Authorized agent-controlled analgesia (AACA) can be implemented to provide prompt, safe, and effective pain relief for the patient who, because of cognitive or physical limitations, is unable to self-administer analgesics using an analgesic pump (Benjenk et al., 2020; Cooney et al., 2013; Gorski et al., 2021). Use the following tips as guidelines to ensure optimal patient comfort and safety when caring for patients receiving AACA.

• Limit the number of authorized agents to one at a given time; alternative authorized agents may be designated to provide respite and/or coverage.
• Use standard AACA medical order sets.
• Provide patient and family/caregiver education regarding the principles of AACA, requirements of an authorized agent, specific policies and procedures related to AACA, and the negative consequences of unauthorized activation of the analgesic infusion pump dosing button.
• Document the identity of the authorized agent(s) and caregiver-authorized agent, as well as education provided and feedback.
• Ensure that authorized agents only activate the dosing button if the patient is awake and/or the patient's words or behavior indicate that the patient is in pain or pain is anticipated. Authorized agents should verbalize an understanding of how to recognize pain, sedation, and respiratory depression.

Source: Adapted with permission from Cooney, M. F., Czarnecki, M., Dunwoody, C., Eksterowicz, N., Merkel, S., Oakes, L., & Wuhrman, E. (2013). American Society for Pain Management nursing position statement with clinical practice guidelines: Authorized agent controlled analgesia. Pain Management Nursing, 14(3), 176-181. https://doi.org/10.1016/j.pmn.2013.07.003