53 and 54 When simulators are used for simulation training, they are either mannequin based or computer screen based. Both simulator types have a place Navitoclax in sedation education and training. Drill scenarios can be developed for personnel to practice and address sedation competencies dealing with specific knowledge and skills, such as airway management, patient resuscitation, medication pharmacology, and team communication. In most

cases, the learning objectives of a particular training course will help determine selection of an appropriate simulator or a combination of simulators.53 In a 2013 study, Tobin et al54 used simulation to teach clinicians about moderate sedation. The results showed a

significant increase in participants’ find protocol level of knowledge, skills, and clinical judgment. As the number of procedures requiring moderate sedation continues to grow, each facility must establish evidence-based policies to ensure patient safety. A typical sedation policy should address the training and qualifications of personnel, monitoring requirements, pharmacological guidelines, patient recovery, quality assurance, and documentation requirements. Maintaining a robust sedation program requires the multidisciplinary involvement of clinicians, pharmacists, quality and risk managers, and hospital administrators. As the practice of moderate sedation continues to evolve, new developments, such as innovative medication delivery systems, the increased use of capnography,

and a greater emphasis on both outcomes measurement and the use of safety checklists, all can help shape its future. Ambulatory Takeaways Sedation policies Phenylethanolamine N-methyltransferase and procedures should be in place in ambulatory surgery centers (ASCs), and all policy decisions should be approved by the facility’s governing body. The term moderate sedation, as defined by the American Society of Anesthesiologists (ASA), is widely accepted and can be included in the policy. However, the medications administered and the health care provider who administers the medications vary according to state law, which should be reflected in the policy. When considering personnel requirements for the policy, a perioperative RN often administers IV sedation under the supervision of a physician. The Centers for Medicare & Medicaid Services (CMS) does not define moderate sedation as anesthesia, as appears in the ASA guidelines1; however, CMS recognizes that sedation occurs on a continuum. The continuum of sedation affects competency and role requirements of the RN who is engaged in the administration of moderate sedation. The RN who is monitoring the patient must have the critical thinking skills necessary to intervene if the patient progresses into deep sedation.