Missouri has an approved RNFA program at Forest Park Community College
AORN recommended education standards for RN first assistant programs
The RNFA education standards are reprinted here as a resource for members who may be interested in pursuing RNFA certification to enhance their careers.
When choosing an RNFA program, prospective students are advised to use these recommended education standards to evaluate each program under consideration. Although programs meeting these standards are considered to be of high quality, there is no formal approval or accreditation process in place. Therefore, any claim that a program is “approved” or “accredited” by AORN or the RNFA Specialty Assembly is inaccurate.
I. Program Overview The RN first assistant (RNFA) program is designed to provide the experienced perioperative nurse with the advanced preparation necessary to assume the role of the first assistant. These programs are equivalent to one year of formal, academic post-basic nursing study and should consist of curriculum that address all of the content areas of the modules in the Core Curriculum for the RN First Assistant,1 take place in colleges and universities approved by appropriate regional accrediting bodies for higher education, and award college credits and degrees or certificates of RNFA status upon satisfactory completion of all requirements.
Using a multidisciplinary faculty and a variety of instructional methodologies, these programs focus on expanded perioperative nursing concepts and nursing behaviors using the nursing process as the basis for providing nursing care to patients experiencing surgical intervention. Based on the Core Curriculum for the RN First Assistant, the structured didactic and supervised clinical learning activities prepare the perioperative nurse with the cognitive, psychomotor, and affective behaviors necessary to assume the role of the first assistant.
AORN’s official statement on the role of the RN first assistant should be recognized by all schools offering RN first assistant programs.
II. Target Audience Registered nurses who practice perioperative nursing.
III. Preadmission Requirements
A. General: General preadmission requirements are facility-determined and may include:
Complete physical exam or current health record.
Complete dental exam or current dental record.
Current tetanus immunization (within a 10-year period).
Mantoux test (PPD). If Mantoux test is positive, a chest x-ray is required.
Hepatavax form—either copy of Hepatavax record or signed statement refusing Hepatavax.
Completed application and tuition fee.
Curriculum vitae or resume.
Photograph.
B. Specific, didactic: Specific didactic requirements may include the following.
Must be a registered nurse, graduated from an accredited school of nursing.
Must be licensed to practice as a registered nurse in the state in which the clinical internship will be accomplished.
Must provide proof of RN licensure.
Experience: The RNFA candidate must have a minimum of two years of recent perioperative nursing experience. This experience must include demonstrated competency in the scrubbing, circulating, or first assisting roles of the intraoperative nursing dimension.
CNOR: Must be CNOR, or CNOR eligible with CNOR status obtained before a certificate of program completion is awarded. All students must submit verification of CNOR status.
CPR: Cardiopulmonary resuscitation (CPR) or basic cardiac life support certification (BCLS) required, advanced cardiac life support (ACLS) preferred.
Recommendations: Must submit two letters of recommendation that validate:
a. One’s proficiency in the roles of scrubbing, circulating, or first assisting.
b. One’s ability to perform effectively in stressful and emergency situations.
c. One’s ability to perform effectively and harmoniously as a team member.
d. One’s ability to perform effectively as a leader.
C. Specific, clinical: Specific clinical requirements may include the following.
Must successfully complete all requirements of didactic component of course before beginning the supervised clinical internship.
Must provide proof of current personal professional liability insurance specific for RN first assistants.
Must provide proof of current CPR, BCLS, or ACLS certification.
IV. Structured Didactic Component A. Content overview:
The didactic component is designed to provide the RNFA candidate with the intellectual concepts and the manual techniques necessary to assume the role of first assisting. Emphasis is placed upon the RNFA’s independent nursing behaviors, which encompass preoperative assessment, postoperative evaluation, and patient education. Nursing diagnosis is stressed as the basis for planning, implementing, and evaluating outcomes of patient care.
The expanded functions unique to the RN first assistant during surgical intervention are emphasized as the RNFA candidate is prepared to assume responsibility in advanced surgical assisting skills such as providing exposure, tissue handling, suturing, providing hemostasis, and using surgical instruments. The collaborative and interdependent relationships of the surgeon-physician, nurse, and patient are stressed. The combination of this intellectual knowledge and manual dexterity prepares the qualified perioperative nurse with the essential skills necessary to function in this expanded professional role. Objectives are based on the Core Curriculum for the RN First Assistant.
B. Faculty: Minimum faculty requirements should include
Master’s-prepared or ARNP perioperative nurse.
Registered nurse who is both a CNOR and RNFA/CRNFA.
Board-certified surgeon.
C. Length of program:
The structured, didactic component should be a minimum of one academic semester of study, including student assignments, classroom instruction, and laboratory practicum.
D. Teaching methodologies: Teaching methodologies should include, but not be limited to, lecture, discussion, independent study requirements, audio-visual aids, demonstration/return demonstration, and laboratory practicums on suturing and knot-tying.
E. Evaluation methodologies: Evaluation methodologies should include, but not be limited to, written examinations, laboratory practicums, nursing care plans, and required independent learning assignments.
F. Textbooks: 1. Required texts should be
Core Curriculum for the RN First Assistant
The current edition of AORN Standards, Recommended Practices, and Guidelines2
A clinical surgery text of choice
A physical assessment text of choice
An anatomy and physiology text of choice
2. Recommended textbooks should include
The RN First Assistant: An Expanded Perioperative Role 3
A perioperative nursing text of choice
A nursing process/nursing diagnosis text of choice
A diagnostic test information text of choice
V. Supervised Clinical Internship
V. Supervised Clinical Internship
A. Content overview:
The RNFA clinical internship exists for the purpose of offering the necessary clinical preparation for perioperative nurses in assuming the expanded role of first assisting. This is a supervised clinical learning experience and is mutually planned by both the student and his or her primary mentor to cover a wide variety of surgical interventions dependent upon individual learning needs. Each student should have an active part in determining objectives, identifying learning resources, and evaluating attainment of goals for his or her individual learning needs.
The primary mentor for this internship should be a surgeon who has agreed to fulfill the mentoring role and who will assist the student in acquiring the knowledge and developing the skills necessary to adequately assist the surgeon and patient during surgical intervention. When feasible, an RNFA/ CRNFA also should be appointed as a mentor for the clinical internship.
B. Faculty: Minimum faculty requirements should include
A surgeon in the student’s primary area of practice.
RNFA program faculty.
C. Length of program:
The supervised clinical internship shall be a minimum of one academic semester of study, with an institution-determined number of clinical hours specific to the role of the RN first assistant.
D. Teaching methodologies: Teaching methodologies should include, but not be limited to, physician-supervised clinical activities, assigned independent learning activities, self-evaluative learning diary, clinical case study project, and surgical intervention participation log.
E. Evaluation methodologies: Evaluation methodologies should include, but not be limited to, completion of assigned independent learning activities, self-evaluative learning diary, clinical case study project, surgical intervention participation log, and mentor evaluations.
Students must satisfactorily complete all requirements. The RNFA program faculty reviews all documentation and the surgeon/RNFA preceptor provides a summative evaluation and recommendation based on all required learning activities.
These recommended education standards were developed by the RN First Assistant Specialty Assembly in July 1994 and were approved by the AORN Board of Directors in November 1994. Originally published March 1995, AORN Journal.
Revised November 1995.
Revised October 1996; approved by the AORN Board of Directors in November 1996.
