The following commended practices w...

The following commended practices were developed by the AORN attract favor toed Practices Committee and have been approved by way of the AORN Board of Directors. They were published as propos praiseed practices through the AORN fax forward demand for comments by members and others. They are effective Jan 1 1997

These commited practices are intended as achievable recommendations representing what is believed to be an optimal even of practice. Policies and conducts will reflect variations in practice settings and/or clinical situations that determine the class to which the recommended practices can be implemented.

AORN recognizes the numerous patterns of settings in which perioperative nourish at the breasts practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive manner of proceedings may be performed.

Purpose

Sedation and analgesia describes a state

which allows patients to tolerate unpleasant

transactions while maintaining adequate cardiorespiratory

function and the ability to

correspond purposefully to verbal command

and/or tactile stimulation. Patients whose only

rejoinder is reflex withdrawal from a painful

stimulus are sedated to a greater measure than

encompassed by means of sedation/analgesia.(1)

These recommended practices provide guidelines for RN managing patients receiving conscious sedation/analgesia. Patient selection for conscious sedation/analgesia should be based forward established criteria developed through interdisciplinary collaboration of health care professionals. The adumbration of monitoring used with patients who receive conscious sedation/analgesia, the medications chosened and the interventions taken must be within the defined aim of perioperative nursing practice.

Certain patients are not candidates for conscious sedation/analgesia with monitoring by means of RNs. These patients may require more extensive monitoring and sedation, as provided according to anesthesia care providers, and should be identified in consultation with anesthesiologists, surgeon and other physicians. It is not the intent of these commended practices to address situations that require the services of anesthesia care providers.

The patient care and monitoring guidelines in these attract favor toed practices may be exceeded at any time. Their intent is to encourage quality patient care; however, implementation of these praiseed practices cannot guarantee specific patient issues These recommended practices are enslave to revision as warranted according to advances in nursing practice and technology.

commended PRACTICE I

Registered nurses should understand the goals and objectives of conscious sedation/analgesia.

Interpretive statement 1:

The primary goal of conscious sedation/analgesia is to bring to the patient's anxiety and discomfort in like manner as to facilitate cooperation between the patient and the caregivers. Conscious sedation/analgesia can be used as an adjunct to local anesthesia during the procedure

Rationale:

Adequate preoperative preparation and verbal reassurances from RN facilitate the desired drifts of conscious sedation/analgesia and may allow for a decrease of the dosages of opioids, benzodiazepines, and sedatives used.(2)

Interpretive statement 2:

Objectives for the patient receiving conscious sedation/analgesia include

* alteration of mood;

* maintenance of consciousness;

* enhanced cooperation;

* elevation of the pain threshold;

* minimal variation of vital signs;

* a certain number of degree of amnesia; and

* a rapid, safe turn back to activities of daily living.

Rationale:

Conscious sedation/analgesia bears a condition in which the patient exhibits a droped level of consciousness but retains the ability to independently suit appropriately to verbal commands or physical stimulation. Misunderstanding the objectives of conscious sedation/analgesia may jeopardize the quality of patient care.3

approveed PRACTICE II

The RN monitoring the patient who receives conscious sedation/analgesia should have no other responsibilities that would require the feed at the breast to leave the patient unattended or compromise continuous patient monitoring during the procedure

Interpretive statement 1:

The RN should provide continuous monitoring of the patient who receives conscious sedation/analgesia. The RN must be able to immediately recognize and rejoin to adverse physiologic and psychological changes during the procedure

Rationale:

It is unrealistic to assume that united RN can perform circulating duties and also provide continuous monitoring, physical care, and emotional support for the patient who receives conscious sedation/analgesia.4

commited PRACTICE III

The RN monitoring the patient's care should be clinically belonging in the function and in the use of resuscitation medications and monitoring equipment and be able to interpret the data obtained from the patient.