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CRNFA Application

Download the CRNFA Certification/Recertification Handbook

To apply for CRNFA certification, click the “Login” link at the top of this page, then click the orange “Register as an Applicant” button to create your online account. After you create your account, you will have access to the online CRNFA certification application.

Once your application has been accepted, you will receive instructions for completing the CRNFA Professional Portfolio. 

Pricing

The fee to apply for CRNFA certification is $550.

CRNFA Eligibility Requirements

Candidates must meet one of two eligibility paths for CRNFA certification depending on Advanced Practice Registered Nurse (APRN) status. All applicants must have completed a formal RNFA program that meets the AORN standards for RN first assistant (RNFA) education programs to be eligible for CRNFA certification.

If the applicant is an RN (not an advanced practice registered nurse), the eligibility requirements for CRNFA certification include the following:

  • Hold a bachelor’s degree or higher in any field.
  • Current, unrestricted RN licensure in the country where currently practicing.
  • Completion of an acceptable formal RNFA program that meets the AORN standards for RN first assistant education programs. A copy of the certificate of completion must accompany the application.
  • Current CNOR certification.
  • A minimum of 2,000 documented hours of practice as an RNFA. Hours may include preoperative, intraoperative, and postoperative patient care.

If the applicant is an advanced practice registered nurse (APRN), e.g., CNS, NP, CNM, or CRNA, the eligibility requirements for CRNFA certification include the following:

  • Master’s, doctoral, or post-master’s certificate in an advanced practice program.
  • Current, unrestricted RN licensure in the country where currently practicing.
  • Completion of an acceptable formal RNFA program that meets the AORN standards for RN first assistant education programs. A copy of the certificate of completion must accompany the application.
  • Certified as an Advanced Practice Registered Nurse (APRN) by an accredited certification program.
  • A minimum of 2,000 documented hours of practice as an RNFA. Hours may include preoperative, intraoperative, and postoperative patient care.

Current CNORs
If you currently hold the CNOR credential and become CRNFA certified, then you will hold both the CNOR and CRNFA credentials and may use both designations after your name (e.g., Jane Doe, MSN, RN, CNOR, CRNFA). However, for operational purposes these credentials become merged, and you must only meet the CRNFA requirements in effect at the time to recertify both credentials.

How do I document 2,000 hours of practice?

You can use one of the following methods to document your 2,000 hours of practice:

All RNFAs, to include APRNs, must have completed at least 2,000 hours of practice as an RNFA at the time of application. Hours may include preoperative, intraoperative, and postoperative patient care, defined as:

  • Preoperative Phase: Includes care provided on the day of the procedure from the time the patient enters the surgical facility until the patient enters the operating room.
  • Intraoperative Phase: Includes care provided from the time the patient enters the operating room until the patient leaves the operating room. While performing in the intraoperative role the RNFA cannot be concurrently serving in any other perioperative role (eg, scrub person).
  • Postoperative Phase: Includes care provided from the time the patient leaves the operating room until the patient is discharged from Phase 1 post-anesthesia care.

In addition:

  • The 2,000 hours must be in the five years immediately preceding application.*
  • At least 500 of the hours must be in the two years immediately preceding application.
  • At least 1,000 hours must involve first assisting practice during the intraoperative period.
  • Pre-, intra-, and postoperative care do not have to be for the same patient. The pre-and postoperative hours do not have to be the cases on which the applicant assisted.
  • The 2,000 hours may include practice in an RNFA internship or practicum, otherwise the hours must be completed after graduation from the RNFA program.
  • Practice hours earned in a volunteer status while working in the RNFA role may be utilized in fulfillment of this requirement.
  • The 2,000 hours may not include attendance of classes, programs or seminars.

The candidate’s name must be listed as RNFA or first assistant and the log must contain the following information:

  • Date of procedure
  • Type of procedure
  • Time of procedure delineating pre-, intra-, and postoperative hours
  • Initials of the surgeon assisted

Preoperative hours may include:

  1. Conducting history and physical assessments
  2. Providing patient, family, or caregiver education
  3. Reviewing patient record in preparation for the surgical procedure
  4. Participating in preoperative components of the Universal Protocol
  5. Communicating the plan of care, special needs of patient and/or surgeon, and other pertinent information with interdisciplinary and/or perioperative team members

Intraoperative hours must include:

Intraoperative hours must include serving in the first assistant role. While performing in the intraoperative role the first assistant cannot be concurrently serving in any other perioperative nursing role.

Postoperative hours may include:

  1. Transporting patient to post-anesthesia care
  2. Assisting with initial post-anesthesia care monitoring
  3. Writing postoperative orders
  4. Writing or dictating progress notes or discharge summaries
  5. Implementing postoperative interventions (eg, changing dressings, checking and monitoring surgical drains, removing/inserting catheters or intravenous lines, providing nutritional support or electrolyte therapy),
  6. Managing wounds
  7. Providing patient, family, or caregiver education
  8. Collaborating with facility and community resources for postdischarge care
  9. Administering medications

*If any of your practice hours occurred more than five years before application, please contact NASC for clarification.

This guide includes handy checklists to check your eligibility and gather your documents before you apply.

This guide includes handy checklists to check your eligibility and gather your documents before you apply.