Request for Clinical Privileges Registered Nurse First Assistant (RNFA)

Name: ______RN Supervising Physician: ______MD

An RNFA is a registered nurse who, through additional education and supervised clinical practice, has acquired knowledge, skills, and judgment that are specific to providing assistance during a surgical procedure as directed by the attending surgeon and as defined in standardized procedures.Performing intraoperative functions as a RNFA is limited to the direct supervision of the attending surgeon physically present in the surgical suite where the case is being performed.[1]

Applicants for the position of registered nurse first assistant (RNFA) must meet the following minimum threshold criteria:

  • Basic education: Bachelor or master of science degree
  • Minimum formal training: Successful completion of an RNFA educational training program approved by AORN that includes a didactic component and at least 120 hours of a clinical component, plus a minimum of two years of perioperative nursing experience in both a scrub and circulating role.
  • Current certification as a certified OR nurse by CCI and current RNFA certification or active participation in the certification process to be achieved within nine months of eligibility
  • Certification in CPR or basic life support
  • Current nursing licensure to practice issued by the Alabama Board of Nursing
  • Personal professional liability insurance coverage issued by a recognized company and of a type and in an amount equal to or greater than the limits established by the governing board
  • Employment by or an agreement with a physician(s) currently appointed to the medical staff

The RNFA shall not function as a scrub nurse concurrently with responsibility as a surgical first assistant.All intra-operative functions below must be performed on direction of the attending surgeon and under the direct supervision of the attending surgeon (physically present in the surgical suite where the case is beingperformed).

Privileges Eligible to be Credentialed /

Requested

To be completed by physician employer
Positioning the patient, preparing and draping the surgical site
Providing exposure, retraction, and hemostasis
Use and handling of surgical instrumentation
Tissue handling, dissection, suturing, and stapling
Making the skin nick or stab wound for laparoscopic surgery or drains excluding placement of trocar for laparoscopic access
Securing drains
Closing of wounds external to the fascia
Harvesting extremity veins and closure of the resulting wounds

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Signature, NP-Surgical Assist Date

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Signature Sponsoring Physician Date

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Signature, Section Chief Date

[1] Source: Alabama Administrative Code - ALABAMA BOARD OF NURSING. CHAPTER 610-X-2