The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse (RN) or an Advanced Practice Registered Nurse (APRN) who functions in an expanded role as a surgical first assistant. The RNFA works in collaboration with the surgeon and other health care team members to achieve optimal patient outcomes; utilizes the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice; and practices intraoperatively at the direction of the surgeon” (AORN, 2015).
The RNFA role is recognized within the scope of nursing practice by the nurse practice acts in all 50 states and may vary depending on patient populations, the environment in which the RNFA practices, services provided, availability of fiscal resources including reimbursement policies, and institutional credentialing regulations. (AORN, 2015).
The graduate of the RNFA program will be able to:
1. Explore potential surgical hazards and safety measures to prevent injury including patient and occupational related hazards.
2. Explain the design and use of key surgical instruments used for surgical procedures.
3. Demonstrate knowledge of common surgical procedures incorporating an understanding of anatomy, physiology and pathophysiology.
4. Demonstrate proper sequence of procedures, assisting behaviors, operative technique and knowledge of potential complications related to the surgical procedure.
5. Exhibit proper handling and knowledge of surgical instruments and medical devices, providing surgical site exposure, handling tissue, cutting tissue, providing hemostasis, suturing, and wound management.
6. Develop a continuous and applicable nursing assessment, plan of care and patient evaluation throughout the perioperative period in collaboration with other health care providers.
7. Document intraoperative patient management in the surgical first-assisting clinical experience.
8. Document postoperative patient management such as participation in postoperative rounds and assisting with discharge planning including identification of appropriate community resources intraoperative clinical experiences precepted by Board-Certified Surgeons.
Admission Process and Minimum Requirements
Applicants must have (1) current RN license, (2) BCLS, ACLS (preferred), (3) minimum cumulative GPA of 3.0 AND (4) one of the following:
*BSN or proof of current enrollment in a RN to BSN program (CNOR/CNOR eligible)
*RN with APRN certification
*RN currently enrolled in APRN program
To be awarded a Certificate of Completion, the student must successfully complete the 3 RNFA courses (9 credits).
Out-of-state students pay in-state fees. Students accepted into certificate programs are not eligible for federal financial aid.
See complete admission requirements on Nursing CAS at NursingCAS.org
Technical & Performance Standards
Students in the RNFA certificate program must meet the Technical and Performance Standards expected of all students in the College of Nursing educational programs. In addition, RNFA program students are expected to possess the mental, auditory, visual, sensory, strength, manual dexterity, and communication skills to:
- Manage common, acute, and life-threatening problems encountered with patients in the perioperative setting.
- Nurture interprofessional relationships that promote optimal patient care.
- Collaborate with the surgeon and other interprofessional team members to achieve optimal patient outcomes.
- Develop the necessary knowledge, judgement, and skills specific to the expanded role of RNFA clinical practice.
- Utilize evidence-based care for meeting the needs of perioperative patients.
- Performs comprehensive health assessments of perioperative patients.
- Fosters patient advocacy and safety.
CCI (Competency & Credentialing Institute) determines acceptability of CRNFA acceptable programs.
Classroom, Clinical and Lab Hours per Credit
The clinical and laboratory hour per credit hour ratio in courses taught in the certificate program is 4:1. Thus, 1 credit equates to 60 hours of clinical or laboratory experience over the course of the term, as well as additional student effort of approximately 30 hours related to preparation for the clinical and laboratory experiences. For didactic courses, a traditional 3 credit-hour course using a face-to-face lecture format involves approximately 45 contact hours as well as 90 or more hours of additional student effort over the course of the term. For didactic courses taught online or using a hybrid format, a 3 credit-hour course would involve at least 135 hours of student effort over the term.