tion, knowing the right equipment and supplies to have on hand, understand- ing the agents commonly used for conscious sedation and the necessary skills needed for emergency interven- tions. To establish true competency, an RN must be able to reverse the con- sequences of over-sedation, including rescue measures. I shall discuss addi- tional skills required to prove com- petency, including advanced cardiac life support (ACLS), advanced airway management, interpretation of appro- priate monitors, including EKG, B/P, SaO2, capnography, written exam and direct skill observation. Regarding requirements for cre- dentialing conscious sedation RNs and non-anesthesiologist physicians direct- ing conscious sedation RNs, I will review the requirements for credential- ing, including a process to evaluate the


To establish true competency means an RN must be able to reverse the consequences of over sedation including rescue measures.”


— Jennifer Butterfield, RN, CASC Lakes Surgery Center


practitioner’s licensure, any disciplin- ary action in the National Practitioner Data Bank (NPDB) and a method of evaluating a practitioner’s performance, including re-evaluation at regular inter- vals and appropriate peer review. For documentation in the medi-


cal record, I will discuss the elements required for proper paperwork includ-


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ing pre-assessment, ordering of medi- cations, use of a monitoring record dur- ing sedation, specific charting of key metrics, and post-procedure monitor- ing until adequate function is returned and patient is ready for discharge. In my discussion of the accredi- tation agency guidelines, I will talk about position statements from these groups as they relate to RNs providing conscious sedation. I will also ask for the members of the audience to put on their risk management hats and discuss potential liability of a conscious seda- tion program that is not comprehensive or followed appropriately.


Jennifer Butterfield, RN, CASC, is the administrator of Lakes Surgery Center in West Bloomfield, Michigan. Write her at Jbutterfield@nshinc.com.


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10 ASC FOCUS MAY 2016


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