RN First Assist-Ambulatory Surgery

Provides assistance to the surgical team during the intra-operative phase of surgical care for the Northwest Region Ambulatory Surgery Centers. Works in collaboration with the surgeon and health care team in the performance of surgical procedures, including assessment, planning, directing, providing and evaluating advanced nursing care.

• Practice standards of performance\: Pre-operative\: Performs pre-operative assessment and evaluation if required. Collaborates with the surgical team on plan of care. Coordinate and communicate with circulator regarding equipment and implant needs for case, assist in obtaining.
• Practice standards of performance\: Intra-operative\: Provides knowledge based technical assistance to the surgeon and operating room team during the operative procedure according to AORN standards, licensure, state regulation and facility/practice protocols, including\: Use of instruments and medical devices. Providing surgical exposure. Handling and/or cutting tissue. Providing hemostatis, clamp, cut, and ligate tissue as directed by the surgeon. Suturing as directed by the surgeon.
• Practice standards of performance\: Post-Operative\: Apply post-op splints and/or braces. During Anesthesia emergence, bring stretcher into room. Help transfer patient to stretcher. Remain in room for turnover unless specific instructions for Post-op care required in PACU.
• Assessment Standard of Performance & Planning\: Communicates information so that continuity of care is maintained. Communicates with patient, family and other staff in a professional and courteous manner. Obtains and demonstrates the skills and knowledge needed to provide appropriate population based and culturally sensitive care to patients and families through education, training and experience. Provides continuous reassessment through the intra operative period. Utilizes knowledge of type of procedure to plan for appropriate set up.
• Practice standards of performance\: Function as an assistant in all surgical specialties at the direction of the attending surgeon. Performs RNFA responsibilities in accordance with the Nurse Practice Act of the State of Oregon, institutional policies and procedures of Kaiser Permanente and the AORN Position Statement on RN First Assistants. Practice within limitations of preparation and experience. Demonstrate RNFA specific clinical skills. Review and update skills checklist on an ongoing basis as specified by policies of Kaiser Permanente. Assists with room preparation and opening of supplies in collaboration with the circulating nurse and scrub person. Have available patient X-rays/MRIs. Check image capture machine and films NOTE\: Notify Team Lead or designee if films/MRIs etc. are not available. Assists in patient transport to the operating room and transfer to the operating room table. Assists in patient positioning. Assists in patient preparation, i.e., prepping, catheterization, clipping, as necessary. Participates in briefing/time out and debriefing. Assists in patient draping. Sets up ESU, lights, suction for the sterile field. Monitors free counted items on the sterile field. Observes for breaks in sterile technique and takes appropriate action as necessary. Assists with instrumentation and equipment as requested. Applies dressings and secures drainage tubes. Assists with patient transfer and positioning post operatively. Assists with room tear down and turn over in collaboration with the circulating nurse and scrub person. Assist in maintaining a safe environment and promoting efficiency in surgical procedures. Available for breaks and lunch relief, local monitor, scrub and circulate as needed.

Provides assistance to the surgical team during the intra-operative phase of surgical care for the Northwest Region Ambulatory Surgery Centers. Works in collaboration with the surgeon and health care team in the performance of surgical procedures, including assessment, planning, directing, providing and evaluating advanced nursing care.

• Practice standards of performance\: Pre-operative\: Performs pre-operative assessment and evaluation if required. Collaborates with the surgical team on plan of care. Coordinate and communicate with circulator regarding equipment and implant needs for case, assist in obtaining.
• Practice standards of performance\: Intra-operative\: Provides knowledge based technical assistance to the surgeon and operating room team during the operative procedure according to AORN standards, licensure, state regulation and facility/practice protocols, including\: Use of instruments and medical devices. Providing surgical exposure. Handling and/or cutting tissue. Providing hemostatis, clamp, cut, and ligate tissue as directed by the surgeon. Suturing as directed by the surgeon.
• Practice standards of performance\: Post-Operative\: Apply post-op splints and/or braces. During Anesthesia emergence, bring stretcher into room. Help transfer patient to stretcher. Remain in room for turnover unless specific instructions for Post-op care required in PACU.
• Assessment Standard of Performance & Planning\: Communicates information so that continuity of care is maintained. Communicates with patient, family and other staff in a professional and courteous manner. Obtains and demonstrates the skills and knowledge needed to provide appropriate population based and culturally sensitive care to patients and families through education, training and experience. Provides continuous reassessment through the intra operative period. Utilizes knowledge of type of procedure to plan for appropriate set up.
• Practice standards of performance\: Function as an assistant in all surgical specialties at the direction of the attending surgeon. Performs RNFA responsibilities in accordance with the Nurse Practice Act of the State of Oregon, institutional policies and procedures of Kaiser Permanente and the AORN Position Statement on RN First Assistants. Practice within limitations of preparation and experience. Demonstrate RNFA specific clinical skills. Review and update skills checklist on an ongoing basis as specified by policies of Kaiser Permanente. Assists with room preparation and opening of supplies in collaboration with the circulating nurse and scrub person. Have available patient X-rays/MRIs. Check image capture machine and films NOTE\: Notify Team Lead or designee if films/MRIs etc. are not available. Assists in patient transport to the operating room and transfer to the operating room table. Assists in patient positioning. Assists in patient preparation, i.e., prepping, catheterization, clipping, as necessary. Participates in briefing/time out and debriefing. Assists in patient draping. Sets up ESU, lights, suction for the sterile field. Monitors free counted items on the sterile field. Observes for breaks in sterile technique and takes appropriate action as necessary. Assists with instrumentation and equipment as requested. Applies dressings and secures drainage tubes. Assists with patient transfer and positioning post operatively. Assists with room tear down and turn over in collaboration with the circulating nurse and scrub person. Assist in maintaining a safe environment and promoting efficiency in surgical procedures. Available for breaks and lunch relief, local monitor, scrub and circulate as needed.

• Two (2) years of intra-operative scrubbing and circulating experience.
• One (1) year of recent experience, within the last two (2) years, as an RNFA or successful completion of a CCI recognized RNFA course and agreement from ASC.

• N/A

• Registered Nurse License (Oregon)

• Advanced Cardiac Life Support

• Basic Life Support

• Nurse Operating Room Certificate

• Meets all qualifications of an RNFA as outlined in AORN Position Statement.

• Two (2) to five (5) years of practice as an RNFA.
• CRNFA Certification preferred.
• Ability to assist on all cases performed within Surgical Services.

• Two (2) years of intra-operative scrubbing and circulating experience.
• One (1) year of recent experience, within the last two (2) years, as an RNFA or successful completion of a CCI recognized RNFA course and agreement from ASC.

• N/A

• Registered Nurse License (Oregon)

• Advanced Cardiac Life Support

• Basic Life Support

• Nurse Operating Room Certificate

• Meets all qualifications of an RNFA as outlined in AORN Position Statement.

• Two (2) to five (5) years of practice as an RNFA.
• CRNFA Certification preferred.
• Ability to assist on all cases performed within Surgical Services.

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