DAFORMFILLABLE.COM | DA FORM 5440-15 Fillable – Army Pubs 5440-15 PDF – DA FORM 5440-15, titled “Delineation of Clinical Privileges-Certified Nurse Midwives”, is a critical document used by the United States Army to outline the clinical privileges granted to certified nurse midwives (CNMs). This form is instrumental in ensuring that CNMs operate within their scope of practice and are authorized to perform specific medical procedures and duties within military medical facilities. Published on February 1, 2004, by the TSG (The Surgeon General), this form remains active and essential for maintaining high standards of care in military health services.
DA FORM 5440-15 – Delineation Of Clinical Privileges-Certified Nurse Midwives
| Form Number | DA Form 5440-15 |
| Form Title | Delineation Of Clinical Privileges-Certified Nurse Midwives |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose and Importance of DA FORM 5440-15
The DA FORM 5440-15 serves to delineate the clinical privileges of certified nurse midwives, clearly defining the range of procedures and responsibilities they are authorized to perform. This delineation is crucial for maintaining patient safety and professional accountability within military healthcare settings. By specifying the clinical privileges, the form helps ensure that CNMs provide care that is within their expertise, thereby enhancing the quality of healthcare services.
Structure and Content of DA FORM 5440-15
Header Information
The form begins with identifying details, including the Pub/Form Number (DA FORM 5440-15) and the Pub/Form Date (02/01/2004). The Pub/Form Title explicitly states the focus on clinical privileges for certified nurse midwives.
Proponent and Status
The Pub/Form Proponent is the TSG (The Surgeon General), indicating that the form is authorized and regulated by the highest medical authority in the Army. The form’s status is ACTIVE, ensuring its current relevance in the administrative and clinical processes.
Prescribing Directive
The form is prescribed by AR 40-68, which provides comprehensive guidelines on clinical privileges and credentialing within the Army Medical Department. This directive ensures that the use of DA FORM 5440-15 aligns with broader regulatory standards.
Key Features and Requirements
Electronic Media and Privacy Act
DA FORM 5440-15 is only produced in electronic media, making it easily accessible and manageable within digital healthcare systems. It also requires a Privacy Act Statement (AR 340-21), highlighting the importance of protecting personal and sensitive information related to the clinical privileges of healthcare providers.
Security and Distribution
The form is classified as UNCLASSIFIED, ensuring no restricted access based on security concerns. The distribution restriction code is A, meaning it is approved for public release and distribution is unlimited. This open distribution policy facilitates transparency and accessibility.
Application and Utilization
Certified nurse midwives utilize DA FORM 5440-15 to document and verify their clinical privileges within Army medical facilities. This process involves detailed assessments of their qualifications, competencies, and scope of practice. By using this form, military healthcare administrators can ensure that CNMs are appropriately credentialed to perform specific medical procedures and provide high-quality care.
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Conclusion
DA FORM 5440-15 plays a vital role in defining the clinical privileges of certified nurse midwives within the Army. By clearly outlining the authorized medical procedures and responsibilities, the form helps maintain high standards of care and ensures that CNMs operate within their professional scope. Understanding and utilizing this form is essential for healthcare providers and administrators committed to delivering exceptional medical services in military settings.
DA FORM 5440-15 Fillable – Army Pubs 5440-15 PDF DOWNLOAD
