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Deborah L. Farina-Mulloy
(617) 244-6793

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Carmen Sierra

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» RN Circulator Laws and Language


CODE OF MASSACHUSETTS REGULATIONS TITLE 105: DEPARTMENT OF PUBLIC HEALTH CHAPTER 130.000: HOSPITAL LICENSURE SUBPART B GENERAL REQUIREMENTS 130.200: Incorporation of Medicare Conditions of Participation in Hospitals Each hospital shall meet all of the requirements of the Medicare Conditions of Participation for Hospitals, 42 C.F.R. 482.11 through 482.62 (hereinafter Conditions of Participation), and as they may be amended from time to time . . . * * 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.


CODE OF MASSACHUSETTS REGULATIONS TITLE 105: DEPARTMENT OF PUBLIC HEALTH CHAPTER 140.000: LICENSURE OF CLINICS SUBPART F SURGICAL SERVICES 140.607: Adequate Assistance (B) Only registered nurses shall function as circulating nurses.

» Registered Nurse First Assistants (RNFAs)

Reimbursement: None

Definition: None

Scope: Massachusetts Board in the Regulation of Nursing, Advisory Ruling on Nursing Practice, Feb. 1986, Rev’d May 2002. The RNFA scope of practice includes the; Pre-operative Phase including but not limited to: Pre-admission assessment Patient & Family Education Patient & Family Interview Immediate preoperative assessment Review of patient data Collaboration & Communication with the OR staff Intra-operative Phase including but not limited to: Handling tissue Providing exposure Using instruments Suturing and providing hemostasis * The RNFA shall not concurrently function as a scrub nurse Post-operative Phase including but not limited to: Communication to the PACU staff Assist with PACU monitoring Writing transfer notes Daily rounds (may include wound management, dressing changes, suture and/or drain removal, other type of catheter & IV removal and as ordered by the duly authorized prescriber)

Guidelines for Perioperative Practice


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