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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.
Journal of Nursing. June. 26-32.
Wansborough,
G. (1996). Quality Assurance Medication Administration Standards. The
College of Nursing of Ontario College Communiqué.
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