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Role of The RN in
Administration of Anesthetic Agents

A licensed nurse who is not a Certified Registered Nurse Anesthetist may not administer general anesthesia or conscious/moderate sedation. 

The NDBON has determined there may be an exception to the above statement in the clinical settings described below.

It is within the Scope of Practice for the Registered Nurse to administer pharmaceutical drugs classified as anesthetic agents used for the purpose of sedation for the client if the following requirements are met:  

  1. To an intubated and/or ventilated client.
  2. During the intubation procedure in an emergency when assisting the licensed physician or anesthesia provider.
  3. For relief of refractory symptoms in intractable distress in the dying patient.

The facility must meet the following requirements:

  1. Written policies and procedures are approved by the organization;
  2. The Registered Nurse has completed a facility approved education program related to the above, and includes the following:
  • Documentation of satisfactory completion of the education program;
  • Supervised practice is on file with the employer, and
  • There is supervised clinical practice during the educational process,  which may be simulated;
  1. The Registered Nurse is authorized to administer anesthetic agents by the organization; and
  2. There must be qualified backup available as determined by facility policy to ensure client safety.

Administration or management of patients receiving anesthetic agents used for the purpose of sedation is outside of the scope of practice of the LPN.

 
References:

CRNAbiz.com: FDA Denies Petition to Remove Diprivan/Propofol Warning. 
FDA Upholds ASA Stance on Safe use of Propofol. (August 19, 2010). 
Minnesota Board of Nursing.  Statement of Accountability for Administration of Medications Classified as Anesthetics by the Registered Nurse (2009).  Retrieved from http://www.nursingboard.state.mn.us/
NDCC 43-12.1 Nurse Practices Act
NDAC Title 5. CHAPTER 54-05-02. Standards of Practice for Registered Nurses.
Package Insert. AstraZeneca Pharmaceuticals - DIPRIVAN® (Revised 08/05).  NDA 19-627/S-045 
South Dakota Board of Nursing.  Administration of Propofol (Diprivan®) by the Registered Nurse – Resolution (2005).  Retrieved 9/13/10 from
http://doh.sd.gov/boards/nursing/title-opinion.aspx 
South Dakota Board of Nursing.  The Role of the Registered Nurse in the Management of Adult Clients Receiving IV Moderate Sedation for Short-Term Therapeutic, Diagnostic, or Surgical Procedures – Position Statement (2003).  Retrieved 10/13/2010 from http://doh.sd.gov/boards/nursing/title-opinion.aspx  
Standards for Joint Commission Accreditation of Healthcare Organizations. Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Provision of Care, Treatment and Service, pp. 17.18, & 25.

 


Adopted: 11/10
Reviewed/Revised:  07/13