New roles and scopes

Registered Nurse First Surgical Assistant

The University of Auckland, supported by HWNZ is delivering the first postgraduate training programme for Registered Nurse First Surgical Assistants (RNFSAs).

Between July 2010 and December 2011, 13 experienced theatre nurses undertook their RNFSA postgraduate qualification as part of the HWNZ funded demonstration.

The advanced RNFSA role builds on the theatre nurse role and provides a new specialist career pathway and portable qualification which will aid nurse recruitment and retention. Nurses are continuing to develop their skills and extend their scope of practice across all specialities as part of innovations that ensure we make the best use of the potential of all members of the healthcare team.

The purpose of the demonstration was to formally introduce the RNFSA role, establish a formal training programme for the RNFSA role, and to train 13 RNFSAs. Underpinning the demonstration were the following objectives:

  • to improve specialty specific elective surgical throughput
  • to provide support for the surgical team to reduce list cancellation
  • to start to build capacity for release time for junior medical staff to be more available to complete more complex surgical tasks
  • to start to build learnings to provide a cost effective operating room model that is sustainable
  • to improve RN recruitment and retention in surgical teams
  • to suitably prepare 13 nurses to undertake the advanced nursing role of surgical assistant (RN).

Demonstration Evaluation

A comprehensive external evaluation was undertaken which found that:

  • the RNFSA role is adaptable across multiple settings in the public sector, teaching and non-teaching hospitals, urban and rural
  • the training programme was seen to strengthen safety and consistency in private settings
  • the role made a positive contribution to surgical teams
  • the role had a positive impact on the length of surgery and readmission rates.

Read the full evaluation report: Registered Nurse First Surgical Assistant Pilot Evaluation (PDF, 991.87KB).

Next steps

Based on the first cohort evaluation and experience, HWNZ is undertaking work to develop and implement a business as usual model that is independent of HWNZ funding and is able to be used by DHBs nationwide for subsequent cohorts.

In parallel with the work to move the innovation from a demonstration model to a business as usual model, HWNZ funded a second cohort of 12 experienced theatre nurses to further embed the role in the public sector. The second cohort began their training in March 2012 and tested the role in a wider range of public sector settings. They undertook clinical placements at Southern, Canterbury, Capital and Coast, Waikato, and Tairawhiti DHBs, as well as at several private hospitals across New Zealand. This second cohort showed that RNFSAs were more likely to be rostered for complex surgery.

The two-phased approach used for this initiative has been successful in embedding this role in the sector. The demand for training RNFSAs in the sector continues and a third cohort is starting in February 2013. 

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© Ministry of Health – Manatu Hauora, 2012