RN First Assistant Research Articles

Clinical Issues-March 2021.

Surgical patients with glycemic controller devices and insulin pumps Key words: glycemic controller, insulin, insulin pump, glucose monitoring, blood glucose level. Using leftover IV fluids to clean the surgical incision site after closure Key words: IV fluid, sterile field, infection, contamination. A certified surgical first assistant's scope of practice after obtaining RN licensure Key words: scope of practice, certified surgical first assistant, RN first assistant (RNFA), license. Using instruments outside the scope of the manufacturer's instructions for use Key words: instructions for use (IFU), instrument, manufacturer, risk. Transferring patients from a prone position on the OR bed to a supine position on the stretcher Key words: patient transfer, positioning device, repositioning, alignment, prone.

An Interprofessional Branching Simulation to Introduce RN First Assistant Students to Their Role in the Perioperative Setting.

Simulation can be an effective tool for educating health profession students and can enhance interprofessional education by involving roles across multiple disciplines. Perioperative nurse educators at one institution used a five-part branching simulation of preoperative, intraoperative, and postoperative events for a single patient undergoing a procedure to introduce RN first assistant (RNFA) students to their role in the perioperative environment. The simulation participants included student RN anesthetists, a surgeon, an RN circulator (played by an actor), and a standardized patient. The objectives for this simulation were to assess the implementation of the didactic RNFA curriculum and to enhance the RNFA students' transition into their role in the perioperative setting. The simulation and multiple debriefings reinforced the concepts of role acquisition, surgical conscience, closed-loop communication, and interprofessional collaboration. Perioperative nurse educators can use this type of educational activity to teach these concepts to their students.

RN First Assistant (RNFA)

RN First Assistant (RNFA)

AORN Position Statement on RN First Assistants

<scp>AORN</scp> Position Statement on <scp>RN</scp> First Assistants

Clinical Issues—December 2015

This MonthComplementary care interventions for pediatric patientsKey words: pediatric, complementary care, music, hypnosis, acupressure, play therapy, pain, anxiety.Cleaning personal eyewearKey words: personal eyewear, eye protection, cleaning, bloodborne pathogen exposure.Education requirements for advanced practice RN (APRN) first assistantsKey words: advanced practice registered nurse, APRN, registered nurse first assistant, RNFA.Degree requirements for entrance to an RN first assistant (RNFA) programKey words: registered nurse first assistant, RNFA, first assistant.Wearing an arm cast in the perioperative settingKey words: arm cast, workplace safety, work restrictions, hand hygiene.

The Role of the RNFA in Anterior Cruciate Ligament Graft Preparation

Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed orthopedic procedures in the United States. Repair of the ACL often requires the use of autografts or allografts, and the RN first assistant (RNFA) often is the team member responsible for preparing the graft. Common grafts used in ACL repair include bone-patellar tendon-bone, hamstring, Achilles tendon, quadriceps tendon, and tibialis anterior tendon. The RNFA must be competent in preparing all of these grafts and in understanding the advantages and disadvantages of using each graft, such as the reasons for graft choice, and must ensure that all graft-related supplies and equipment are available and ready for use. The ability to prepare all graft types expands treatment options, reduces surgical time, and enhances the role of the RNFA.

Clinical Issues—February 2013

This MonthObtaining RN first assistant privileges to practiceKey words: RN first assistant (RNFA), privileging process, practice issues.Creating policies and procedures for the RN first assistant credentialing processKey words: RN first assistant (RNFA), credentialing process, privileging process.Infection prevention guidelines for break rooms or lounges used by perioperative personnelKey words: infection prevention, disease vectors, OR lounges, OR break rooms.Sterilizing instruments when the sterilizer is malfunctioningKey words: off‐site sterilization, sterilizing instruments, malfunctioning equipment.Guidelines for the location of automatic endoscope reprocessorsKey words: endoscope reprocessor, department layout.

The RN First Assistant: An Expert Resource for Surgical Site Infection Prevention

The role of the RN first assistant (RNFA) has expanded and evolved during the past three decades. Studies that have examined patient care outcomes relative to RNFAs substituting for surgeons as first assistants have noted no resulting adverse consequences, and the use of RNFAs in surgery may improve patient outcomes. This article reports on an intervention to improve surgical outcomes in patients undergoing cardiac surgery that involved replacing surgical residents with RNFAs for the harvesting of saphenous vein grafts. The resulting benefits were a significant decrease in surgical times as well as improvement in surgical site infection rates.

Marketing an RN first assistant practice—Attracting and keeping clients

The goal of marketing an RN first assistant (RNFA) business is to enhance the RNFA's professional reputation, sell the business' services, and build solid client relationships. This article provides prospective RNFA business owners with marketing strategies and techniques for finding clients and keeping their business.

