DAFORMFILLABLE.COM | DA FORM 5440-30 Fillable – Army Pubs 5440-30 PDF – DA FORM 5440-30 – Delineation Of Clinical Privileges – Nephrology is a critical document used by the U.S. Army to outline and authorize specific clinical privileges for nephrology practitioners. Effective since February 1, 2004, this form ensures that only qualified healthcare professionals perform specific nephrology procedures and services within the Army Medical Department. The form is prescribed by AR 40-68 and is produced exclusively in electronic media.
DA FORM 5440-30 – Delineation Of Clinical Privileges – Nephrology
| Form Number | DA Form 5440-30 |
| Form Title | Delineation Of Clinical Privileges – Nephrology |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
Purpose and Importance of DA FORM 5440-30
Ensuring Qualified Care
The primary purpose of DA FORM 5440-30 is to delineate clinical privileges for nephrology, ensuring that healthcare providers possess the necessary qualifications and skills to perform specialized procedures. This form plays a crucial role in maintaining high standards of medical care and patient safety within military healthcare facilities.
Compliance and Legal Framework
DA FORM 5440-30 is mandated by AR 40-68, which governs the clinical privileges and medical care standards within the Army. Additionally, the form requires compliance with AR 340-21 to include a Privacy Act Statement, ensuring that the collection and handling of personal data adhere to privacy laws and regulations.
Components of DA FORM 5440-30
Clinical Privileges Section
The form includes a comprehensive list of clinical privileges specific to nephrology. This section details the various procedures and treatments that a nephrology practitioner is authorized to perform, such as dialysis, kidney biopsies, and management of chronic kidney disease.
Practitioner Information
This section requires detailed information about the healthcare provider, including their qualifications, certifications, and experience. It ensures that only those with the requisite expertise are granted specific clinical privileges.
Approval and Signatures
The form must be reviewed and approved by authorized personnel within the Army Medical Department. This includes signatures from supervising physicians, credentialing officers, and other relevant authorities to validate the practitioner’s qualifications and the granting of privileges.
Process of Obtaining Clinical Privileges
Submission and Review
To obtain clinical privileges, a nephrology practitioner must complete DA FORM 5440-30, providing all necessary documentation and evidence of their qualifications. The completed form is then submitted to the appropriate medical authority for review.
Verification and Approval
The review process involves verifying the practitioner’s credentials, training, and experience. Once verified, the form is approved, and the practitioner is granted the specified clinical privileges, allowing them to perform nephrology procedures within the Army Medical Department.
Significance of Electronic Media Production
DA FORM 5440-30 is produced exclusively in electronic media, facilitating easier access, distribution, and storage. This electronic format supports efficient management and reduces the risk of lost or damaged paperwork, ensuring that clinical privilege records are maintained accurately and securely.
Public Release and Distribution
Security Classification
The form is classified as UNCLASSIFIED, meaning it does not contain sensitive information that would compromise national security if disclosed.
Distribution Code
The distribution code A indicates that DA FORM 5440-30 is approved for public release and distribution is unlimited. This ensures transparency and accessibility, allowing relevant parties to obtain and utilize the form without restrictions.
Conclusion
DA FORM 5440-30 – Delineation Of Clinical Privileges – Nephrology is an essential document within the Army Medical Department, ensuring that nephrology practitioners are properly credentialed and authorized to perform specialized procedures. By adhering to the guidelines set forth in AR 40-68 and AR 340-21, this form upholds the highest standards of medical care and patient safety. Its electronic format and unrestricted distribution further enhance its accessibility and utility in maintaining effective clinical privilege management.
DA FORM 5440-30 Fillable – Army Pubs 5440-30 PDF DOWNLOAD
