DAFORMFILLABLE.COM | DA FORM 5441 Fillable – Army Pubs 5441 PDF – DA FORM 5441 – Evaluation Of Clinical Privileges – Anesthesia is a critical document used in the military healthcare system. This form plays a significant role in evaluating and certifying the clinical privileges of anesthesia providers. Understanding its purpose, structure, and proper usage is essential for maintaining high standards in medical practice within the military. This article provides a detailed overview of DA FORM 5441, ensuring that healthcare professionals can effectively utilize it in their evaluations.
DA FORM 5441 – Evaluation Of Clinical Privileges – Anesthesia
| Form Number | DA Form 5441 |
| Form Title | Evaluation Of Clinical Privileges – Anesthesia |
| Form Date | 02/01/2004 |
| Form Proponent | TSG |
What is DA FORM 5441?
DA FORM 5441 is an Evaluation Of Clinical Privileges – Anesthesia form used by the United States Army. It was published on February 1, 2004, and remains an active form, prescribed under AR 40-68. This form is essential for documenting the clinical competencies and privileges of anesthesia providers, ensuring they meet the required standards for patient care.
Purpose of DA FORM 5441
The primary purpose of DA FORM 5441 is to evaluate and certify the clinical privileges of anesthesia providers. This form helps to ensure that providers have the necessary skills and competencies to perform anesthesia-related procedures safely and effectively. By thoroughly documenting the qualifications and performance of anesthesia providers, the form helps maintain high standards in military medical practice.
Key Features of DA FORM 5441
Publication Details
- Pub/Form Number: DA FORM 5441
- Pub/Form Date: 02/01/2004
- Pub/Form Title: Evaluation Of Clinical Privileges – Anesthesia
- Pub/Form Proponent: The Surgeon General (TSG)
- Pub/Form Status: Active
- Prescribed Forms/Prescribing Directive: AR 40-68
Footnotes and Distribution
- Footnotes:
- 14: Requires Privacy Act Statement (AR 340-21)
- 42: Item only produced in electronic media
- Security Classification: Unclassified
- Dist Restriction Code: A (Approved for public release; distribution is unlimited)
- Pub/Form IDN: 990001
- Pub/Form PIN: 066531
Importance of DA FORM 5441 in Military Healthcare
Ensuring Competence and Safety
DA FORM 5441 is crucial in the military healthcare system as it ensures that anesthesia providers are competent and qualified. This evaluation form assesses various aspects of a provider’s skills, including their ability to perform anesthesia-related procedures safely and effectively. By maintaining rigorous evaluation standards, the form helps to protect patient safety and uphold the quality of care in military medical facilities.
Compliance with Regulations
The use of DA FORM 5441 is mandated by AR 40-68, which outlines the standards and procedures for granting clinical privileges to healthcare providers. Compliance with these regulations is essential for maintaining the integrity and accountability of the military healthcare system. The form’s requirement for a Privacy Act Statement under AR 340-21 ensures that the evaluation process respects the privacy and confidentiality of healthcare providers.
How to Complete DA FORM 5441
Sections of the Form
DA FORM 5441 is structured to capture comprehensive information about an anesthesia provider’s qualifications and performance. Key sections of the form include:
- Personal Information: This section collects basic details about the provider, including their name, rank, and contact information.
- Professional Qualifications: This section documents the provider’s educational background, certifications, and relevant training.
- Clinical Performance: This section evaluates the provider’s clinical skills, including their ability to perform specific anesthesia procedures.
- Supervisor’s Evaluation: This section provides space for a supervisor to assess the provider’s overall performance and competency.
Tips for Accurate Completion
- Ensure Accuracy: All information provided on DA FORM 5441 should be accurate and up-to-date. Double-check details to avoid errors that could impact the evaluation process.
- Provide Detailed Assessments: When evaluating clinical performance, provide detailed and specific feedback. This helps to create a comprehensive picture of the provider’s capabilities.
- Follow Privacy Guidelines: Adhere to privacy guidelines as outlined in AR 340-21. Ensure that any personal information included in the form is handled confidentially.
Conclusion
DA FORM 5441 – Evaluation Of Clinical Privileges – Anesthesia is a vital tool in the military healthcare system, ensuring that anesthesia providers meet the necessary standards for clinical practice. By understanding the purpose and proper use of this form, healthcare professionals can contribute to maintaining high standards of patient care and safety. Compliance with regulations and accurate completion of the form are essential for effective evaluations.
DA FORM 5441 Fillable – Army Pubs 5441 PDF DOWNLOAD