An RN First Assistant's Guide to Private Practice

In 1984, AORN developed its first official statement on RN first assistant (RNFA) practice. This article is a guide for RNFAs seeking self-employment. The dynamics of change, with reference to the role of the RNFA, in perioperative nursing and entrepreneurship will be discussed. Nurses' responsibilities in this expanded role, methods of becoming a change agent, and methods of obtaining privileges to practice as a self-employed RNFA (ie, functioning under the supervision of a surgeon) in health care organizations will be identified. Current trends and issues influencing RNFA practice, including certification, reimbursement, practice setting, education, competition, and changes in health care, also will be discussed.

Marketing the RN First Assistant Role

Nurses who are educated and certified for the RN first assistant (RNFA) role must look for ways to introduce the RNFA role into their health care setting while also marketing their services over another assistant's services. This article offers information on the RNFA role, including practice requirements, a job description, and strategies to help institute the first assistant role into a health care facility.

The future of robotics can be ours

As the use of robotic aides increases the possibility of telesurgery, the perioperative scope of practice could include using patients' homes or other nontraditional settings as surgical sites. Even mobile surgical vans could be used. To perform telesurgery, the health care industry actively must define the role of the health care professional with the patient who can make an incision and insert a laparoscope. This may create an opportune time to promote the RN first assistant (RNFA) role--a goal that will involve expanding our state nurse practice acts to allow RNFAs to perform various functions for true advanced practice in nontraditional settings. Additionally, it will mean defining what functions and personnel must be available in these new creative settings. Current experiments have focused on using nonlicensed assistants, which can lead to legal and moral concerns. Legal and moral concerns include not only appropriate personnel, but also patient privacy. In telesurgery, patient information would be transmitted over communication lines, possibly seriously jeopardizing patient privacy. Perioperative nurses must be vigilant regarding patient privacy and continue to be patient advocates. Additional concerns relate to the possible complications or emergencies that can occur in any procedure, such as bleeding, cardiac arrest, or malignant hyperthermia. As this field is being developed, these concerns must be addressed, and possible complications and emergencies must be prepared for. All patients deserve highly trained individuals to care for them. It is a concern that unlicensed personnel are being considered to manage these potentially serious situations. It is now more important than ever that perioperative nurses stay on top of technologic advances. One surgeon stated that perioperative nurses are at a point in history in which they can make a difference--a potentially lifesaving difference. Nurses will have to be comfortable with new technology, know when it is working well, and be able to assess the patient's status critically. The use of robotic aides can decrease the amount of physical work that nurses do; however, they also have the capability to denigrate nurses' positions. If not careful, nurses could lose their focus on the caring aspect of the nursing profession. Although computers remain machines programmed by humans, it seems they more often are masters of information. Today, procedures can be performed in cyberspace as if surgeons were present at the surgical sites. Could robotic aides and computers do a better job than physicians and nurses, causing these health care providers to become extinct? Probably not. Although robots and computers may be able to replicate the knowledge and skill of physicians, patients require human interaction that computers cannot provide. This involves feelings and human communication beyond current technology, despite robotic engineers' continuing attempts to replicate this. The ultimate use of robotics remains uncertain; however, the human touch will not soon, if ever, be replaced by robotic technology. It is now of utmost urgency that all perioperative nurses refine and hone the caring skills that Florence Nightingale instilled to ensure their professional future. Robotics is a new and challenging aspect being added to nursing care. Nurses must take an active role, embrace this technology, and work to maximize their position with it.

RN First Assistants Expand Their Perioperative Role

At the Cleveland Clinic Foundation, the RN first assistant (RNFA) role has expanded to include radial artery (RA) harvesting for coronary artery bypass surgery. This new role encompasses preoperatively assessing the RA with the Allen's test and perfusion index; intraoperatively removing the RA, dissecting the RA as a pedicle, and maintaining hemostasis and wound closure; and postoperatively collaborating with the postoperative muse clinician during patient care and management in the intensive care unit. This article outlines the RNFA's expanded role in this detailed surgical procedure.

Implementation of the RN First Assistant Role

The RN first assistant (RNFA) program at Children's Hospital of The King's Daughters in Norfolk, Va, began as a dream in which RNs could expand their role within a cost-effective, hospital-based implementation of the RNFA role. Our dream included a career development path for perioperative nurses who had few other career options within the surgical arena. This article describes how the dream came true.

The Mentoring Relationship

he historical roots of the word nieiitor originate in Greek mythology. In T Homer's The OOyssey, Mentor was a guide. protector. tutor, and advisor to Telemachus, the son of Odysseus and Penelope. Mentor motivated Telemachus to achieve his life's tasks. History notes other mentoring relationships: Socrates and Plato. Lorenzo de Medici and Michelangelo, Verrocchio and Leonard0 da Vinci, Sigmund Freud and Carl Jung, Ruth Benedict and Margaret Mead, and Anne Sullivan and Helen Keller.' This article describes mentoring as applied to the nursing profession with specific reference to the RN first assistant (RNFA) role. We will review the research on mentoring relationships;