DA Form 5441-14. Evaluation of Clinical Privileges-Nurse Anesthetist

DA Form 5441-14 is intended for the evaluation of clinical privileges for Nurse Anesthetists. This form plays a pivotal role in assessing and establishing the qualifications and requested privileges for certified nurse anesthetists involved in administering anesthesia during medical procedures.

The form includes sections where the nurse anesthetist provides personal and professional details, including certifications and qualifications specific to anesthesia practice. It necessitates outlining the requested clinical privileges, covering aspects of anesthesia administration and perioperative monitoring.

Important fields in this form include the nurse anesthetist's identification details, requested clinical privileges, and supporting documentation showcasing their expertise in anesthesia practice. Accurate completion of this form is of paramount importance as it ensures that the nurse anesthetist is granted privileges aligned with their skill set and experience in anesthesia care.

Application Example: A certified nurse anesthetist joining a military medical facility would utilize DA Form 5441-14 to request clinical privileges. By accurately completing the form and providing necessary documentation, the nurse anesthetist's proficiency in administering anesthesia and perioperative care is evaluated, enabling the medical facility to grant appropriate privileges.

No additional documents are explicitly mentioned as required for filling this form.

Related Form: DA Form 5441-11, 5441-12, 5441-13, and 5441-15 are related forms intended for different clinical privilege evaluation processes.