Ohio guides RN moderate sedation through a Board of Nursing interpretive guideline rather than a task-specific rule — in the Board’s own words, “In this statement the Board does not announce a new rule but instead gives licensees specific guidelines regarding their obligations under existing law” (§ Accountability). It sets out when administering sedating medications and monitoring the sedated patient falls within RN scope, lists what an RN’s education/training and demonstrated competence should include, and draws a line at deep sedation and anesthesia for the RN who is not a CRNA. Everything below is quoted or paraphrased from the Board’s web page, cited by its own section headings.
Ohio at a glance
| Board | Ohio Board of Nursing |
| Document | Interpretive Guideline, Registered Nurse Care of Patients Receiving Intravenous Moderate Sedation for Medical and/or Surgical Procedures — a web page on nursing.ohio.gov, not a PDF, so there are no page numbers. Citations here are to its own headings: § Preamble, § Guidelines, § Considerations, § History and § Accountability (short for Accountability and Responsibility of Nurses). |
| Rule it applies | The Nurse Practice Act (Chapter 4723, ORC) and the nursing rules (Chapters 4723-1 to 4723-27, OAC). Licensees are told to review Section 4723.01, ORC; Rules 4723-4-03 and 4723-4-06, OAC; Chapter 4731-25, OAC (Office Based Surgery); and the Board’s Utilizing Interpretive Guidelines (§ Accountability). On deep sedation and anesthesia it points to Rule 4731-25-01(C-D), OAC (§ Guidelines). It does not describe what any of those contains. |
| Status | Interpretive, not a rule — the Board’s own words are quoted above (§ Accountability). The law it interprets binds the nurse: “The RN must apply the Nurse Practice Act (Chapter 4723, ORC) and rules regulating the practice of nursing (Chapters 4723-1 to 4723-27, OAC) to the specific practice setting” (§ Accountability). Inside the guideline the operative verbs are may, should and should not; shall does not appear. |
| Dates | Approved July 20, 2007 · revised March 16, 2016 · revised July 23, 2020 · reapproved March 27, 2024 · reviewed May 27, 2026 (§ History). No effective date and no review cadence are stated. |
| Who it covers | The RN — “the registered nurse (RN) responsible for monitoring the patient during the procedure” (§ Preamble), and the RN administering sedating medications for procedural moderate sedation (§ Guidelines). The deep-sedation line is addressed to “an RN who does not hold an APRN License with the designation CRNA” (§ Guidelines). |
| Who it does not cover | Two circumstances are carved out: the guideline “is not meant to include the provision of nursing care within a medical mobile transport unit and in clinical circumstances where the patient is intubated, or is being emergently intubated, and ventilated” (§ Preamble). LPNs are not addressed — the letters appear only in the name of the Board’s “OBN RN and LPN Decision Making Model” (§ Accountability). CRNAs appear only as the exception to the deep-sedation line. |
| Settings the document names | It does not list practice settings. It conditions RN sedation practice on “a supportive clinical environment that contains appropriate monitoring capabilities and the availability of the necessary health care personnel and equipment to address complications” (§ Guidelines). Named are the institution and its credentialing requirements, privileges and policy (§ Guidelines; § Considerations); office-based surgery under Chapter 4731-25, OAC (§ Guidelines); and, in the exclusion above, “a medical mobile transport unit” (§ Preamble). |
| Re-verification interval | Not stated. The RN “should maintain documentation of his/her acquisition of education, demonstrated competency” (§ Considerations); the guideline names no interval, renewal or re-demonstration. |
| Where the record lives | With the RN — it is the nurse who “should maintain documentation” of education, demonstrated competency and “other documentation that ensures practice is in compliance with the standards of safe nursing practice” (§ Considerations). Employer record-keeping is not addressed; “employer/institutional policy” appears only as the source of the RN’s responsibilities “prior to, during, and following the procedure” (§ Considerations). |
| CE hours | Not stated. No contact-hour count, named course or renewal-CE requirement appears; the guideline describes what the RN’s “education/training and demonstrated competence should include” (§ Considerations), not hours. |
What the Ohio Board of Nursing says
The guideline is conditional from its first operative sentence: administering sedating medications and monitoring the sedated patient “may be within the scope of registered nursing practice if the following guidelines are observed” (§ Guidelines), in circumstances where patient safety “can be ensured through a supportive clinical environment” (§ Guidelines). Paraphrased, the RN may execute the regimen “with a valid authorized provider order”, and in executing it should monitor the patient’s hemodynamic, respiratory, mobility and consciousness/pain parameters, communicate changes in patient status, implement emergency measures “until other qualified healthcare personnel assume care of the patient”, and “maintain continuous intravenous access” (§ Guidelines). The nurse doing the monitoring “should not engage in other activities that would divert the nurse’s attention from the patient” (§ Preamble) — a should not, with no nurse-to-patient ratio and no second nurse named.
