Alabama regulates registered-nurse moderate sedation by rule, not by advisory statement: § 610-X-6-.08 sits inside the Alabama Board of Nursing’s Chapter 610-X-6 of the Alabama Administrative Code. It sets a minimum training, a monitoring duty, a certification, and two conditions without which the nurse “may not administer medications for moderate sedation” (p. 15). Everything below about Alabama’s rule is quoted or paraphrased from that chapter, with page numbers.
Alabama at a glance
| Board | Alabama Board of Nursing |
| Document | Alabama Board of Nursing Administrative Code, Chapter 610-X-6, Standards of Nursing Practice — 28-page chapter PDF stamped “Supp. 11/13/23” (p. 15); sedation rule at pp. 14–16. Page numbers here refer to that PDF. |
| Rule it is | § 610-X-6-.08, Standards For Moderate Sedation. Stated statutory authority: “Code of Ala. 1975, §§34-21-1(3)(b), 34-21-2(a)(21), 34-21-2(c)(6)” (p. 16). |
| Status | A regulation, not an advisory. The chapter defines its modal verbs — “Shall: Duty, requirement, or condition” (p. 3), “May not: Prohibition” (p. 2) — and requires that “The RN, LPN, or APRN shall comply with the standards of practice within these rules” (p. 4). |
| Dates | Effective April 24, 2003; replaced December 28, 2009; then “Repealed and New Rule: Filed July 25, 2016; effective September 8, 2016” (p. 16). No later amendment appears in that history note. |
| Who it covers | “the registered nurse” (p. 14) throughout. An advanced practice nurse “shall comply with the standards for RNs as specified in these rules” (p. 8). |
| Who it does not cover | Licensed practical nurses — among “Tasks that shall not be performed by a licensed practical nurse” (p. 25) is “IV medications for the purposes of moderate sedation or anesthesia” (p. 25). That prohibition sits in the LPN rule; .08 itself does not use the words licensed practical nurse. |
| Settings the document names | Rule .08 names no facility type; it names “the procedural area” (p. 14). |
| Re-verification interval | Not stated. Rule .08 requires “demonstrated clinical competence” (p. 14) and attaches no interval to it — though the chapter attaches intervals to comparable requirements elsewhere (see the first question below). |
| Where the record lives | Not stated for sedation training; rule .08 ties the practice to “facility policies and procedures” (p. 14). The chapter makes the nurse accountable for documentation related to “Continuing education records” (p. 7). |
| CE hours | Not stated. Chapter 610-X-6 sets no contact-hour count and no renewal-CE requirement for sedation; the word hour does not appear in it. It requires an “organized program of study” (p. 14) without sizing it. |
What Rule 610-X-6-.08 says
After patient assessment and verification of the required presence in the procedural area, “the registered nurse may administer ordered medications for the purpose of inducing moderate sedation that allows the patient to be aroused and to retain reflexes for short-term therapeutic or diagnostic procedures, pursuant to facility policies and procedures” (p. 14). The “minimum training for the registered nurse managing the care of patients receiving moderate sedation shall include” (p. 14) six subjects:
- “Anatomy, physiology, pharmacology, cardiac arrhythmia recognition, and complications related to sedation and medications” (p. 14).
- “Total patient care requirements to be assessed during moderate sedation and recovery, including but not limited to the following physiologic measurements” (p. 14) — respiratory rate, oxygen saturation and blood pressure (p. 14), cardiac rate and rhythm and level of consciousness (p. 15).
- “Principles of oxygen delivery, respiratory physiology, transport, uptake and demonstration of the ability to use oxygen delivery devices” (p. 15).
- Anticipation and recognition of potential complications of sedation in relation to the type of medication being administered (p. 15).
- “Requisite knowledge and skills to assess and intervene in the event of complications or undesired outcomes and to institute nursing interventions, in compliance with orders or institutional protocols or guidelines” (p. 15).
- “Demonstration of skill in airway management resuscitation” (p. 15).
