July 20, 2019


New AORN Position Statement on Advanced Practice Registered Nurses in the Perioperative Environment

The APRN practicing in the perioperative environment as a first assistant at surgery: “…is required, as of January 1, 2016, to acquire the knowledge and skills needed to provide safe, competent surgical first assisting services by completing a program that covers the content of the AORN Standards for RN First Assistant Education Programs, which may be a standalone program or may be a portion of a graduate or postgraduate program (eg, additional coursework included in a graduate APRN program);…”

RN First Assistant in Surgery Role

The Association of PeriOperative Registered Nurses (AORN) states that 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. The American College of Surgeons (ACS) in Physicians as Assistants at Surgery 2013 Study states “Registered nurses with specialized training may also function as first assistants.”

About NIFA®

The National Institute of First Assisting, Inc. (NIFA) is a Colorado institution that specializing in health care education specific to operating room nurses and APRNs since 1995. The NIFA RN First Assistant Program for APRNs is presented through accredited colleges nationwide, overseen by their accredited nursing programs and meets all AORN Standards for RNFA Education.

During 2017 NIFA enrolled over 360 APRNs (Compared to 250 in 2016)

Traditionally, the RNFA in surgery has been defined as a perioperative nurse certified (RN, CNOR). NIFA conducted a student survey to find out why so many APRNs were enrolling into the program. The main responses were:
  1. Credentialing Committees required RNFA training
  2. APRNs want to follow patients through the entire process
  3. APRNs greatly help the doctors workload
  4. APRNs can bill Medicare Medicaid
Because of deadline of January 2016 in the new AORN Position Statement more APRNs will need this specialized training.

Online RNFA Program for APRNs

This college RNFA online program addresses all the modules of the AORN Core Curriculum for RN First Assistants. In total, home studies would represent approximately 48 hours followed by a 140-hour internship which the student arranges at their facility.

6 Day SutureStar Workshop for APRN

The NIFA program offers APRN students an optional SutureStar Workshop with up to 54 hours of hands-on labs, doing cases cut-to-close – including home labs to ensure retention. During the six day workshop, the APRN RNFA student will have placed and tied off approximately 400 sutures. Also, new APRNs to surgery attend a Monday night “APRN/VIP Night” to demonstrate knowledge of OR fundamentals and sterile technique. This hands-on experience is so comprehensive that, since 1997, we have guaranteed that an RNFA student will learn to master the skills of a competent and confident assistant or we will retrain them free of charge. We are the only program that presents cases such as AAA, ORIF, Colon Resection, TAH/BSO, C-Section, Laparoscopic, Endoscopic Vessel Harvesting, and Carotid Endarterectomy classes for a nominal charge to the student during the six day classroom portion of the program. Click here for the brochure.
“… The (NIFA) workshop was FANTASTIC!!! I am an ICU nurse by trade and have NO OR experience…the equipment and models were just incredible. I was so impressed, and felt like it was worth every single penny I spent to get there to come. I am 100% satisfied…”

Lindsay Morgan FNP-C, RNFA

“I just wanted you all to know a little about the SutureStar Workshop. The course uses clinical simulation to teach complex information while incorporating psychomotor skills required in the operative setting. I was truly impressed with the grueling course. Rest assured you will learn and I think be pleased with your individual outcomes… Make sure you well rested, complete the prior learning material and be ready to learn.”

Steve Branham RN, MSN, PhD, ACNP-BC, FNP-BC, CCRN, RNFA Assistant Professor Texas Tech University

Upon Graduation

Many APRN students graduate between 5-8 months, but have two years to complete the program. Graduates receive a Certificate verifying that they have successfully completed the RNFA program designed specifically for APRNs, meets all the standards as set forth by the AORN and is accepted by the Competency and Credentialing Institute leading qualified graduates to the national exam. Your NIFA certificate is recognized by all 50 Boards of Nursing.

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