Or an advanced registered nurse practitioner with specialized surgical and firstĪssistant training. They recognize that the role of the RNFA is to provide quality care, working effectively as a member of a multi-disciplinary team towards better patient outcomes.The Registered Nurse First Assistant (RNFA) is a registered nurse who has receivedĪdvanced training as a certified perioperative nurse (CNOR) and surgical first assistant, These positions have been created and supported by administrators, surgeons, and nurse managers who are innovative and envision the need for this enhanced nursing role. Provincially, there seems to be a growing awareness and need for the services that an RNFA can provide. As of July 2003, that number has grown to 17. Five years ago there was only one RNFA employed in Ontario. One of the main focuses of this group is promoting the RNFA role in hospitals across Ontario. This group is steadily growing in numbers and at present has 58 members. In 2000 a dedicated group of RNFA’s started the Operating Room Nurses Association of Ontario (ORNAO) RNFA Interest Group. In addition, the RNFA may participate in nursing and medical research projects. The RNFA performs postoperative nursing assessments, wound surveillance, educates patient/family with discharge planning and is involved with patient follow-ups. The RNFA handles tissue, maintains hemostasis and performs wound closure.Īfter surgery, the RNFA helps to transport the patient and communicates pertinent patient information to the post anesthetic care unit (PACU), intensive care unit (ICU) or ward staff. In collaboration with the surgeon, using knowledge, skills and judgement the RNFA provides exposure of the surgical site with the use of retractors, suction, and sponges. The RNFA assists with patient preparation, positioning, prepping, and draping. The RNFA also applies principles of asepsis, knowledge of anatomy, physiology and operative technique. The role of the RNFA in surgery may include assisting for all types of surgical procedures, working in collaboration with the surgeon as the surgical assistant, assisting anesthesia and nursing. The main focus of the RNFA in Ontario seems to be within the operating room. Prior to surgery, in conjunction with other members of the surgical team, the RNFA may be responsible for preoperative nursing assessment and health teaching provide patient/family support, initiate the perioperative nursing plan of care, and communication of the plan of care with other health-care professionals. This unique position encompasses all phases of surgical care – from the time the patient enters the hospital until time of discharge. The RNFA program consists of a theoretical foundation, classroom and laboratory experience as well as a surgeon mentored clinical internship. Nurses who are interested in applying for the RNFA program must have two-five years operating room experience, along with other stringent admission criteria. An RNFA is an experienced operating room nurse who has completed additional formal education. This expanded role gives perioperative nurses an opportunity to increase their knowledge and skills, while enhancing their quality of work life. In several areas of the province there has been a shortage of physician assistants. It will directly benefit patient care, the surgeon and nursing. The RNFA is an extended role of the operating room nurse. There are seven hospitals in Ontario currently using RNFA’s. ![]() The RNFA role, which is well established in the United States, is now gaining momentum across Canada. One of the many changes that the health-care system has seen over the last few years is the introduction of the Registered Nurse First Assistant (RNFA).
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