DAFORMFILLABLE.COM | DA FORM 5440-55 Fillable – Army Pubs 5440-55 PDF – The DA FORM 5440-55 is an essential document used in the field of orthopaedics. This form, titled Delineation Of Clinical Privileges – Orthopaedics, plays a crucial role in defining the clinical privileges granted to orthopaedic practitioners within the military healthcare system. Understanding the details and proper usage of this form is vital for compliance with military healthcare regulations and ensuring the highest standards of patient care.
DA FORM 5440-55 – Delineation Of Clinical Privileges – Orthopaedics
| Form Number | DA Form 5440-55 |
| Form Title | Delineation Of Clinical Privileges – Orthopaedics |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Overview of DA FORM 5440-55
Purpose and Usage
The DA FORM 5440-55 is used to specify the clinical privileges that are granted to orthopaedic surgeons and practitioners. These privileges outline the specific procedures and treatments that the practitioner is authorized to perform. The form ensures that only qualified personnel are permitted to carry out specialized orthopaedic procedures, thereby maintaining patient safety and healthcare quality.
Publication and Status
- Pub/Form Number: DA FORM 5440-55
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Delineation Of Clinical Privileges – Orthopaedics
- Pub/Form Proponent: The Surgeon General (TSG)
- Pub/Form Status: Active
Regulatory Framework
Prescribing Directive
The usage of DA FORM 5440-55 is prescribed by AR 40-68, which governs the credentialing and privileging of healthcare providers within the Army Medical Department. This regulation ensures that all medical personnel meet the necessary qualifications and standards to perform their duties effectively and safely.
Privacy and Distribution
- Footnotes:
- 42: This form is only produced in electronic media.
- 14: The form requires a Privacy Act Statement as per AR 340-21.
- Distribution: The form is unclassified and approved for public release. Distribution is unlimited, making it accessible to all relevant military personnel.
Importance of Clinical Privileges in Orthopaedics
Ensuring Qualified Practice
The delineation of clinical privileges is crucial in orthopaedics to ensure that practitioners perform only the procedures for which they are adequately trained and experienced. This helps in minimizing risks and enhancing the quality of care provided to patients.
Compliance with Military Standards
Adhering to the standards set forth in DA FORM 5440-55 and AR 40-68 is mandatory for maintaining compliance with military healthcare regulations. It ensures that orthopaedic practitioners are continuously evaluated and credentialed according to the latest standards and practices.
Key Elements of DA FORM 5440-55
Form Details
- Pub/Form IDN: 990001
- Pub/Form PIN: 081327
- Security Classification: Unclassified
Sections of the Form
The DA FORM 5440-55 includes various sections that capture essential information about the practitioner and the specific clinical privileges being granted. These sections typically include:
- Personal Information: Details about the orthopaedic practitioner, including name, rank, and contact information.
- Qualifications: Documentation of the practitioner’s qualifications, training, and experience in orthopaedics.
- Privileges Granted: A detailed list of the specific procedures and treatments the practitioner is authorized to perform.
- Approval and Signatures: Approval from the relevant authorities, including the signature of the commanding officer or designated medical authority.
Best Practices for Using DA FORM 5440-55
Accurate and Complete Documentation
It is vital to ensure that all information entered on the DA FORM 5440-55 is accurate and complete. This includes verifying the practitioner’s qualifications and the specific privileges granted.
Regular Updates
Privileges should be reviewed and updated regularly to reflect any changes in the practitioner’s qualifications or changes in medical standards and procedures. This ensures ongoing compliance and the highest level of patient care.
Conclusion
The DA FORM 5440-55 – Delineation Of Clinical Privileges – Orthopaedics is a fundamental document in the military healthcare system, ensuring that orthopaedic practitioners are properly credentialed and privileged to perform specific procedures. By adhering to the guidelines and best practices associated with this form, military healthcare facilities can maintain high standards of care and compliance with regulatory requirements.
For more detailed information or to access the form electronically, military personnel can refer to the relevant Army regulations and resources.
DA FORM 5440-55 Fillable – Army Pubs 5440-55 PDF DOWNLOAD
