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Susan Southwick
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» RN Circulator Laws and Language

Hospital

ALABAMA ADMINISTRATIVE CODE
ALABAMA STATE BOARD OF HEALTH ALABAMA DEPARTMENT OF PUBLIC HEALTH; DIVISION OF LICENSURE AND CERTIFICATION
CHAPTER 420-5-7: SURGICAL SERVICES
420-5-7-.17 Surgical Services.
The document entitled 42 Code of Federal Regulations, (42 C.F.R.) "Public Health" part 482.51* as revised as of October 1, 1992, is hereby incorporated by reference and made a part of this rule as if set out in full and all provisions thereof on November 16, 1994.
* 42 CFR 482.51: Condition of participation: Surgical services.
(1) The operating rooms must be supervised by an experienced registered nurse or a doctor of medicine or osteopathy.
(3) Qualified registered nurses may perform circulating duties in the operating room. In accordance with applicable State laws and approved medical staff policies and procedures, LPNs and surgical technologists may assist in circulatory duties under the supervision of a qualified registered nurse who is immediately available to respond to emergencies.

ASC

ALABAMA ADMINISTRATIVE CODE
ALABAMA STATE BOARD OF HEALTH ALABAMA DEPARTMENT OF PUBLIC HEALTH; DIVISION OF LICENSURE AND CERTIFICATION
CHAPTER 420-5-2: AMBULATORY SURGICAL TREATMENT FACILITIES
420-5-2-.02 Administration
(3) Personnel
(b) Director of Nursing Services. A registered professional nurse shall be responsible for proper performance of nursing services provided in the center.
(e) Other required Nursing Service Personnel.
1. Operating Room
(i) Personnel in the operating room must include at least one (1) registered professional nurse to serve as the circulating nurse in each operating room. Additional personnel may include another RN, LPN or surgical technician to scrub.

» Registered Nurse First Assistants (RNFAs)

Reimbursement: None

Definition: Alabama Administrative Code - ALABAMA BOARD OF NURSING. CHAPTER 610-X-2: DEFINITIONS. 610-X-2-.07 Standards Of Nursing Practice- Specific Settings. (7) Registered Nurse First Assistant (RNFA): A registered nurse who, through additional education and supervised clinical practice, has acquired knowledge, skills, and judgment that are specific to providing assistance during a surgical procedure as directed by the attending surgeon and as defined in standardized procedures.

Scope: Alabama Board of Nursing, Chapter 610-X-6, Standards of Nursing Practice, 610-X-7.04, Registered Nurse as Surgical First Assistant. (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 trocar for laparoscopic access. (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. Approval by the Board is required prior to implementation of RNFA standardized procedures for all practice settings. (6) The RNFA shall not function as a scrub nurse concurrently with responsibility as a surgical first assistant.

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