ALLIED HEALTH PROFESSIONALS
DELINEATION OF CLINICAL PRIVILEGES
ORTHOPAEDIC PHYSICIANS ASSISTANT - CERTIFIED (OPA-C)
Clinical Privileges:
By requesting the privileges listed below, the employing physician is attesting that he or she has knowledge of the
education, ability and competence of the Certified Orthopaedic Physicians Assistant. The physician is also attesting
that granting these clinical privileges is consistent with current medical practice and will not adversely affect
patient safety and that he or she shall be legally responsible and accountable for all of the clinical activities
performed by the Certified Orthopaedic Physicians Assistant including ensuring that the Certified Orthopaedic
Physician Assistant performs only those clinical privileges as have been approved and granted.
All clinical privileges shall be performed under the direct supervision of the employing physician. Adherence to the
principles of aseptic techniques per accepted standards of practice and the Hospital's Infection Control policies is
required of all Certified Orthopaedic Physician Assistants.
________________________________________ may perform the following clinical /surgerical procedures:
(Type or Print Name)
Requested
Approved
Denied
Responsible for the accurate recording and reporting of any facts,
Including evaluation and treatment of the whole care of the
patient.
Assist with patient education involving the whole patient care and
plan of treatment.
Assist with application and execution of orthopaedic procedures
and services and execute the legal orders of the supervising
orthopaedic physician concerning the whole care of the patient.
Follow-up care and services may be rendered by the Orthopaedic
Physician's Assistant Certified commensurate with education and
experience. All entries into the patient chart must be reviewed and
signed by the supervising physician.
In the event of an emergency situation, administration of all
recognized first aid procedures.
Performance of History and Physical Assessment. Aspirations and
Injections.
Application and removal of all types of traction, casts, splints, and
other immobilization devices and equipment.
Assist with and perform digital blocks, hematoma blocks and the
use of local anesthetics.
Assist with the reduction of fractures and dislocations.
Assist with and perform the removal or excision of superficial
orthopedic hardware.
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Pre-admission patient evaluation and work-up, including history
and physical assessment, patient education, and the institution of
routine orders, all of which are to be reviewed by the supervising
physician.
Institute admission, in-house, transfer and discharge orders, all of
which are to be reviewed by the supervising physician.
Evaluation of patient status by:
1) Routine daily rounds.
2) Evaluation of laboratory parameters, radiological and other
diagnostic studies.
3) Progress Notes.
4) Routine Orders.
Assist in setting orthopaedic instrumentation and equipment.
Assist with patient preparation to include draping and positioning.
First and second assist with all procedures to include tissue
retraction, suturing of tissues, cutting of suture, closing of the
operative case, and application of any appropriate appliance.
Removal of sutures and staples.
Application of casts, splints, traction, and other orthopaedic
devices and equipment
Cast and splint changes, dressing changes with routine wound care
as necessary.
Institute and execute routine post-operative orders of the
supervising physician.
Chart progresses and other notes as necessary.
Dictate noted and discharge summaries.
Signature of Applicant
Date
Employing Physician (Print full name)
Signature of Employing Physician
Date
Upon review of documentation relative to the clinical competence of this applicant, I find that he/she meets the
criteria for registration as a Orthopaedic Physician Assistant Certified and is qualified to perform procedures as
requested and approved under the supervision of the employing physician.
Signature of Chief, Surgery Service
Date
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