Educate your staff on conscious sedation
Many are not up-to-date on anesthesia care
Nurses don’t receive the information they need in nursing school regarding conscious sedation, says Jan Odom, MS, RN, CPAN, clinical nurse specialist at Forrest General Hospital in Hattiesburg, MS.
To monitor conscious sedation, nurses must know about complications, interventions in the event of complications, assessment of patient care requirements before and after conscious sedation, principles of oxygen delivery, respiratory physiology, skills in airway management, and the pharmacology of the medication, she explains. (For more information on knowledge needed to monitor conscious sedation, see chart, p. 23.)
Also, practitioners need to be aware of when they are crossing lines in the continuum of anesthesia care, says Robert P. Gordon, MD, attending anesthesiologist at Westchester County Medical Center and assistant professor of anesthesia at New York Medical College, both in Valhalla. A patient undergoing conscious sedation must be able to maintain an open airway and cough when secretions increase, for example.
Adapt learning to nurses’, doctors’ needs
The education can be handled in different ways. Odom’s hospital offers a four-hour workshop, three hours of didactic work, an airway workshop, an arrhythmia workstation, and a one-hour test.A preceptorship, in which a nurse who’s going to administer medication and monitor patients actually works with another expert nurse, is ideal, Odom says. The preceptorship should include a competency valuation, she advises.
"There is a difference between learning a piece of knowledge and learning a piece of practice," she says.
Gordon’s facility used three teleconferences to educate large numbers of physicians and nurses. These teleconferences typically are sponsored by large pharmaceutical companies and are free for the institutions, he says.
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