Registered Nurse First Assist (RNFA) Checklist

GENERAL SKILLS:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Advanced directives
Patient / family teaching
Restrictive devices (restraints)
Lift / transfer devices
Specialty beds
End of life care / palliative care
Wound assessment & care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Bar coding for medication administration
Diabetic care and education
Blood Glucose Monitor (BGM)
Cardioversion / defibrillation
Electronic ICU
National Patient Safety Goals
Accurate patient identification
Effective communication
Interpretation & communication of lab values
Medication administration
Medication reconciliation
Labeling (medications & specimens)
Anticoagulation therapy
Monitoring conscious sedation
Pain assessment & management
Infection control
Universal precautions
Isolation
Minimize risk for falls
Prevention of pressure ulcers
Use of rapid response teams
Awareness of HCAHPS

GENERAL SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Cardiac arrest/adult CPR infant-child CPR
Advanced directives
Awareness of HCAHPS
Patient/family teaching
Lift/transfer devices
Specialty beds
Restrictive devices
End of life care/palliative care
Automated Medication Dispensing System, Pyxis, Omnicell, or other
Bar coding for medication administration
Diabetic management in the OR
National Patient Safety Goals
Accurate patient identifcation/surgical site verfcation with OR team
Effective communication
Interpretation & timely communication of lab values
Labeling (medications & specimens)
Medication reconciliation
Anticoagulant therapy
Monitoring conscious sedation
MDRO HAI
Hand hygiene WHO/CDC
CLABSI infections
CAUTI prevention
Identify patient suicide risk
Universal protocol
Surg site infection control

GENERAL SURGERY:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Bowel resection
Cholecystectomy/cholangiogram
Colostomy/ileostomy 0 1 2 3 4 5
Gastrectomy
Hemicolectomy
Hepatic resection
Herniorrhaphy-femoral/inguinal
Hiatal herniorrhaphy
Pancreatectomy
Organ procurement
Radical mastectomy
Saphenous vein ligation/stripping
Splenectomy
Thyroidectomy
Tracheostomy
Vagotomy
Familiarity with pediatric procedures
Abdominal perineal resection
Adrenalectomy bariatric surgery (gastric bypass)

ENDOSCOPY:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Bronchoscopy
Colonoscopy
Culdoscopy
Cystoscopy
Esophagoscopy
Gastroscopy
Hysteroscopy

GYNECOLOGY:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Caesarean section
Dilation & curettage
Hysterectomy - vaginal
Hysterectomy - abdominal
Radium insertion
Salpingo-oopherectomy
Shirodkar procedure
Termination of pregnancy
Tubal ligation
Vaginectomy

LAPAROSCOPIC PROCEDURES:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Appendectomy
Cholecystectomy
Colon resection
Gastric bypass
Hernia repair
Nephrectomy
Prostatectomy
Sinus surgery
Salpingo-oophorectomy
Splenectomy
Tubal ligation
Vaginal hysterectomy
Laryngoscopy
Mediastinoscopy
Pelviscopy
Sigmoidoscopy
Thoracoscopy
Whipple
Nissen fundoplication

ORTHOPEDIC:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Achilles tendon repair
Amputation
Arthroscopy/anthrotomy
Closed pinning & reduction of extremities
External compression devices
Hip compression nails & lag screws
Total joint replacement - knee
Total joint replacement - hip
Total joint replacement - shoulder
Spica cast
ORIF - shoulder, hip, humerus
Repair of dislocation
Patellectomy
Tendon implants & reanastomosis

UROLOGY:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Circumcision
Cystoscopy/ureteroscopy
Cystectomy
Hypospadias repair
Implants
Lithotripsy
Nephrectomy
Orchiectomy
Prostatectomy
Ureterolithotomy
TURP
PVP - Photo Vaporization of Prostate
Vasectomy

NEUROLOGY:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Kyphoplasty
A-V malformation
Laparoscopic spine procedures
Burr holes for subdural hematoma
Carotid ligation
Cervical sympathectomy
Cranioplasty
Craniotomy
Disectomy/laminectomy
Halo traction application
Insertion of nerve stimulator
Myelomeningocele repair
Shunt procedure
Spinal fusions
Ventriculostomy

