SPS Plenary Session | May 20, 2019, 3:45 pm
Nancy Crego, PhD, RN, CCRN; Lorie Reilly, MSN, CRNP, CPNP
Dr. Crego and Ms. Reilly provided a robust discussion on the evolution of the nurse’s role in pediatric sedation and current regulatory requirements, including the wide disparities that are found between individual State Boards of Nursing (BON) as well as institution to institution. They also discussed how these variables can impact and create difficulties in the development of standardized credentialing processes, standards of care and competencies.
Dr. Crego started the session with an interesting talk on the evolution of healthcare systems and sedation related medication practices as compared to current standards and practices. Interesting facts: the first US children’s hospital opened in 1855 and Chloral Hydrate was first synthesized in 1832! She discussed nurse training then and now, as well as the development, evolution, and use of early monitoring equipment, much of which is still used today, albeit in more technologically advanced forms requiring significantly more education and training. In 1947, JAMA published an article on preventable anesthesia-related deaths, including contributing factors. The article espoused the need for post-anesthesia rooms with specifically trained nursing personnel. Interestingly, while the mortality rates were higher, current research shows contributing factors remain very similar today.
Ms. Reilly then segued into a discussion on sedation credentialing based on ASA standards, CMS guidelines, Joint Commision requirements, and individual State Board of Nursing Scopes of Practice and institutional policies. She spoke of the challenges of developing a national standardized pediatric sedation certification due to the variability of individual State Board of Nursing Scopes of Practice as well as the costs associated with the development and maintenance of specialty certifications, particularly for specialties with smaller numbers such as pediatric sedation nurses. She provided a history on nursing involvement with the SPS including the formation of the nursing committee in 2011. This committee is dedicated to improving safety, efficiency and efficacy in pediatric sedation and is working diligently to increase on-line educational opportunities and update standards of care and competencies. Finally, she shared the current status of SPS nursing involvement which includes over 100 individual dues-paying members with 600 more institutional members, making nursing the highest represented discipline in this wonderful multidisciplinary organization!