The passage this page turns on is the education-and-competency list. The RN’s “education/training and demonstrated competence should include the following”: “age-specific physiologic parameters” covering “oxygen delivery, transport and uptake”, “airway management”, “utilization of appropriate monitoring modalities, infusion devices, and emergency equipment” and “cardiac arrhythmia recognition and intervention”; “indications, contraindications, and potential complications related to moderate sedation/analgesia including recognition of deep sedation”; “pharmacology pertaining to age-appropriate and weight-appropriate medications used for moderate sedation/analgesia and their respective reversal agents”; and “RN responsibilities prior to, during, and following the procedure that requires moderate sedation/analgesia as defined in employer/institutional policy” (§ Considerations). It follows the sentence an educator will be asked about:
“The RN providing care to patients receiving intravenous moderate sedation/analgesia should maintain documentation of his/her acquisition of education, demonstrated competency, and other documentation that ensures practice is in compliance with the standards of safe nursing practice.”
Ohio Board of Nursing — Interpretive Guideline (§ Considerations; reapproved March 27, 2024, reviewed May 27, 2026)
What an Ohio facility should be able to show
The guideline addresses the nurse, not the employer, and its documentation sentence names three things: education, demonstrated competency and “other documentation” (§ Considerations). They translate into three records:
- The framework each regimen runs under — the “other documentation that ensures practice is in compliance with the standards of safe nursing practice” (§ Considerations): your “employer/institutional policy” defining the RN’s responsibilities “prior to, during, and following the procedure” (§ Considerations), and “a valid authorized provider order” for the regimen (§ Guidelines).
- Per-nurse documentation of education/training covering the four content areas the guideline lists (§ Considerations).
- Per-nurse documentation of demonstrated competency — the guideline’s phrase is “demonstrated competency” (§ Considerations), and for anesthetic agents “the necessary knowledge and competency” (§ Guidelines) — on an interval your own policy names; the guideline 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 Ohio facilities ask
Does Ohio set a renewal interval for sedation competency?
No. The guideline asks the RN to “maintain documentation of his/her acquisition of education, demonstrated competency” (§ Considerations) and is silent on how often either is refreshed — no interval, no renewal, no contact-hour count. The interval you write into your policy is your own.
Does Ohio require the CSRN™ course specifically?
No. The guideline names no course at all, and no state mandates this specific one. It describes content instead: what the RN’s “education/training and demonstrated competence should include” (§ Considerations). CSRN™ is designed to serve as that evidence — a named credential, assessed competency and an employer-verifiable certificate ID.
Can an Ohio RN administer an anesthetic agent for moderate sedation?
The guideline says the RN “who has acquired the necessary knowledge and competency” may, “in the presence of the authorized provider who” has institutional privileges/credentials for anesthetic agents in procedural moderate sedation or adheres to Chapter 4731-25, OAC (§ Guidelines). No drug is named anywhere in it. The RN without a CRNA designation “should not” administer medications “to induce deep sedation and/or anesthesia (see Rule 4731-25-01(C-D) OAC)” or “independently select the medication or dosage to induce deep sedation or anesthesia to be administered during a procedure” (§ Guidelines).
Compliance note (last reviewed September 2026): This page is educational information about the Ohio Board of Nursing’s interpretive guideline on RN care of patients receiving intravenous moderate sedation, not legal advice or a compliance determination. Every quotation was checked word-for-word against the Board’s web page (reapproved March 27, 2024; reviewed May 27, 2026) on 2026-09-01; section references are to that page’s own headings. The guideline states no review cadence; confirm the current version and your own facility policy before relying on this summary. No state mandates this specific course.