Simulating Rescue Strategies From Procedural Sedation: One Aspect of Competency Validation

Quality and Safety in Nursing Education identifies both teamwork and patient safety as key domains in which competencies are required. An example that makes these competencies necessary in day-to-day clinical safety is procedural sedation. Procedural sedation is a key area of risk in an acute-care facility. Safety in this area requires teamwork. The Joint Commission requires that risk management also examine the process of procedural sedation outside the operating room. This assures equity of care and oversight by the anesthesia department. Procedural sedation is not within the current National Council Licensure Examination blueprint (NCSBN, 2019). It is up to employers to validate the hired registered nurse has the skills, knowledge, and attitude to safely administer these high-risk medications. Working as a taskforce, five disciplines from ten areas that administered procedural sedation in our acute care facility created a three-component competency validation approach. The novel component was the development of a high-fidelity simulation validating the ability of the registered nurse to rescue a patient from loss of protective reflexes. The outcome of the simulation process included a clinical reasoning evaluation by the clinical educator. This article is a discussion of the development and clinical usefulness of this simulation tool as a competency adjunct.