Association of periOperative Registered Nurses

Maryland  Government Affairs

State Coordinator

Joan Spear
(443) 280-1429

Regional Coordinator

Bonnie Vencill
(804) 526-3704

RN Circulator Laws and Language

Hospital: MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE LETTER DATED FEBRUARY 23, 2006: "Consistent with this unambiguous opinion of the Maryland Board of Nursing as well as various principles related to patient safety, it is the position of the Office of Health Care Quality that circulating duties which occur in Maryland hospitals and ambulatory surgical facilities must be performed by a registered nurse."
ASC: MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE LETTER DATED FEBRUARY 23, 2006: "Consistent with this unambiguous opinion of the Maryland Board of Nursing as well as various principles related to patient safety, it is the position of the Office of Health Care Quality that circulating duties which occur in Maryland hospitals and ambulatory surgical facilities must be performed by a registered nurse."

Registered Nurse First Assistants (RNFAs)

Reimbursement:  Code of Maryland, Title 15, Subtitle 7, 15-701 (2) Notwithstanding any other provision of a policy, contract, or certificate subject to this subsection, if the policy, contract, or certificate provides for reimbursement for a service that is within the lawful scope of practice of a health care provider licensed under the Health Occupations Article, the insured or any other person covered by or entitled to reimbursement under the policy, contract, or certificate is entitled to reimbursement for the service.
Definition:  Maryland Board of Nursing, Declaratory Ruling 94-3, June 28, 1994 The Registered Nurse First Assistant is an expert perioperative nurse. In the pre-operative and post-operative arena, the RNFA functions in an independent registered nursing role. In the intraoperative arena, the Registered Nurse First Assistant functions in an interdependent role with the surgeon.
Scope:  Maryland Board of Nursing, Declaratory Ruling 94-3, June 28, 1994 The expanded nursing role of the Registered Nurse First Assistant encompasses pre-operative, intraoperative, and post-operative functions. The Registered Nurse First Assistant functions include pre-operative patient assessment, patient teaching and staff teaching. The Registered Nurse First Assistant intra-operative functions include, but are not limited to: positioning, prepping and draping; aiding in exposure; retraction; hemostasis; use and handling of surgical instrumentation; and, tissue handling including dissecting, suturing, tying, stapling, and stab wound (nick) for laparoscopy surgery or drains. The Registered Nurse First Assistant post-operative functions include patient evaluation, evaluation of diagnostic and/or laboratory studies, resource for patient pain management, and patient and staff teaching.

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