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Patient Safety Tool: Pre-Procedure Evaluation Template for Procedures Requiring Moderate Sedation

The VA National Center for Patient Safety has developed a free, downloadable pre-procedure evaluation template for procedures that require moderate sedation.

The template identifies key features of patient evaluation that should be performed prior to beginning such procedures.

Download the pre-procedure evaluation template (pdf) for adaptation and use in your facility.

Note: View our database providing more than 125 reports that link to free, downloadable and adaptable tools for use in surgery centers, hospitals and other organizations by clicking here.

Related Articles on Moderate Sedation:

How to Peer Review an RN Performing Moderate Sedation

In-Office vs. ASC Reimbursement for Moderate Sedation During Pain Management Procedures

Staff Education Tool: Moderate Sedation Study Aid Poster

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