Concious Sedation...on your unit??

Conscious sedation used to be done on our unit in Postpartum. That was about 8 years ago.

Now it is only done in Labor and Delivery if needed and the nurses there are trained specifically for this. They have a written protocol, but I don't know what it is.

I work in the CVR ICU and we do CS frequently. Requires certification on the RNs part to be able to administer the drugs & monitor the patient, and there is of course extra charting to do. I'm not totally positive, but I don't believe our hospital does CS on the floors. If a patient on the floors needs a procedure requiring CS then they go to the normal place for the procedure rather than having it done in the room like would be done with our ICU patients.

Hello,

Our hospital offers conscious sedation classes, and once you have passed the class, then you are able to do conscious sedation anywhere in the hospital. The only problem with this, is do the nurses really have time out on the floors to monitor the patient afterwards? The answer, is no, unless they get another nurse to watch their patients. We do cardioversions in the room on our step-down units, and the nurses recover the patients themselves. We don't have to do the special paperwork on our CCU/ICU if we document everything in our notes, as it is usually an emergent need. Hope this helps...

With the new JCAHO regulations, they are getting more requirements with administering "conscious sedation" in the hospital.. One of the issues in question was, "What type of monitoring is required?" and when will it be considered "conscious sedation"..

Anyone please reply..

kv

we must be certified, test and 3 check off's prior to being able to do.

The units allowed to are; all ICU's, PACU, special proceedures, ER, L&D

we have a form, we must do vs every 5 minutes during, then your usual post Q15 x 4 so on. includes GCS. Must have suction, O2, heart monitor, crash cart nearby.

These patients are a 1:1 until the vs hit 30 min. appart.

Do you use a standardized form for all conscious sedation??

And, to certify, what guidelines do you go by? Did you just certify in your hospital? How do you define and determine when it constitutes "conscious sedation??"... The guidelines of JCAHO state when the patient's cognitive function is impaired, which would include the level 1 and level 2 right??? Tell me what you think.....

Karen

all RN's at my institution must recert yearly on VAD (venous access devices) Con. Sedation. I am in CCU so I do lots of CS, as I did in the ER. We have a flow sheet we use. It helps with charting, easy to use...

Did you use a cardiac monitor?? and if you did, do you need to be ACLS certified??? The JCAHO standards are not real clear and I was curious what others are doing..

Let me know..

Thanks for your mailed response ,

Karen

we use cardiac monitors, with sat probe, O2, & NBP. Most have successfully completed ACLS (no such thing as certified---passing gives one no license to do anything). All have completed BCLS. Hope this helps...

Thanks!!!! I appreciate it..

Karen

CS is done in the scope room, in the ER, in PACU and in ICU....the nurse must attend a class and pass the test. Documentation during the CS is done on an anesthesia flow sheet and after the procedure, a PACU flow sheet is used. Pt must meet all DC criteria as if they were in PACU being d/c'd to home.

Thanks.. I appreciate your input.

One of the concerns we have is when do you "have" to have a cardiac monitor and when is it not necessary. Patients with cardiovascular disease, and those you expect to see arrythmias with is advised, however, that doesn't mean that the patient couldn't still crash. Will it then be the doctor's discretion??

Karen