AORN standards for RN first assistant education programs

AORN Journal, Sept, 2005

Registered nurse first assistant (RNFA) education programs are designed to provide RNs with the educational preparation necessary to assume the role of the first assistant in operative and other invasive procedures. 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 (1); and award college credits or degrees and 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.

The "Standards for RN first assistant education programs" serve as the foundation upon which RNFA programs are developed and implemented. These standards are intended to guide program administrators and faculty in designing and evaluating curricula. These standards are broad in scope, definitive, relevant, and attainable, and they provide the framework for RNFA education. AORN's "Official statement on RN first assistants" (2) should be recognized by all institutions offering RNFA programs.

STANDARD I

Preadmission requirements for RNFA education programs shall include the following.

A. General admission requirements as determined by each educational institution.

B. Proof of licensure to practice as an RN in the state in which the clinical internship will be undertaken.

C. Verification of certification as one of the following:

1. CNOR or CNOR eligible, or

2. board certified or board eligible as an advanced practice nurse (APN).

APNs without competence in intraoperarive patient care must undergo an assessment regarding clinical skills and knowledge. If it is determined that skills and knowledge are deficient, faculty in the educational institution shall develop a plan to remediate identified deficiencies.

3. Certification must be submitted before program completion.

D. Cardiopulmonary resuscitation (CPR) or basic cardiac life support (BCLS) certification is required; advanced cardiac life support (ACLS) is preferred.

E. Letters of recommendation attesting to the years of experience as an RN and knowledge, judgment, and skills specific to surgical patient care.

STANDARD II

The didactic component of the curriculum for RNFA education programs shall be designed and evaluated based on a course description that identifies course content, faculty, length of the course, instructional and evaluation methodologies, and instructional resources.

A. Course content shall emphasize the expanded functions unique to the RNFA during operative and other invasive procedures, including, but not limited to,

1. preoperative patient management in collaboration with other health care providers, including, but not limited to,

a. performing a preoperative evaluation/focused nursing assessment,

b. communicating or collaborating with other health care providers regarding the patient's plan of care, and

c. writing preoperative orders according to established protocols;

2. intraoperative surgical first-assisting, including, but not limited to,

a. using instruments and medical devices,

b. providing exposure,

c. handling and cutting tissue,

d. providing hemostasis, and

e. suturing;

3. postoperative patient management in collaboration with other health care providers in the immediate postoperative period and beyond, including, but not limited to,

a. writing postoperative orders and operative notes according to established protocols,

b. participating in postoperative rounds, and

c. assisting with discharge planning and identifying appropriate community resources as needed. (2)

B. A multidisciplinary faculty should include

1. a perioperative nurse with a master of science in nursing degree,

2. a CNOR/RNFA or certified RNFA (CRNFA), and

3. a board-certified surgeon.

C. The course shall be a minimum of one academic semester of study, including student assignments, classroom instruction, and laboratory practicums.

D. Instructional methodologies shall include, but not be limited to, lecture, interactive discussion, independent study, instructional media, demonstration/return demonstration, and laboratory practicums.

E. Evaluation methodologies shall include, but not be limited to, written examinations, laboratory practicums, and independent critical thinking assignments.

F. Instructional resources shall include

1. Core Curriculum for the RN First Assistant (1) and

2. texts or other instructional media that include anatomy and physiology, operative and other invasive procedures, and preoperative and postoperative patient assessment and management.