How to NAPS: A Discussion of the Safety and Implementation of a Nurse Administered Propofol Sedation (NAPS) Program

Anesthesia shortages impact patient accessibility to endoscopy procedures. The administration of midazolam and fentanyl by a nurse is an accepted practice of delivering procedural sedation, though there is still controversy around the safety of a nurse administered propofol sedation (NAPS) program. Applicable professional organizations have provided statements supporting NAPS by a trained and competent nurse under the direction of an appropriately credentialed proceduralist. Research demonstrates the safety of NAPS in comparison to procedural sedation provided by anesthesia personnel or administration of midazolam and fentanyl by a nurse. Research shows that patients, providers, and health care organizations can see procedural and financial benefit of implementing a NAPS program. An outline of implementation and development of a NAPS program is presented covering equipment, supplies, resources, provider credentialing, nurse education and training requirements, patient eligibility criteria, propofol administration order sets, and a quality assurance program.