Rule .08 also names a credential — “The registered nurse shall have advanced cardiac life support (ACLS) or comparable certification” (p. 15) — and a dedicated attendant: “The registered nurse managing and monitoring the patient receiving moderate sedation shall have no other responsibilities during the procedure that would leave the patient unattended or compromise continuous monitoring” (p. 15). The monitoring duty is wider than its list: the nurse “shall ensure safety considerations, including but not limited to continuous monitoring of” (p. 15) blood pressure, cardiac rate and rhythm, continuous intravenous access, level of consciousness, oxygen saturation and respiratory rate (p. 15). Six parameters are named; the duty is not limited to them. Entry is stated in the negative: the nurse may not administer without both the “Physical presence of a physician, dentist, or certified registered nurse anesthetist and licensed or unlicensed assistive personnel” (p. 15) and the “Immediate availability of monitors, defibrillator, airway devices including suction, and emergency medications” (p. 15).
“The minimum requirements for a registered nurse to perform moderate sedation and associated monitoring includes; successful completion of an organized program of study, supervised clinical practice, and demonstrated clinical competence.”
Alabama Board of Nursing — Ala. Admin. Code r. 610-X-6-.08(2), Standards For Moderate Sedation (Chapter 610-X-6, p. 14; punctuation as printed)
What an Alabama facility should be able to show
Rule .08 translates into three records an Alabama facility should be able to produce:
- The sedation policy, staffing and equipment the rule conditions the practice on — administration “pursuant to facility policies and procedures” (p. 14), the limit on the monitoring nurse’s other responsibilities (p. 15), the duty to ensure “safety considerations, including but not limited to continuous monitoring of” six named parameters (p. 15), and .08(7)’s presence and immediate-availability conditions (p. 15).
- Per-nurse evidence of the organized program of study — the instruction itself, against the six training subjects (pp. 14–15). The chapter’s definition: “An organized sequence of learning activities that provides the instructional foundation (didactic and clinical) for participants to achieve the desired learning outcomes in a given subject matter” (p. 3). That foundation is didactic and clinical: the course and its certificate evidence the didactic side; the clinical instruction happens where the nurse practises.
- Per-nurse evidence of supervised clinical practice, demonstrated clinical competence, and the ACLS or comparable certification .08(6) requires (pp. 14–15) — the hands-on half, defined as practising the skill under a qualified instructor’s supervision (p. 3), plus the card.
The CSRN™ course — 10 CE contact hours developed and delivered by Capt. M. Ron Eslinger, CRNA, with module exams, case studies and a certificate ID your credentialing office can verify — is built to be record 2 on that list. Facility seats and roster tracking →
Questions Alabama facilities ask
Does Rule 610-X-6-.08 set an interval for re-verifying sedation competency?
No. It requires “demonstrated clinical competence” (p. 14) and attaches no interval to it. The chapter attaches intervals elsewhere: § 610-X-6-.13(3) requires, for wound care beyond basic education, “successful completion of an organized program of study, supervised clinical practice, and demonstrated clinical competence, initially and at periodic intervals” (p. 22); § 610-X-6-.14(2) states the same three requirements for the LPN performing intravenous therapy, again with “initially and at periodic intervals” (p. 23). Rule .08(2) sets out those same three requirements for the registered nurse and stops before the interval clause; the interval you write into your sedation policy is your own.
Does Alabama require the CSRN™ course specifically?
No. Rule .08 requires no particular moderate sedation course and names no provider or curriculum for one — though .08(3) does set out six training subjects (pp. 14–15) — and no state mandates this specific course. The credential it does name, ACLS or comparable certification (p. 15), is a separate record, and this course is not that card. For sedation education .08 names a category — “successful completion of an organized program of study” (p. 14); the supervised clinical practice and demonstrated clinical competence it names alongside stay with your facility, as does the certification.
Does the rule name any drug, or address sedation deeper than moderate?
Rule .08 names no drug. It speaks of “ordered medications” (p. 14) and “emergency medications” (p. 15). The phrase deep sedation does not appear anywhere in Chapter 610-X-6. The practice .08 authorises is the one the chapter defines: sedation that retains “the patient’s ability to maintain a patent airway, respiratory rate, and rhythm” (p. 2). That boundary is also the boundary of this course: it addresses moderate sedation, not deeper levels.
Compliance note (last reviewed September 2026): This page is educational information about Ala. Admin. Code ch. 610-X-6 and rule 610-X-6-.08, not legal advice or a compliance determination. Every quotation was checked word-for-word against the 28-page chapter PDF served by the Alabama Legislature’s administrative-code service on 2026-09-02, which is stamped “Supp. 11/13/23”; page numbers refer to that PDF. Rules are amended and re-supplemented; confirm the current text and your own facility policy before relying on this summary. No state mandates this specific course.