Guidelines in Practice: Moderate Sedation and Analgesia

Moderate sedation and analgesia (MSA) can help patients experience less anxiety and discomfort, tolerate procedures that do not require general anesthesia, and maintain the ability to respond to verbal commands. Nurses administer MSA in a variety of clinical areas, and facility leaders may have difficulty creating a single standard of care for this task. Completion of a presedation assessment that includes the patient in the decision-making process is an important aspect of care. When administering MSA, nurses should have immediate unrestricted patient access and no competing responsibilities that could distract them from monitoring and assessing the patient. Nurses should complete education and competency verification activities before administering MSA. AORN recently revised the "Guideline for care of the patient receiving moderate sedation/analgesia," and this article addresses the standard of care, the presedation assessment, patient monitoring, and competency; it also includes scenarios describing specific concerns in two patient care areas.