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Guidelines, Statements & Standards

Facts at your fingertips: Review important practice guidelines and the roles and responsibilities nurses play in specific procedures.

Responsibilities of the Registered Nurse Related to Conscious Sedation

Responsibilities of the Registered Nurse Related to Conscious Sedation

Position
The Canadian Society of Gastroenterology Nurses and Associates
supports the position that registered nurses trained and experienced in Gastroenterology nursing and endoscopy may be given the responsibility of administration and maintenance of conscious sedation in the presence of  and on the order of a  physician. In addition, the Registered Nurse may be given the responsibility for the administration of reversal agents prescribed by the physician. The Registered Nurse must have  education, knowledge of medications used and skills to assess, diagnose and intervene in the event of complications. Whether or not the registered nurse actually administers the sedative/analgesic, the Registered Nurse is responsible for assessing and monitoring the patient throughout the procedure and post procedure phase of the patient's care. 

A second Registered Nurse may be required to assist during procedures requiring complex technical requirements or in procedures that are complicated due to the severity of the patient's illness. 

Automatic monitoring devices may enhance the ability of the registered nurse to accurately assess the patient, but are no substitute for the watchful, educated assessment by the Registered Nurse. 

The Registered Nurse is accountable for the responsibilities he/she accepts. The registered nurse functions within the limitation of the institutional policies and the provincial governing bodies. 

Definition
Conscious sedation provides a minimally reduced level of consciousness in which the patient retains the ability to independently and continuously maintain an airway and respond appropriately to physical stimulation or verbal command. 

Background 
Conscious sedation is commonly used during diagnostic and therapeutic Endoscopic procedures. The safe administration and maintenance of conscious sedation is one of the most important responsibilities of the Registered Nurse working in an Endoscopy Setting. Care of the patient undergoing a diagnostic or therapeutic Endoscopic procedure continues to be more critical in nature, more complex in technology and more comprehensive in scope. Nursing care of the patient has changed to include a continuous comprehensive nursing assessment, administration and maintenance of conscious sedation in the presence of a physician, administration of reversal agents, utilization of equipment during the endoscopic procedures, and comprehensive documentation.
 

Disclaimer 
The CSGNA
assumes no responsibility for the practices or recommendations of any member or other practitioner or for the policies and practices of any Endoscopy unit.

Bibliography
American Society of PostAnaesthetic Care
.
Nurses (1991). Position Statement on the role of the Registered Nurse in the management of the patient receiving conscious sedation. 
Bailey, R. (1996). Consensus in Endoscopy. Canadian Journal of Gastroenterology. July 10(4) 237-242
. 
Bell,G., McCloy,R., Charlton, J., Campbell, D.,
Dent,N., Gear, M., Logan, R., Swan, C.(1991)Recommendations for standards of sedation and patient monitoring during
.
Gastrointestinal Endoscopy. Gut 7 (32) 823-827. 
Kidwell,J.(1991). Nursing care of the patient receiving conscious sedation during gastrointestinal procedures. Gastroenterology Nursing 13(3) 134-139. 
McCloy, R., Fleisher,D(1993). Sedation and monitoring for gastrointestinal endoscopy. UK Colloquim International, Ltd. 
Society of Gastroenterology Nurses and Associates Inc ( 1991). Position Statement: Responsibilities of the Gastroenterology Nurse related to Conscious Sedation. 
Society of Gastroenterology Nurses and Associates (2000) Position Statement : Sedation and Analgesia Associates
. 
Somerson, S., Husted, C., Sicilia, M. (1995). Insights into Conscious Sedation. American
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Journal of Nursing. June. 26-32
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Wansborough, G. (1996). Quality Assurance Medication Administration Standards. The College of Nursing of Ontario College Communiqué.