PLASTICS:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Abdominal lipectomy
Blepharoplasty
Face lift
Mammoplasty
Augmentation
Reduction
Liposuction
Otoplasty
Scar revisions
Skin grafting

OPTHOMOLOGY:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Cataract extraction
IOL implants
Corneal transplant
Orbital implant
Enucleation
Repair of retinal detachment
Scleral buckle

EAR, NOSE & THROAT:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Caldwell-luc
Cleft lip/palate repair
Laryngectomy
Radical neck
Tonsillectomy & adenoidectomy
Mandibulectomy
Mastoidectomy
Rhinoplasty/septoplasty
Sinusotomy

VASCULAR:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Angiography
A-V access graft
Aortic aneurysm: abdominal
Peripheral vascular bypass procedures
Endarterectomy: carotid
Thrombectomy
Embolectomy
Vena cava ligation

ENDOVASCULAR:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Endoluminal AAA
Carotid revascularization endarterectomy
Cerebral aneurysm repair

TRANSPLANT:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Bone
Corneal
Harvesting
Heart/lung
Kidney
Liver
Multi organ
Pancreas
Skin

THORACIC/CARDIOVASCULAR:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Aortic femoral bypass graft
Femoral popliteal bypass
Pacemaker implantation/explanation
Care of patients with pacemaker
Care of patients with intra-aortic balloon pump
Septal defects, ASV, VSD
Coronary Artery Bypass & Graft (CABG) on pump
Valve replacement/repair
Aortic aneurysm
Thoracotomy/lobectomy
Endoscopic vein harvesting
Maze procedure

TRAUMA:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Burns
Gunshot/stab wounds
Motor vehicle accidents
Traumatic amputations

EQUIPMENT:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Argon beam coagulator
Camera/video systems
Cell saver
Cidex soak
Cryo-ophthalmic unit
Cavitron Ultrasonic Surgical Aspirator (CUSA)
Hypo/hyperthermia unit
Drill and saws
Electrosurgical unit
Fiber optic luminator
Cavitron
Autoclave
Fracture tables
Harmonic scalpel
Ligasure
Stapling devices
Mesh graft/dermatone
Microscopes
Nitrogen tank
Pneumatic tourniquet
Stealth
Steris unit
Pulsevac irrigation
Autotransfusion system
Laser equipment
Care of scopes & fberoptic equipment
Venodyne robotics (Da Vinci)

PROCEDURAL SKILLS (In Collaboration with Team)

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Position patient
Surgical draping
Creates sterile field
Maintains sterile field
Provides wound exposure
Use of instruments
Use of retractors
Suctioning and sponging techniques
Use of medical devices
Use of medications/solutions
Clamping blood vessels
Coagulating bleeding points
Ligating vessels
Other procedures in collaboration with surgeon
Safe tissue handling
Safe cutting of tissue
Suturing muscle
Suturing fascia
Suturing subcutaneous tissue
Suturing skin tissue
Assist with dressings/drains
Placing drains
Assist with cannulation
Assist with decannulation
Knot tying
Assists: SC local anesthesia
Preop nursing assessment
Periop nursing assessment
Write preop orders per hospital protocol
Environmental sanitation
Monitors surgical environment
Controls surgical environment
Working knowledge of equipment
Laser safety
Working knowledge of supplies
Sponge, needle, instrument count
Write post-op protocol orders per hospital protocol
Write opperative notes per hospital protocol
Participate in postop rounds & D/C planning
Electrosurgery experience
Recognize & intervene for safety hazards

AGE-SPECIFIC COMPETENCIES EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3: 1) Limited or no experience 2) Experienced, but may need review or supervision 3) Able to function independently *
Newborn/neonate (birth-30 days)
Infant (31 days- 1 year)
Toddler (ages 2-3 yrs)
School Age (ages 6-12 yrs)
Adolescent (ages 13-21 yrs)
Young Adult (ages 22-39)
Adult (ages 40-64)
Older Adult (ages 65+)