Ala. Admin. Code r. 610-X-7-.04 - Registered Nurse As Surgical First Assistant (RNFA)

Current through Register Vol. 40, No. 6, March 31, 2022

(1) The registered nurse may function as a surgical first assistant according to standardized procedures, as defined in Rule 610-X-6-.12. The RNFA has the duty to verify that standardized procedures are in effect before performing the functions of a surgical first assistant.
(2) Performing intra-operative functions as a RNFA is limited to the direct supervision of the attending surgeon physically present in the surgical suite where the case is being performed.
(3) When directed by the attending surgeon, the RNFA intra-operative functions include, but are not limited to:
(a) Positioning the patient, preparing and draping the surgical site.
(b) Providing exposure, retraction, and hemostasis.
(c) Use and handling of surgical instrumentation.
(d) Tissue handling, dissection, suturing, and stapling.
(e) Making the skin nick or stab wound for laparoscopic surgery or drains, excluding placement of primary trocar for laparoscopic and robotic access. Secondary placement of trocars for laparoscopic and robotic surgery if the RNFA is deemed competent to perform by the attending surgeon who is within proximity of the sterile field.
(f) Securing drains.
(g) Closing of wounds external to the fascia.
(h) Harvesting extremity veins and closure of the resulting wounds.
(4) Functions for the RNFA that are not listed in these rules shall be defined in standardized procedures, which require Board approval prior to implementation for all practice settings.
(5) Standardized procedures for the RNFA shall include a statement of clinical privileges for additional technical functions that are permitted in a hospital.
(6) The RNFA shall not function as a scrub nurse concurrently with responsibility as a surgical first assistant.
(7) Practice as a registered nurse first assistant does not include the functions and privileges reserved for advanced practice nurses elsewhere in these rules.


Ala. Admin. Code r. 610-X-7-.04
New Rule: Filed February 4, 1997; effective March 11, 1997. Repealed: Filed October 29, 2001; effective December 3, 2001. New Rule: Filed November 23, 2009; effective December 28, 2009. Amended: Filed April 15, 2010; effective May 20, 2010. Adopted by Alabama Administrative Monthly Volume XXXIV, Issue No. 10, July 29, 2016, eff. 9/8/2016. Amended by Alabama Administrative Monthly Volume XXXV, Issue No. 10, July 31, 2017, eff. 9/3/2017.

Author: Alabama Board of Nursing

Statutory Authority: Code of Ala. 1975, ยง 34-21-2(c)(21).

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