DNP Projects
Date of Award
7-28-2026
Document Type
Graduate Paper
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Dr. Rachelle Larson
Second Advisor
Dr. Carrie Hoover
Subject Categories
Nursing
Abstract
Background
A Midwest hospital implemented a registered nurse (RN) procedural sedation program to provide safe, cost-effective sedation for selected operating room procedures under physician supervision, improving patient access while optimizing anesthesia resources.
Methods
A retrospective descriptive program evaluation examined 1,117 patients who received RN-administered procedural sedation for vascular and neurovascular procedures during 2022 and 2024. Outcomes included anesthesia consultation, anesthesia takeover, reversal agent use, and adverse events. Patient demographics and procedure duration were analyzed. Six procedural sedation nurses completed a self-efficacy survey assessing confidence in sedation-related competencies. Descriptive statistics and qualitative review of adverse event narratives were performed.
Results
Among 1,117 patients, 85.6% were classified as American Society of Anesthesiologists (ASA) II or III, with a mean procedure duration of 68 minutes. Anesthesia consultation occurred in 1.2% of cases, and anesthesia assumed care in 0.6%. Adverse events occurred in 0.3% of patients, with no reversal agents administered. All adverse events occurred in the 2022 cohort receiving midazolam; no adverse events were observed in the 2024 cohort receiving remimazolam. All six procedural sedation nurses reported moderate to high confidence across sedation-related competencies.
Conclusion
RN-administered procedural sedation was safe and effective for appropriately selected patients undergoing vascular and neurovascular procedures. Structured onboarding supported high nurse confidence in sedation, demonstrating the feasibility of this care model.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Fredrickson, Cassandra, "Registered nurse procedural sedation in operating room: An analysis of patient safety and nurse confidence efficacy of 2 years post implementation" (2026). DNP Projects. 26.
https://digitalcommons.csbsju.edu/nursing_dnp/26