Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory : an integrative review

Conway, Aaron, Page, Karen, Rolley, John X., & Worrall-Carter, Linda (2011) Nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory : an integrative review. International Journal of Nursing Studies, 48(8), pp. 1012-1023.

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Abstract

Objectives: To identify and appraise the literature concerning nurse-administered procedural sedation and analgesia in the cardiac catheter laboratory.

Design and data sources: An integrative review method was chosen for this study. MEDLINE and CINAHL databases as well as The Cochrane Database of Systematic Reviews and the Joanna Briggs Institute were searched. Nineteen research articles and three clinical guidelines were identified.

Results: The authors of each study reported nurse-administered sedation in the CCL is safe due to the low incidence of complications. However, a higher percentage of deeply sedated patients were reported to experience complications than moderately sedated patients. To confound this issue, one clinical guideline permits deep sedation without an anaesthetist present, while others recommend against it. All clinical guidelines recommend nurses are educated about sedation concepts. Other findings focus on pain and discomfort and the cost-savings of nurse-administered sedation, which are associated with forgoing anaesthetic services.

Conclusions: Practice is varied due to limitations in the evidence and inconsistent clinical practice guidelines. Therefore, recommendations for research and practice have been made. Research topics include determining how and in which circumstances capnography can be used in the CCL, discerning the economic impact of sedation-related complications and developing a set of objectives for nursing education about sedation. For practice, if deep sedation is administered without an anaesthetist present, it is essential nurses are adequately trained and have access to vital equipment such as capnography to monitor ventilation because deeply sedated patients are more likely to experience complications related to sedation. These initiatives will go some way to ensuring patients receiving nurse-administered procedural sedation and analgesia for a procedure in the cardiac catheter laboratory are cared for using consistent, safe and evidence-based practices.

Impact and interest:

9 citations in Scopus
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8 citations in Web of Science®

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ID Code: 61445
Item Type: Journal Article
Refereed: Yes
Keywords: Artificial cardiac pacing, Capnography, Cardiac electrophysiology, Conscious sedation, Deep sedation, Heart catheterization
DOI: 10.1016/j.ijnurstu.2011.04.013
ISSN: 0020-7489
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 18 Jul 2013 23:37
Last Modified: 22 Jul 2013 00:57

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