Official Course Description: MCCCD Approval: 12/15/92
PON285 19932-99999	LEC	4 Credit(s)	4 Period(s)
Registered Nurse First Assistant
Expansion of perioperative nurse role and responsibilities. Emphasis on the intraoperative period. Theory of tissue handling, providing tissue exposure, using instruments, suturing, and providing hemostasis. Prerequisites: Current Registered Nurse license, experience as R.N. in the Operating Room, current Cardiopulmonary Resuscitation (CPR) card or permission of department.

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MCCCD Official Course Competencies:
PON285   19932-99999	Registered Nurse First Assistant

1.	List factors influencing scope of practice as determined by branches of government, Board of Medicine and Practice Act. (I)
2.	Explain liability determinations in relation to specific Operating Room (OR) situations. (II)
3.	Explain the nursing process as the foundation for Registered Nurse First Assistant (RNFA) practice. (III)
4.	Given OR situations, synthesize the data collected by the Registered Nurse First Assistant. (IV)
5.	Define meachanisms of microbial transmission and list principles of asepsis. (V)
6.	Describe principles of wound healing and specify infection control practices. (VI)
7.	List anatomic and physiologic considerations related to specific surgical areas of intervention. (VII)
8.	Given physiological alterations, list appropriate nursing interventions within Registered Nurse First Assistant (RNFA) guidelines. (VIII)
9.	Given specific surgical patients, identify problems and determine alternative solutions. (IX)
10.	Describe surgical techniques related to tissue handling within Registered Nurse First Assistant (RNFA) guidelines. (X)
11.	Describe monitoring of patients in Operating Room (OR) according to Registered Nurse First Assistant (RNFA) guidelines. (XI)
12.	Given specific surgical complications, explain appropriate emergency measures. (XII)
13.	Describe professional responsibilities of the Registered Nurse First Assistant (RNFA) regarding credentialing and accountability. (XIII)
14.	Describe and demonstrate techniques for effective communication with hospital personnel and patients. (XIV)
15.	Evaluate personal development and professional code of ethics related to role and responsibilities of Registered Nurse First Assistant (RNFA). (XV)

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MCCCD Official Course Outline:
PON285   19932-99999	Registered Nurse First Assistant

I. Derivation of Authority-Scope of Practice A. Legislative authority B. Board of Medicine C. Practice Act II. Scope of Practice A. Within B. Outside C. Liability III. Steps of the Nursing Process A. Evaluation of the nursing process/definition of nursing B. Assessment 1. Description 2. Nursing interview 3. Organizing and prioritizing data C. Nursing diagnosis 1. Characteristics 2. Components 3. Process IV. Nursing Process Implementation A. Perform nursing interventions B. Communication of nursing interventions C. Documentation D. Revising plan of care E. Evaluation and reassessment F. Intergrating the nursing process V. Mechanisms of Microbial Transmission A. Transmission of infection 1. Infectious reservoirs 2. Surgical importance B. Barriers to microbial transmission 1. Proper operating room attire 2. Skin preparation 3. Sterile field 4. Sterilization and disinfection 5. Principle of confine and contain VI. Wound Healing and Surveillance A. Wound classification system B. Principles of wound healing C. Complications of wound healing D. Indications of anti-microbial therapy E. Utilization of wound surveillance reports F. Role of Infection Control Committee VII. Anatomic and Physiologic Considerations A. General surgery B. Plastic surgery C. Orthopedic surgery D. Gynecologic and obstetric surgery E. Ophthalmologic surgery F. Neurosurgery G. Otolaryngologic surgery H. Thoracic surgery I. Vascular surgery J. Genitourinary surgery K. Cardiovascular surgery VIII. Surgical Interventions A. Nursing interventions 1. Positioning 2. Skin preparation 3. Incisional approach 4. Draping 5. Special suture needs 6. Special equipment/supply needs B. RNFA requirements C. Wound closure D. Post-operative needs E. Evaluation of patient outcomes IX. Decision-Making Behavior A. Patient 1. Needs 2. General health and age 3. Pre-existing problems 4. Anatomic considerations B. Nursing diagnosis C. Medical diagnosis D. Technique-related considerations E. Alternatives X. Tissue Handling A. Types of tissue B. Wound exposure 1. Manual 2. Instruments C. Dry wound D. Homeostasis 1. Manual 2. Instruments 3. Chemical 4. Electrical 5. Laser XI. Monitoring A. Vital signs B. Measurement of venous pressure C. EKG D. Intake and output E. Pulse oximetry F. Respiratory measurements XII. Complications A. Hemodynamic B. Metabolic C. Cardiac D. Potential injury 1. Chemical 2. Physical 3. Electrical 4. Mechanical E. Emergency measures XIII. Practice A. Privileges 1. Institutional 2. Non-institutional B. Credentialing C. Professional accountability 1. Certification 2. Continuing education 3. Research 4. Autonomy 5. Creativity XIV. Effective Communication A. Theory and practice B. Barriers C. Facilitating D. Written communication XV. Professional Development and Ethics A. Interpersonal communication B. Adopting assertive behavior C. Codependency issues D. Stress management E. Skills inventory F. Professional code of ethics

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