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California   Oregon   Washington 


Source:California Board of Registered Nursing
Type of Guidance: Registered Nurse Practice Information (07/97)
Impact: RNs
Guidance*: Conscious Sedation(7-1997) – Page 1

  • It is within the scope of practice for the Registered Nurse (RN) to administer medications for the purpose of induction of conscious sedation for short-term therapeutic, diagnostic or surgical procedures.
  • No limits are placed on the type of medication or route of administration.
  • The knowledge and skills required for the administration of conscious sedation are the same as would be necessary for any other medication the nurse administers.
  • The RN does not have the authority to administer medications which would result in deep sedation and/or loss of consciousness.
Read Registered Nurse Practice Information: Conscious Sedation


Source: California Society of Anesthesiologists
Type of Guidance:Guideline (05/08)
Impact: MDs, DOs, RNs, PAs
Guidance*: CSA Guidelines for Deep Sedation by Non-Anesthesiologists (5-2008)

Only physicians or dentists who are qualified by education, training and licensure to administer deep sedation should supervise the administration of deep sedation. Non-anesthesiologist sedation practitioners may directly supervise patient monitoring and the administration of sedative, analgesic or anesthetic medications by a supervised sedation professional. Alternatively, they may personally perform these functions, with the proviso that the individual monitoring the patient should be distinct from the individual performing the diagnostic or therapeutic procedure. The supervised sedation professional who is granted privileges to administer sedative, analgesic or anesthetic drugs under supervision of an anesthesiologist or a non-anesthesiologist sedation practitioner and to monitor patients during deep sedation can be a registered nurse who has graduated from a qualified school of nursing or a physician assistant who has graduated from an accredited physician assistant program. They may only administer sedative, analgesic or anesthetic medications on the order of an anesthesiologist or non-anesthesiologist sedation practitioner.

Read CSA Guidelines for Deep Sedation By Non-Anesthesiologists

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Source:Oregon State Board of Nursing
Impact:Policy Guideline (02/06)
Impact: RNs, NPs, CNS
Guidance*:Oregon State Board of Nursing Policy Guideline:Nursing Scope of Practice for the Use of Sedating and Anesthetic Agents (2-2006)

  • The Oregon State Board of Nursing affirms that it is within the role and scope of practice for the RN, NP and CNS to administer sedating and anesthetic agents to produce moderate and deep procedural sedation and moderate and deep sedation for the non-intubated or intubated/ ventilated patient, provided that the nurse have the specified knowledge and skills and specified requirements are met.
  • The RN, NP or CNS may also manage patients who are recovering from sedation.
    In addition, there are other special circumstances in which a nurse, under the direction of a LIP, may use Ketamine in non-intubated patients provided appropriate criteria are met.
  • The administration of sedating and anesthetic agents for the purposes of moderate or deep sedation expressed by this policy exceeds the scope of practice for the Licensed Practical Nurse (LPN) or unlicensed assistive personnel (UAP). These guidelines do not apply to Certified Registered Nurse Anesthetist (CRNA).

Read the Oregon Board of Nursing Policy Guideline

Source:Oregon State Board of Nursing
Type of Guidance: Policy Guideline (02/06)
Impact: RNs
Guidance*: Oregon State Board of Nursing Policy Guideline - Appendix: Questions and Answers (2-2006) – Page 7

I have been offered a job as a RN in a free standing Endoscopy Suite. They want to train me to administer Propofol to sedate patients for procedures. Is it within my scope of practice to administer this drug?

A:It is within your scope of practice as long as the patient's ASA's physical status classification is I, II or III (adult) or I or II (pediatric) and the nurse responsibility and requirements relating to procedural sedation are met.

Read the Oregon Board of Nursing Policy Guideline (Page 7)

Source:Oregon Revised Statutes
Type of Guidance:Oregon Revised Statutes Chapter 678.255 (2013 EDITION)
Impact:MDs, DOs, RNs, CRNAs
Guidance*: 678.255 Provision of nurse anesthetist services in ambulatory surgical centers. (2013) 

Anesthesia care in an ambulatory surgical center shall be delivered by an anesthesiologist or by a certified registered nurse anesthetist acting with the medical collaboration of an anesthesiologist.

When no anesthesiologist is readily available for medical collaboration on anesthesia services for a procedure performed in an ambulatory surgical center, a certified registered nurse anesthetist may deliver services as specified in this section without medical collaboration.

This section does not prohibit any other licensed healthcare professional from rendering or supervising anesthesia services if such services are within the scope of the professional's license.

Read the ORS 678.255

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Source: Department of Health Nursing Care Quality Assurance Commission
Type of Guidance:Advisory Opinion (03/15)
Impact: RNs
Guidance*: Administration of Sedating, Analgesic, and Anesthetic Agents Number: NCAO 7(3-15-15)

The Nursing Care Quality Assurance Commission (NCQAC) concludes that registered nurses (RNs): may administer and maintain sedating, analgesic, anesthetic, and reversal agents prescribed by authorized providers. These medications include, (but are not limited to), diazepam, chloral hydrate, nitrous oxide, etomidate, propofol, ketamine, fentanyl, methohexital, bupivacaine, ropivacaine, succinylcholine, and midazolam.

The NCQAC advises nurses to use the Scope of Practice Decision Tree to determine whether an activity is within the nurse’s individual scope of practice.

Read Advisory Option NCAO 7.1 

Source: Washington State Legislature
Type of Guidance:Washington Administrative Code – Title 246, Chapter 330 (04/09)

Impact:MDs, RNs,CRNAs
Guidance*:Ambulatory surgical facilities: Anesthesia services(5-8-2009)

An ambulatory surgical facility must: Adopt and implement policies and procedures that:

  • Identify the types of anesthesia and sedation that may be used;
  • Identify areas where each type of anesthesia and sedation may be used; and
  • Define the staff qualifications and oversight for administering each type of anesthesia and sedation used in the facility.
  • Use facility policies and procedures which define standards of care; and
  • Assure emergency equipment, supplies and services are immediately available in all areas where anesthesia is used.
Read Chapter 246-330-215 WAC

Other State Resources:

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