As the health care industry’s most comprehensive library of customizable policy and procedure templates, MCN Healthcare’s Outpatient Surgery and Ambulatory Services Policy and Procedure Manual includes this customizable template, Sedation Monitoring Form. MCN’s policy library helps you meet compliance with Joint Commission and federal regulations including CMS, CDC, OSHA, OIG, HIPAA and more.

MCN’s templates save you time, money and resources, rather than developing healthcare policy and procedure manuals from scratch.

Here is some sample content from Sedation Monitoring Form:

	SEDATION MONITORING Patient Name: PREPROCEDURE ASSESSMENTArrival Date: Time: Time MD Notified: ? Patient ID Explanation of procedure/sedation given: ? Yes Patient accepts plan for sedation: ? Yes Patient to be discharged to care of: Possibility of pregnancy? Preg. test results: Diagnosis: Chief Complaint: Continuous IV inf. Solution Rate Cath Site Time: Signature: T P R B/P O2 Sat LOC Height Weight Allergies: Current Meds/Supplements: Type sedation planned: ASA Class by MD: RespiratoryCardiovascularNeurologicalPsychological? Regular? ...
Second excerpt:
	...Locked Safety Belt Padded Boney Prominence Gonadal ShieldBody Wt: Bolus: Cont. Infusion: Procedure Performed: Procedure Started: Procedure Ended: Monitored By: Assisted By: MD: Sent to Lab - Pathology: PAIN MANAGEMENT:Epidural Test Dose at TimeTrigger Points:FACET BLOCK: Cervical Thoracic LumbarXylocaine 1.5% MPF Epinephrine 1:200,000 1.5 mL ? Negative ? Positive Left POST PROCEDURE MONITORINGTo PACU at timeTimeBPPRO2 SatPatient Response/LOCInterventionPatient Transferred...