pharmacology, cardiac arrhythmia recognition and
complications related to sedation and medications.
(b) Total patient care requirements to be assessed during moderate sedation
and recovery including physiologic measurements including but not limited to,
- Respiratory rate
- Oxygen saturation
- Blood pressure
- Cardiac rate and rhythm
- Level of consciousness
(c) Principles of oxygen delivery, respiratory physiology, transport and uptake
and demonstration the ability to use oxygen delivery devices.
(d) Anticipation and recognition of potential complications of sedation in
relation to the type of medication being administered.
(e) Requisite knowledge and skills to assess and intervene in the event of
complications or undesired outcomes and to institute nursing interventions in
compliance with orders or institutional protocols or guidelines.
(f) Demonstration of skill in airway management resuscitation.
(4) The registered nurse managing and monitoring the patient receiving
moderate sedation shall have no other responsibilities during the procedure that
would leave the patient unattended or compromise continuous monitoring.
(5) The registered nurse shall ensure safety considerations including but not
limited to continuous monitoring of:
- Blood pressure
- Cardiac rate and rhythm
- Continuous intravenous access
- Level of consciousness
- Oxygen saturation
- Respiratory rate
(6) The registered nurse shall have advanced cardiac life support (ACLS) or
comparable certification.
(7) The registered nurse may not administer medications for moderate
sedation if the following are not available:
- Physical presence of a physician or dentist and assistive personnel.
- Immediate availability of monitors, defibrillator, airway devices including suction, and emergency medications.
Alabama Board of Nursing
P.O. Box 303900
Montgomery, AL 36130-3900
Phone:
800.656.5318 toll free
334.293.5200 Montgomery local
Fax:
334.293.5201
Online:http://www.abn.state.al.us/