Sara Jo Randolph, CRNFA Degrees and Certifications: Associate of Science in Nursing: 1976 Central Florida Community College Certified Nurse Operating Room (CNOR): 1994 Registered Nurse First Assistant (RNFA): 1995 Areas of Practice as RNFA: Obstetrics and Gynecology: 1979-88 Plastic Surgery: 1988-90 General Surgery: 1988-95 Orthopaedics (Dr Duke): 1995-present What is a CRNFA? The RNFA is a perioperative registered nurse who works in collaboration with the surgeon and health care team members to achieve optimal patient outcomes. The RNFA must have acquired the necessary knowledge, judgment, and skills specific to the expanded role of RNFA clinical practice. Intraoperatively, the RNFA practices at the direction of the surgeon and does not concurrently function as a scrub nurse. There were 1,591 CRNFAs as of January 1, 2007 Scope of Practice Examples of RNFA behaviors in the perioperative arena include: PREOPERATIVE patient management in collaboration with other health care providers, including but not limited to: Performing preoperative evaluation/ focused nursing assessment Communicating/collaborating with other health care providers regarding the patient plan of care Writing preoperative orders according to established protocols; Intraoperative surgical first-assisting, including but not limited to: Using instruments/medical devices Providing exposure Handling and/or cutting tissue Providing hemostasis Suturing POSTOPERATIVE patient management in collaboration with other health care providers in the immediate postoperative period and beyond, including but not limited to: Writing postoperative orders/operative notes according to established protocols, Participating in postoperative rounds Assisting with discharge planning and identifying appropriate community resources as needed. Preparation of the RNFA Development of this set of behaviors begins with and builds upon the education program leading to licensure as an RN, which teaches basic knowledge, skills, and attitudes essential to the practice of perioperative nursing. Further preparation for the RNFA includes perioperative nursing practice with diversified experience culminating in the nurse achieving CNOR certification through the Competency and Credentialing Institute (CCI). Additional preparation is then acquired through completion of an RNFA program that meets the AORN standards for RN first assistant education programs and is accepted by CCI. These programs should be equivalent to one academic year of formal, post-basic nursing study; consist of curricula that address all of the modules in the Core Curriculum for the RN First Assistant; and award college credits and degrees or certificates of RNFA status upon satisfactory completion of all requirements. The RNFA programs should be associated with schools of nursing at universities or colleges that are accredited for higher education by an accrediting agency that is nationally recognized by the Secretary of the US Department of Education. The registered nursing program should be approved by a state licensing jurisdiction for nursing programs at the university, college, or community college level or by another national or regional agency that is nationally recognized by the Secretary of the US Department of Education as a specialized accrediting agency for nursing programs. Each RNFA demonstrates behaviors that progress on a continuum from basic competency to excellence. When educational and experiential requirements have been met, the RNFA is encouraged to achieve and maintain certification status (CRNFA) through CCI, an independent entity. Qualifications For Entry Into A RNFA Practice: AORN believes the minimum qualifications to practice as a RN first assistant are as follows: Certification in perioperative nursing (CNOR) Successful completion of an RNFA program that meets the AORN standards for RN first assistant education programs and is accepted by CCI Compliance with statutes, regulations, and institutional policies relevant to RNFAs.