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» RN Circulator Laws and Language


LOUISIANA ADMINISTRATIVE CODE Title 48 PUBLIC HEALTH" GENERAL Part I. General Administration Subpart 3. Licensing Chapter 93. Hospitals Subchapter A. General Provisions (29 LR 2399 LOUISIANA REGISTER ISSUE: Volume 29, Number 11 ISSUE DATE: November 20, 2003) 9401. Organization and Staffing C. A qualified registered nurse shall perform circulating duties for surgical procedures performed. In accordance with the needs of patients and the complexity of services performed, licensed practical nurses and operating room technicians may assist in circulatory duties under the supervision of a registered nurse who is immediately available to respond to emergencies. Licensed practical nurses and operating room technicians may perform scrub functions under the supervision of a registered nurse.



» Registered Nurse First Assistants (RNFAs)

Reimbursement: Louisiana Revised Statutes, Title 22, Chapter 1, Part 5, 215.24 A. Any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, health maintenance organization subscriber agreement, health and accident insurance policy, or any other insurance contract of this type, including a group insurance plan and a self-insurance plan that provides medical and surgical benefits which are delivered, issued for delivery, or renewed in this state on or after January 1, 2004, shall not deny coverage of perioperative services rendered by a registered nurse first assistant if the insurer covers the same such first assistant perioperative services when they are rendered by an advanced practice nurse, a physician assistant, or a physician other than the operating surgeon. Payments to RNFAs for such services shall be subject to the same credentialing and contracting requirements that apply to other health care providers paid for such services.

Definition: Louisiana Revised Statutes - TITLE 22. INSURANCE. CHAPTER 1. GENERAL PROVISIONS. PART 6. HEALTH AND ACCIDENT INSURANCE. 22:215.24. Health insurance coverage for activities performed by a registered nurse first assistant. C. As used in this Section: (3) "Registered nurse first assistant" or "RNFA" means a person who has met all of the following requirements: (a) Is licensed as a registered nurse in accordance with state law. (b) Is experienced in perioperative nursing. (c) Has successfully completed a recognized program.

Scope: Louisiana Board of Nursing, Declaratory Statement for Registered Nurse First Assistants, Adopted 5/31/85, Revised 3/19/87; 2/4/98. In accord with LRS 37:913(14)(l) and LAC 46:XLVII.3703.A registered nurses may perform additional activities beyond those taught in basic nursing education programs. Scope of Practice - The registered nurse serving as first assistant is a part of perioperative nursing practice. Perioperative nursing is a specialized area of practice. The activities included in first assisting are further refinement of perioperative nursing practice which are executed within the context of the nursing process. The RNFA collaborates with the surgeon in performing a safe operation to promote optimal patient outcomes and does not concurrently function as a scrub nurse. The observable intraoperative nursing behaviors are based on an extensive body of scientific knowledge and may include: -handling tissue; -providing exposure; -using instruments; suturing; and -providing hemostasis.

Guidelines for Perioperative Practice


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