Developed By: Committee on Pain Medicine
Last Amended: October 16, 2013 (original approval: October 16, 2002)
The management of acute and chronic pain via continuous epidural, intrathecal and peripheral nerve catheter techniques is safe and effective. In order to provide optimum patient care, it is essential that registered nurses participate in the management of these analgesic modalities. This is the current and established standard of care.
A registered nurse (RN) qualified by education, experience, credentials and on-going competency assessment who follows a patient-specific protocol written by a qualified physician should, under the direction of a physician, be allowed to:
- Initiate, adjust and discontinue catheter infusions,
- Administered analgesic boluses through the catheter as prescribed by a physician,
- Replace empty medication syringes and bags with new pre-filled syringes and bags using proper aseptic technique,
- Monitor the catheter insertion site,
- Remove the catheter,
- Monitor the patient for analgesic efficacy and side effects,
- Treat analgesic-related side effects.
The role of the RN in actively and safely participating in these aspects of acute and chronic pain management has been well-established. Major nursing organizations strongly support involvement of the RN in these specific aspects of continuous regional analgesia. Their participation in small community hospitals, large medical centers, hospices, long-term care centers and patient homes has contributed significantly to the success of these techniques in the management of pain. The RN has been active in all aspects of established catheter and infusion care in all settings where the techniques are employed, including the post anesthesia care unit, intensive care unit, hospital ward and within the outpatient setting.
The safe and excellent pain control achieved by this team approach to pain care has been thoroughly evaluated by scientific study published in peer-reviewed literature and has become well established in routine clinical practice throughout the world.
Refer to the “Statement on Pain Relief During Labor” (Committee of Origin: Obstetric Anesthesia) for the role of registered nurses in the management of continuous regional analgesia in labor and delivery units.