No interventions are required to maintain a patent airway, and spontaneous

ventilation is adequate. Cardiovascular function is usually maintained.5(p1005) Whether a sedation policy is already in place at a facility or is in the process of being developed, this article addresses essential policy elements as well as emerging research and literature topics related to sedation that administrators and health care providers can use to ensure that their sedation policy is evidence based. Also provided in this article are tools and resources for maintaining evidence-based policies as part of a robust sedation program. Multidisciplinary PLX3397 order team members who are developing a sedation policy should consider the following elements: administrative aspects (eg, purpose and scope statements, governance, necessary equipment), assignment of responsibilities, competency and credentialing, preprocedure evaluation, medications, and documentation. Facilities typically will have a policy and procedure template

to help standardize and guide policy decisions. A sedation policy should begin with the purpose and scope. The purpose and scope clarify patient populations, types of practitioners, and types of sedation (eg, moderate, deep) to which the policy pertains. Regarding sedation types, it is helpful to include a list of sedation levels as defined by the ASA,7 particularly because some health care providers may be new to moderate sedation. A section on governance should identify which

administrative entities (eg, clinical Sitaxentan departments, hospital committees) have oversight of the sedation program. In selleck addition, the policy should delineate specific locations where sedation may be administered. Necessary equipment and other measures to ensure patient safety (eg, heart monitoring, pulse oximetry, supplemental oxygen delivery, resuscitative equipment) can guide selection of these locations. For example, procedures and sedation should not be performed in locations where an emergency code cart with resuscitation equipment is not available. The policy should assign responsibilities to both the “”operator”" (ie, the practitioner, often a physician, who is performing the procedure, directing sedation, or performing the procedure and directing sedation) and the “”monitor”" (ie, the clinician, often a periprocedure RN, who is monitoring the patient during sedation and administering medications). Having role delineation in a policy addresses periprocedure patient monitoring and satisfies an important regulatory issue: the operator does not perform the procedure and simultaneously monitor the patient while administering sedation.8 For instance, the Institute for Safe Medication Practices states, “”…only persons trained in the administration of general anesthesia, who are not simultaneously involved in the procedures, should administer propofol to nonventilated patients.