Missouri’s Board of Nursing does address sedation in rule. In the chapter that governs intravenous therapy it does so once, in a single sentence, and as a prohibition aimed at practical nurses: section (7) of 20 CSR 2200-6.030 bars named categories of practical nurse from ten duties “under any condition” (p. 4), the tenth being “Administer intravenous medications for procedural sedation/anesthesia or deep sedation” (p. 4). For the RN who administers moderate sedation it sets no training, monitoring or re-verification standard; the phrase moderate sedation does not appear in it.
Missouri at a glance
| Board | Missouri State Board of Nursing (p. 2) |
| Document | “Chapter 6—Intravenous Infusion Treatment Administration” (p. 2) of the Missouri Code of State Regulations, edition stamp “John R. Ashcroft (5/31/24)” (p. 1). Page numbers count that PDF’s sheets, not its printed folios (p. 4 here is printed 5). |
| Rule it is | It is the rule — five rules, 20 CSR 2200-6.020 to 6.060 (p. 1), sedation at 6.030(7)(J), issued under “section 335.017, RSMo 2016, and section 335.036, RSMo Supp. 2023” (p. 4). |
| Status | Regulation with the force of law, not guidance: codified text in the “CODE OF STATE REGULATIONS” (p. 1), imperative throughout — “shall only perform” (p. 3) for the qualified practical nurse, “shall not, under any condition” (p. 4) for the sedation item. No advisory disclaimer. |
| Dates | “Original rule filed Sept. 1, 2005, effective April 30, 2006” (p. 4), amended repeatedly since, most recently “Amended: Filed Jan. 5, 2024, effective June 30, 2024” (p. 4). Edition stamp “(5/31/24)” (p. 1). |
| Who it covers | “qualified practical nurses” (p. 3) — graduate practical nurses inside the time frame it cross-references, temporary-permit holders, and currently licensed Missouri practical nurses, “unless specifically stated otherwise within the text of the specific rule” (p. 3). Registered professional nurses appear in defined roles of their own, among them supervising that work (p. 3). |
| Who it does not cover | Addressed to three categories of practical nurse, quoted in full below (p. 4); registered professional nurses are not among the licensees it names, and no other provision attaches a sedation condition to an RN. On whether an RN may administer these medications the chapter is silent — authority in neither direction. |
| Settings the document names | Named once, and not about sedation: clinical sites for the practical nurses’ IV course “may include, but are not limited to” (p. 5) acute care, long-term care, ambulatory care and community agencies that provide IV infusion treatment. No sedation setting is named; hospital does not occur in the chapter. |
| Re-verification interval | Not stated. The chapter attaches no interval, expiry or re-check to the “documented competency verification by the individual’s employer” (p. 3) it requires before certain practical-nurse functions; nor would re-verification reach the sedation item, barred “under any condition” (p. 4). |
| Where the record lives | The chapter names the verifier — “the individual’s employer” (p. 3) — and no file, custodian or retention period. The record duties it does impose fall on the IV-course provider (p. 5). No sedation record is named in the chapter. |
| CE hours | Not stated: no continuing-education hours and no contact-hour count for any nurse, and the words continuing education do not appear in the chapter. Its nearest ongoing education duty is addressed to the practical nurse, not the RN — at 6.030(2)(B), “ongoing, documented” specialized knowledge, education, skills, training, judgment and experience in IV work (p. 3), with no hours, provider or interval named. |
What 20 CSR 2200-6.030 says
The rule grades what a qualified practical nurse may do, each step conditioned on “documented competency verification by the individual’s employer” (p. 3), and then sets a ceiling: ten duties barred outright — administering chemotherapy, beginning a transfusion, accessing an implanted port, neonatal IV therapy, thrombolytics and, last, the sedation item (p. 4):
“Graduate practical nurses, IV-Certified licensed practical nurses, and licensed practical nurses who hold an active multistate license to practice under the nurse licensure compact shall not, under any condition, perform the following functions or duties”
“(J) Administer intravenous medications for procedural sedation/anesthesia or deep sedation.”
