Kentucky guides nurse-administered procedural sedation through a Board of Nursing advisory opinion rather than a Board of Nursing regulation of its own — in the Board’s own words, an opinion “is not a regulation of the Board and does not have the force and effect of law” (p. 1). Advisory Opinion Statement #32 says which nurses may administer medications for procedural sedation and analgesia, draws a hard line at anesthesia, and says facilities should have “an educational and/or credentialing mechanism” for documenting nurse competency (p. 4). This page draws only on the document’s procedural sedation and analgesia sections (pp. 2–5), the scope grid (p. 8), the scope-determination note (p. 9) and document-level facts; everything below is quoted or paraphrased from the Board’s PDF marked Revised 10/2025, with page numbers.
Kentucky at a glance
| Board | Kentucky Board of Nursing |
| Document | Advisory Opinion Statement #32, The Role of Nurses in Procedural Sedation, Regional Anesthesia, and Analgesia, and Airway Management in Various Settings — 10 pages, marked “(Revised 10/2025)” (p. 1). (The URL’s file name still says chest-tube-removal; this revision has no chest-tube section.) |
| Rule it applies | Issued under KRS Chapter 314; applies KRS 314.021(2) (decisions based on the nurse’s educational preparation and current clinical competence) and KRS 314.011, under which “the administration of medications is within the scope of practice of nurses in Kentucky” (pp. 1–2). Names 201 KAR 8:550, 902 KAR 20:106 and 902 KAR 20 without restating them (p. 2), and Advisory Opinion Statement #41 for scope determinations (p. 9). |
| Status | Advisory: not a regulation of the Board, without the force and effect of law, and “issued as a guideline to licensees who wish to engage in safe nursing practice” (p. 1). The statute beneath it binds: KRS 314.021(2) “requires licensees to practice nursing with reasonable skill and safety” (p. 1). The RN best-practice list is written in must-statements (p. 4) — inside an advisory opinion, Board guidance on safe practice, not regulation. |
| Dates | “Approved Date: 4/1995” (p. 1), revised thirteen times since, most recently 10/2025, plus five editorial revisions. Effective date: not stated. Review cycle: not stated. |
| Who it covers | The RN “who is educationally prepared and currently clinically competent” may “administer medications for procedural sedation and analgesia” (p. 3); a non-CRNA APRN may “prescribe and administer medications for moderate procedural sedation/analgesia” when “educationally qualified and clinically competent” (p. 4). LPNs are addressed only to be excluded from intravenous push or bolus sedation (p. 3). |
| Who it does not cover | “the advanced practice registered nurse designated as a certified registered nurse anesthetist (CRNA) functioning within his/her authorized scope of practice” and “the nurses administering for deep sedation/analgesia in ventilator patients in the acute care setting” (p. 2). Drug choice too: “It is not within the authority of the Board to determine how or for what purpose a specific drug is being administered” (p. 3). |
| Settings the document names | Procedural sedation and analgesia are “primarily used for noninvasive and minimally invasive procedures outside the operating room, including emergency departments, dentistry, radiology, gastrointestinal endoscopy, obstetrical suites, outpatient clinics, psychiatric clinics, pain clinics, special procedure areas, in-home, and hospice” (p. 2). |
| Re-verification interval | Not stated. The opinion asks for “current clinical competence” (p. 2) and “documented competency” (p. 4) and a facility process for evaluating and documenting it (p. 4); it names no interval, renewal cycle or re-validation date. |
| Where the record lives | For the nurse, “obtaining relevant certifications within a specialty area” or “a portfolio of trainings, workshops, and continuing education that demonstrates the acquisition of additional knowledge and clinical competency in the specialty area” (p. 2). For the facility, an “educational and/or credentialing mechanism” with a “process for evaluating and documenting the nurse’s competency” (p. 4). |
| CE hours | Not stated. No contact-hour count, course length or renewal-CE requirement appears in the document. Continuing education appears once, as one ingredient of the competency portfolio (p. 2). Advanced cardiac life support is mentioned once (p. 5) — as a rescue means the nurse weighs when no reversal agent exists, not as a required card. |
What the Kentucky Board of Nursing says
The operative language is a five-point list (p. 4). Paraphrased: nurses must have the training, skills, knowledge and ability to administer these drugs safely and competently, and should know their institution’s guidelines and the nurse-anesthetist and anesthesiologist associations’ guidelines the opinion names; nurses must have “the ability to assess, interpret, and intervene in the event of complications”; nurses should refer to best practice standards and facility policy; facilities should implement policies and procedures “based on current standards of practice, accreditation standards, regulations, or other requirements” (p. 4); and:
“Facilities should have an educational and/or credentialing mechanism that includes a process for evaluating and documenting the nurse’s competency in regard to these procedures.”
