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Linda Zimmerman
(207) 876-2763

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Dawn A. Vocke RN,MSN, MBA, CNOR

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» Registered Nurse First Assistants (RNFAs)

Reimbursement: Maine Revised Statutes, Title 24, Chapter 19, Subchapter I, 2332-L 3. Required coverage for services. Notwithstanding any other provisions of this chapter, a nonprofit hospital and medical service organization that issues individual and group health care contracts that provide coverage for surgical first assisting benefits or services shall provide coverage and payment under those contracts to a registered nurse first assistant who performs services that are within the scope of a registered nurse first assistant's qualifications. The provisions of this subsection apply only if reimbursement for an assisting physician would be covered and a registered nurse first assistant who performed those services is used as a substitute.

Definition: Maine Revised Statutes - TITLE 24. INSURANCE. CHAPTER 19. NONPROFIT HOSPITAL OR MEDICAL SERVICE ORGANIZATIONS. SUBCHAPTER I. GENERAL PROVISIONS. 2332-L. Coverage for services provided by registered nurse first assistants. 1. DEFINITIONS. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. C. "Registered nurse first assistant," or "RNFA," means a person who: 1) Is licensed as a registered nurse under Title 32, chapter 31; 2) Is experienced in perioperative nursing; and 3) Has successfully completed a recognized program

Scope: Maine State Board of Nursing At its December, 1995 meeting, the Board adopted the Association of Operating Room Nurses (AORN) Recommended Education Standards for RN First Assistant Programs, and determined that an advanced practice registered nurse does not automatically qualify as a registered nurse first assistant in the operating room but must meet the same requirements as set forth in the AORN's recommended standards. The Board at its February 16-17, 1994 meeting reiterated its position with respect to RN First Assistants and percutaneous endoscopic gastrostomy. The RN First Assist may assist during surgery, but may NOT perform this procedure. The Board at its June 15-16, 1993 meeting determined that it is not within the scope of practice of a RN First Assistants to (1) take histories and perform physical exams; (2) make patient rounds; and (3) write medical orders. The Board at its February 16-17, 1994 meeting clarified that the intent of the Board was to disallow the RN First Assistant in the O.R. from being utilized as a physician extender, i.e. performing the history and physical examination that is clearly the physician's responsibility.

Guidelines for Perioperative Practice


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