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Sample H&P privilege language
There are a variety of viable ways to approach the
delineation of medical history and physical exam (H&P)
privileges. Following is a sampling of core privilege
statements for various disciplines. Some address H&Ps in
explicit terms, and others use alternative language.
Podiatry
H&P as it pertains to Podiatry, Excision-cutaneous
lesions, Excision-nail- matrix, Excision-foreign body,
Tenotomy & Capsulotomy of digits, Excision-tendon
lesions (ganglion), Excision-inter-metatarsal neuroma,
Excision-soft tissue lesion from rearfoot (ganglion),
Plantar fascia release; Exostectomy of phalanx,
Arthroplasty of toes, Tendon transfer or redirection in
forefoot, Syndactylism of toes, Osteotomy of phalanges
(with or without fixation), Bunionectomy (with or without
osteotomy or implantation), Remodeling of lesser
metatarsal (Plantar condylectomy, Tailor's bunion, Solitary
metatarsal head resection), Sesamoidectomy, ProsthesisMPJ, Osteotomy of metatarsal (with or without fixation),
Open repair of fracture-forefoot, Pan- Metatarsal head
resection, Bunionectomy with osteotomy, Excision
osseous tumor digit and forefoot, Skin Transfers/rotation
flips, Partial ostectomy-lesser tarsus, Excision plantar
calcaneal exostosis, Excision-retro-calcaneal exostosis
spur, Fusion of metatarsal-cuneiform joint, Capsulotomy
of midfoot, Amputation of ray. MUST CO-ADMIT
WITH AN ACTIVE STAFF MEMBER.
Source: Flagler Hospital
Internal medicine
Admission, diagnosis, treatment of the medical patient
to include H&Ps. Includes ICU admission with
appropriate consult. Includes privileges for Evaluation and
Management, Supervision of TPN, Thrombolytic Therapy,
interpretation of EKG, Holter Monitors, Simple
Spirometry, Bone Marrow, Lumbar Puncture, Arterial
Monitoring, Joint Aspiration, Endotracheal intubation, and
Femoral Central Line placement, arterial lines without
cutdown, paracentesis, thoracentesis, suturing of simple
skin lacerations, removal of non-penetrating corneal
foreign bodies, and minor strains and sprains, ventilator
management, temporary transcutaneous pacemakers, and
I&D of abscess, performance (not interpretation) of stress
tests, and simple skin biopsy and removal.
Source: Flagler Hospital
Family medicine
Admission of patients, medical history and physical
examination, other diagnostic tests and therapeutic
services, chart in the patient’s medical record, refer and
request consultation.
Source: Vicki Bond, CPMSM, ACHE, MHS
General surgery
Admit, evaluate, diagnose, consult, and provide pre,
intra and post-operative care, and perform general surgical
procedures, to pediatric (excluding newborn) and adult
patients, except where specifically excluded from practice,
to correct or treat various conditions, diseases, disorders
and injuries of the alimentary tract, abdomen and its
contents, extremities, breast, skin and soft tissue, head and
neck, vascular and endocrine systems. Includes
management of Level II trauma and care, stabilization and
transfer out of critically ill patients with underlying surgical
conditions from the emergency department, medicine,
surgery and intensive care units.
Source: Melinda E. Whitney, RN, BSN, BS, MS, CPHQ,
CPMSM, FACHE
Nurse practitioners (NP) in acute care
Assess, diagnose, monitor, promote health and
protection from disease, and manage patients within age
group of collaborating/supervising physician. NPs
[may/may not] admit patients to the hospital. They may
provide care to patients in the intensive care setting in
conformance with unit policies as well as assess, stabilize,
and determine disposition of patients with emergent
conditions consistent with medical staff policy regarding
emergency and consultative call services. General core
privileges include the procedures on the following
procedure list and such other procedures that are
extensions of the same techniques and skills.
 Perform history and physical
 Apply, remove, and change dressings and bandages
 Counsel and instruct patients, families, and caregivers
as appropriate
 Debridement and general care for superficial wounds
and minor superficial surgical procedures
 Dictate discharge summaries
 Direct care as specified by medical staff-approved
protocols
 Implement therapeutic intervention for specific
conditions when appropriate
 Implement palliative and end of life care through
evaluation, modification, and documentation
according to the patient’s response to therapy,
changes in condition, and to therapeutic
interventions to optimize patient outcomes.
 Initiate appropriate referrals
 Insert and remove nasogastric tube
 Make rounds on hospitalized patients
 Order and initial interpretation of diagnostic testing
and therapeutic modalities such as laboratory tests,
medications, hemodynamic monitoring, treatments,
IV fluids and electrolytes, EMG, electrocardiogram,
and radiologic examinations including arthrogram,
ultrasound, CT, MRI, and bone scan studies, etc.
 Perform urinary bladder catheterization (short term
and indwelling), e.g., Robinson, coudé, Foley
 Perform venous punctures for blood sampling,
cultures, and IV catheterization
 Record progress notes
Source: Core Privileges for AHPs: Develop and
Implement Criteria-Based Privileging for Nonphysician
Practitioners, Third Edition
All privilege form excerpts were reprinted with permission.