Use Of Seclusion Or Restraints In Hospitals

(1) Seclusion or restraint must not be imposed as punishment, as a convenience for staff, or as a substitute for habilitative or rehabilitative programs. The owner or operator must ensure that seclusion or restraint is imposed only in accordance with the following: (a) Seclusion or restraint is only to prevent injury to self or others or to prevent serious disruption of the therapeutic environment. Only current behavior may justify use of seclusion or restraint; (b) Seclusion or restraint must be ordered by a physician following assessment of the need for seclusion or restraint. In emergency situations, other trained clinical professionals may initiate seclusion or restraint prior to obtaining an order. Seclusion or restraint cannot be ordered on a PRN basis; (c) Justification of the need for seclusion or restraint must be documented in the patient’s record and must reflect that less-restrictive measures were deemed inadequate; (d) Seclusion or restraint must be discontinued when other less-restrictive interventions will achieve the same results or when the behavior which led to the seclusion or restraint is under control; (e) Seclusion or restraint must not be used in a manner which causes physical discomfort, harm or pain to the patient; (f) Regular attention must be given to patients while in seclusion or restraint in regard to meals, clothing, toileting and exercise of restrained extremities; (g) Seclusion rooms must be clean, dry, comfortable and not contain anything with which the patient might harm self or others. Seclusion rooms must be designed so that the entire room is visible from the door window (h) Restraint must be imposed in an area as private as possible; and (i) All uses of seclusion or restraint must be reviewed regularly by the Chief Executive Officer or designee.