Assessments

(1) The hospital must conduct the following types of assessments: (a) Risk Assessments: 1. Each service recipient must be assessed to identify individuals at risk of need for external controls such as isolation or restraint for his or her behavior. This assessment should include identification of any specific situations or issues, including cultural issues, that could potentially trigger behavior that might require the use of isolation or restraint. HOSPITAL ISOLATION AND RESTRAINT CHAPTER 0940-03-06 2. Each service recipient must be assessed to identify potential risks to the service recipient that might be associated with the use of isolation or restraint. The assessment shall include risks of physical/medical and psychological/emotional harm associated with the use of isolation or restraint, including risks related to cultural issues. 3. Risk assessments must be performed at admission by a licensed independent practitioner and updated by a licensed independent practitioner or other licensed mental health professional when there is significant change in mental status, behavior, or physical/medical condition. Risk assessments must be documented in the service recipient’s record. (b) Assessment of Need: 1. Prior to the use of isolation or restraint, the service recipient must have an assessment that supports that the use of isolation or restraint is necessary to assure the physical safety of the service recipient or a person nearby and that all less restrictive interventions have been ineffective or determined to be inappropriate. 2. If the licensed independent practitioner authorizing the use of isolation or restraint is present at the time of the initiation of isolation or restraint, the licensed independent practitioner shall document the assessment of need in the service recipient’s record. 3. If the use of isolation or restraint is initiated in the absence of a licensed independent practitioner, a licensed mental health professional shall document the assessment of need in the service recipient’s record at the time use of isolation or restraint is initiated. The licensed independent practitioner authorizing the use of isolation or restraint must document the rationale for the use of isolation or restraint in the service recipient’s record at the time the verbal/telephone order is authenticated. (c) Follow-up Assessment: 1. Within one (1) hour of the initiation of the use of isolation or physical restraint, a licensed independent practitioner or a registered nurse trained in accordance with 0940-03-06-.19 must see and assess the service recipient’s condition. This assessment must be conducted regardless of the length of time the service recipient is in isolation or physical restraint. This assessment must be documented by the licensed independent practitioner or registered nurse in the service recipient’s record. 2. When chemical restraint is used, a physician must see and assess the service recipient’s condition within one (1) hour of the administration of the medication used for chemical restraint. This assessment must be documented by the physician in the service recipient’s record.