Kentucky Board of Nursing — Advisory Opinion Statement #32 (Revised 10/2025, p. 4)
The best-practice list restates it for the RN: “RNs must have documented competency in administering medications for procedural sedation, including the ability to recognize and manage potential complications” (p. 4). The grid’s moderate-sedation row conditions nurse administration on a qualified healthcare provider’s order and prescription, and carries both “Must be performed under the direction of a qualified healthcare provider” and “May require direct supervision” in different cells (p. 8).
Procedural sedation is within RN scope; “the purpose of anesthesia” is not
The Board “advises it is more appropriate to focus on the level of sedation, rather than a particular medication” (p. 3), and the procedural sedation and analgesia sections name no specific agent. The line is at anesthesia, not at a drug: “It is NOT within the scope of registered nursing practice to administer medications for the purpose of anesthesia” (p. 3), and “The registered nurse has the right and obligation to refuse to administer and/or continue to administer medication(s) in amounts that may induce anesthesia” (p. 4). RNs are expected to “differentiate between minimal, moderate, and deep sedation and ensure that the patient’s level of sedation remains within the prescribed parameters” (p. 5).
What a Kentucky facility should be able to show
The opinion’s facility items and its RN best-practice list translate into three records:
- Sedation policies and procedures “based on current standards of practice, accreditation standards, regulations, or other requirements” and developed “considering the purpose and setting” (p. 4), with “oxygen delivery devices, suction equipment, and resuscitation equipment” “readily available” (p. 5).
- Per-nurse evidence of educational preparation in one of the two forms the opinion names — “relevant certifications within a specialty area” or a “portfolio of trainings, workshops, and continuing education” (p. 2) — for every RN and non-CRNA APRN who administers medications for procedural sedation.
- Per-nurse documented competency, produced by the facility’s “process for evaluating and documenting the nurse’s competency” (p. 4) and covering “the ability to recognize and manage potential complications” (p. 4) and training “in emergency procedures” (p. 4) — on an interval your own policy names; the opinion sets none.
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 records 2 and 3 on that list. Facility seats and roster tracking →
Questions Kentucky facilities ask
Does Kentucky set a renewal interval for sedation competency?
No. Advisory Opinion Statement #32 asks for “current clinical competence” (p. 2) and “documented competency” (p. 4), but names no interval and no renewal cycle. The interval is yours to set; a certificate with an expiry date makes it visible on the roster.
Does Kentucky require the CSRN™ course specifically?
No. Advisory Opinion Statement #32 requires no particular course, and no state mandates this specific one. What it describes is evidence: “relevant certifications within a specialty area” or a training-and-continuing-education portfolio as the nurse’s demonstration of preparation (p. 2), and a facility process for “evaluating and documenting the nurse’s competency” (p. 4). CSRN™ is designed to serve as that evidence.
Can a Kentucky LPN administer IV push medications for procedural sedation?
No. The Board’s opinion is that administering intravenous medications “via push or bolus for procedural sedation or analgesia or for the purpose of anesthesia” is not within the licensed practical nurse’s scope (p. 3). The procedural sedation sections describe no other LPN role — monitoring, for example, is not addressed — so anything beyond that line is a facility-policy and scope-determination question, for which the opinion points nurses to Advisory Opinion Statement #41 (p. 9).
Compliance note (last reviewed September 2026): This page is educational information about Kentucky Board of Nursing Advisory Opinion Statement #32, not legal advice or a compliance determination. Quotations and page numbers were checked against the Board’s PDF marked Revised 10/2025 on 2026-09-01. The Board has revised this opinion thirteen times since 1995 (p. 1); confirm the current revision and your own facility policy before relying on this summary. No state mandates this specific course.