Growth in an Anesthesiologist- and Nurse Anesthetist-Supervised Sedation Nurse Program Using Propofol and Dexmedetomidine.
In 2007, the Department of Anesthesia at the University of Iowa established an anesthesiologist-supervised nurse-managed sedation program. In 2008, the use of propofol and dexmedetomidine by nurses was approved in Iowa. We reviewed 11,038 elective sedation cases done between January 1, 2007, and June 30, 2014. Caseload increased from 170 to 470 cases/quarter. Propofol use increased from 0% to approximately equal to 70% of cases and dexmedetomidine from 0% to approximately equal to 25% of cases. There were no safety issues. The number of nurses working each day (on average) increased from 2.2 to 4.7, but supervising providers remained at 1/day. There were no changes in general anesthesia or monitored anesthesia care cases performed for comparable procedures. Trained, supervised nurses can safely administer propofol or dexmedetomidine to selected patients for a wide variety of procedures.
From the Department of Anesthesia, University of Iowa, Carver College of Medicine, Iowa City, Iowa.
Joss
J
Thomas
Franklin
F
Dexter
Ruth E
RE
Wachtel
Michael M
MM
Todd
D000293:Adolescent; D000328:Adult; D000072080:Anesthesiologists / Q000592:standards / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009719:Nurse Anesthetists / Q000592:standards / Q000639:trends*; D016730:Program Development / Q000379:methods* / Q000592:standards; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D055815:Young Adult
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D015742:Propofol