Alabama BON review – September 30, 2016
Reviewed by Sedation Certification – March 20, 2019
State Sedation Policy – Yes
Can RN’s give sedation – Yes
Can RN’s give Propofol/Ketamine – No

610-X-6-.08 Standards for Moderate Sedation

1) After patient assessment and verification of the physical presence of a physician, dentist, or certified registered nurse anesthetist and licensed or unlicensed assistive personnel in the procedural area, the registered nurse may administer ordered medications for the purpose of inducing 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;

i. respiratory rate,
ii. oxygen saturation,
iii. blood pressure,
iv. cardiac rate and rhythm, l
v. 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:

a. blood pressure,
b. cardiac rate and rhythm,
c. continuous intravenous access,
d. level of consciousness
e. oxygen saturation
f. 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:

(a) Physical presence of a physician, dentist, or certified registered nurse anesthetist and licensed or unlicensed assistive personnel.

(b) Immediate availability of monitors, defibrillator, airway devices including suction, and emergency medications.

Author: Alabama Board of Nursing
Statutory Authority: Code of Ala. 1975, §§34-21-1(3)(b), 34-21-2(a)(21), 34-21-2(c)(6).
History: New Rule: Filed March 20, 2003; effective April 24, 2003.
Repealed and New Rule: Filed November 23, 2009; effective December 28, 2009.
Repealed and New Rule: Filed July 25, 2016; effective Sept. 8, 2016.