CRNFA - Certified Registered Nurse First Assistant

The Certified Registered Nurse First Assistant (CRNFA) is offered by the National Assistant at Surgery Certification (NASC).

The Registered Nurse First Assistant (RNFA) is a perioperative registered nurse (RN) or an Advanced Practice Registered Nurse (APRN) who functions in an expanded role as a surgical first assistant. The RNFA collaborates with surgeons and other healthcare team members and does not function concurrently as a scrub technician or circulator.

Examples of duties of the RNFA include:

• Performing focused preoperative assessments

• Using instruments and medical devices

• Providing hemostasis

• Suturing

• Wound management

• Participating in postoperative rounds

• Assisting with patient discharge

Programs

Initial accreditation set by the Association of periOperative Registered Nurses (AORN) required formal training through college programs. The National Institute of First Assisting (NIFA) has partnered with accredited college nursing programs across the country to become the largest trainer of RN First Assistants.

Class Options and Formats

The class has several online options through the NIFA. A hands-on workshop for the practicum portion is offered in several cities throughout the country.

Accredited nursing programs around the country offer a combination of classroom, online, and laboratory instruction.

Class Time Required

The length of RNFA training varies by program. In general, programs include three semester credit hours of study in the classroom and laboratory. A clinical component will include at least 120 clinical practice hours.

Cost

Program cost will also depend on the college or online program selected. Community college programs can start as low as $841 to over $5,000 at larger universities.

Acceptable RNFA programs are eligible for certification and are in compliance with AORN recommendations.

Nurses interested in becoming a Certified Registered Nurse First Assistant must enroll in an RNFA program and complete training before becoming eligible for the CRNFA examination. 

Minimum Requirements To Qualify For A RNFA Program

As of January 2020, the minimum degree requirement is a baccalaureate degree in nursing. Nurses must possess clinical experience and a certification in perioperative nursing (CNOR). If the nurse does not have their CNOR credential at the time of application, it must be obtained before an RNFA certificate will be issued. This certification and experience may be waived for APRNs.

Once these requirements are met, the nurse will enter a program to become an RNFA. The nurse must then function in this role for 2,000 hours before being certified.

Applying for CRNFA

After completion of the RNFA program, the nurse must have documented 2,000 hours of clinical practice in preoperative, intraoperative, or postoperative care. The hours must be obtained in the five years immediately preceding application with additional practice requirements. The nurse can then apply for certification.

CRNFA certification does not involve an exam. In May 2021, a professional portfolio took the place of examination in order to demonstrate satisfactory competence. The professional portfolio includes clinical, workplace safety, and professional practice case studies. Instructions for completing the case studies are provided by the credentialing body, National Assistant at Surgery Certification (NASC). Portfolios are evaluated by committees of active and former CRNFAs.

Cost

The cost of CRNFA certification by professional portfolio is $550. The cost for Registered Nurse Assistant at Surgery – Certified (RNAS-C) is $275.

The CRNFA certification is good for five years. Nurses who hold the CNOR credential will have this merged with the CRNFA credential once obtained. The recertification period and requirements will be determined by the CRNFA credential to cover both certifications.

Requirements to meet recertification:

• Be CRNFA certified

• Be currently licensed as an RN in the country where you currently practice

• Have the minimum number of practice hours depending on the recertification method (points or contact hours)

• Currently certified as a CNOR or APRN

Renewal Fees

Renewing with Contact Hours

• Between January 1 - July 1: $450

• Between July 2 - December 31: $500

Renewing with Points

• Between January 1 - July 1: $450

• Between July 2 - December 31: $500

One-Year Extension

• Between January 1 - July 1: $195

• Between July 2 - December 31: $195

The NASC offers a certification guidebook with documentation checklist, how to document practice hours and how to create a portfolio.

• Certified Perioperative Nurse (CNOR)

• Certified Foundational Perioperative Nurse (CFPN)

• Certified Surgical Services Manager (CSSM)

• Certified Ambulatory Surgery Nurse (CNAMB)

• Clinical Nurse Specialist Perioperative Certification (CNS-CP)

• Nursing Professional Development-Board Certified (NPD-BC)