Missouri Code of State Regulations — 20 CSR 2200-6.030(7) and its item (J), Chapter 6, Intravenous Infusion Treatment Administration (Secretary of State PDF, p. 4)
The rule fixes a licence-level bar — a nurse holding one of those three credentials may not push IV medication for procedural sedation — and points instead at the employer’s own lawful written policy, at (2)(E) for the practical nurse and at (3)(C) for the RN (p. 3). But section (3) is addressed only to the RN who directs and supervises qualified practical nurses in IV work (p. 3), so it does not reach the RN on a sedation case where no qualified practical nurse is involved.
Two cautions. The chapter points six times to “20 CSR 2200-5.010” (p. 3), rescinded effective November 30, 2018 (paraphrased from the Chapter 5 PDF). And Chapter 6 is not the Board’s only rule using the word: paraphrased from 20 CSR 2200-4.200, a collaborative practice arrangement may not delegate authority to administer certain controlled substances to induce sedation or general anesthesia — not an RN sedation standard.
What a Missouri facility should be able to show
Missouri’s rule gives a ceiling and a pointer — which licences may not administer IV sedation medication, and employer policy for the rest. Three records carry it:
- Your written moderate-sedation policy, dated and approved — and the roster it governs. The chapter conditions lawful practice on the employer’s lawful written policies and procedures, for the practical nurse and for the RN who directs and supervises that nurse’s IV work (p. 3); the policy does the work Chapter 6 does not. The roster makes the rule’s own line checkable: none of those three practical-nurse categories assigned to administer IV medications for procedural sedation (p. 4).
- Per-nurse evidence of initial education and training for every RN who administers or monitors moderate sedation — Chapter 6 states none for the RN, so it is evidence you generate, not evidence you cite to a rule.
- Per-nurse evidence of ongoing competence, on an interval your own policy names — this chapter sets none, for any nurse, for any task.
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 Missouri facilities ask
Does Missouri set a renewal interval for sedation competency?
No. Chapter 6 sets none, and it sets no continuing-education hours for anyone. The only duty in it that recurs on a calendar is an IV-course provider’s annual report to the board (p. 6) — about a course, not a nurse’s skill. The interval in your policy is your own; a certificate with an expiry date makes it visible on the roster.
Does Missouri require the CSRN™ course specifically?
No. Chapter 6 requires no course of a registered nurse at all, and no state mandates this specific one. The only course it regulates is the practical nurse’s IV-certification course (p. 5). It names no sedation training for the RN, so it carries no approved-provider list for one. CSRN™ is designed to serve as the evidence your own policy calls for — a named credential, assessed competency and an employer-verifiable certificate ID.
The rule bars practical nurses from IV sedation medications. Does that make it an RN task?
Not on the strength of this rule. 20 CSR 2200-6.030(7)(J) is a prohibition, and a prohibition on one licence is not a grant to another: the chapter sets no RN sedation standard and nowhere says that a registered nurse may administer these medications. Paraphrased, § 335.016(16)(c), RSMo puts administering medications as prescribed inside professional nursing, and § 335.017, RSMo — a section this rule is issued under (p. 4) — provides that nothing in it is to be construed as prohibiting registered professional nurses from administering intravenous fluid treatment. Neither mentions sedation; the word does not occur in the Revisor of Statutes’ current text of Chapter 335, RSMo. Your facility answers that question, not the Board.
Compliance note (last reviewed September 2026): This page is educational information about Missouri’s 20 CSR 2200-6, not legal advice or a compliance determination. Every quotation was checked against the Secretary of State’s current-edition PDF on 2026-09-02. Three other Missouri documents — §§ 335.016 and 335.017, RSMo, 20 CSR 2200-5.010 and 20 CSR 2200-4.200 — are paraphrased here, quoted nowhere, all checked the same day. Chapters 1, 2, 3, 7 and 8 of Division 2200 were not read for this page, so treat statements here as findings about the documents named, not about every rule the Board publishes. Confirm the current edition and your own facility policy before relying on this summary. No state mandates this specific course.