Moderate Sedation: Complying With Regulatory and Accreditation Requirements

Moderate sedation or analgesia, also known as “conscious sedation”, involves the use of a medication to provide relief of anxiety and pain. The patient does not lose consciousness, but does not perceive pain to the extent he or she may have otherwise. Each year, millions of procedures using moderate sedation are performed in ambulatory, ancillary, or acute care settings by non-anesthesia credentialed personnel for common procedures such as cardiac catheterization, endoscopy, and colonoscopy. Sedation of some level is often performed in critical care units to help patient’s better tolerate mechanical ventilation; and in the Emergency Department, moderate sedation is often used for endotracheal intubation, fracture reduction and lumbar puncture.

While many of these procedures may seem low risk, without the proper knowledge or expertise they can result in unintended complications, infections, and medical errors. A successful outcome requires clinicians to perform many tasks: the evaluation and monitoring of the patient throughout the course of care; the use of safety protocols; and the practice of infection prevention, to name a few. 

“A patient’s response to medication cannot always be predicted. There are many complex interactions between the agents used, a patient’s physical health, and drug sensitivities. Moderate sedation or analgesia may easily progress to deep sedation and loss of consciousness, as well as other possible consequences such as respiratory depression, cardiac arrhythmia and hypotension. This is why moderate sedation should only be administered by appropriately trained, qualified and credentialed personnel who have a thorough understanding of the dosing and effects for the medications used, as well as for the reversal agents used to counteract them.” – Bernadette  Henrichs, PhD, CRNA, CCRN. Professor & Director, Nurse Anesthesia Program, Goldfarb School of Nursing at Barnes-Jewish College.

Healthcare professionals must become familiar with the new Centers for Medicare and Medicaid Services (CMS) regulations and interpretive guidelines for hospitals and ambulatory surgery centers (ASCs); standards by accreditation agencies such as The Joint Commission,  The Accreditation Association for Ambulatory Health Care (AAAHC),  American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), and DNV/NIAHO; guidelines by the Centers for Disease Control and Prevention (CDC); and professional association standards of practice, such as those offered by the American Society of Anesthesiologists (ASA),  the Society of Gastrointestinal Enterology Nurses and Associates (SGNA),  the American Association of Nurse Anesthetists (AANA), the Association of peri-Operative Nurses (AORN),  and the Infusion Nurses Society (INS).  These are the tools we need for a successful outcome, and to help us meet the highest standard of care.

Envision, Inc. has created a training program for healthcare professionals involved in the administration, care and monitoring of patients undergoing moderate sedation comprised of a 15 minute video and a comprehensive study guide.

After viewing this program and reading the study guide, the viewer will be able to:

• Identify the pharmacology of the medications and agents used in moderate sedation/analgesia
• Discuss how to deliver these medications safely
• List the elements of pre-procedural, procedural, and post-procedural assessment and monitoring of patients who receive moderate sedation/analgesia
• Discuss the safety and infection prevention protocols involved in delivering moderate sedation
• Identify current regulations, standards, recommended practices and guidelines that apply to the use of moderate sedation/analgesia

For more information on this program and a free preview prior to purchase, please visit the Envision, Inc. website at http://www.envisioninc.net/index.php/programs/details/moderate_sedation_complying_with_accreditation_and_regulatory_requirements/.