Section 385.1650  Restraints

a)         Restraints shall not be used except as a temporary measure to administer treatment or medications or in an emergency.

1)         In the case of administering treatment or medication, restraints shall be used only with the written order of the physician.  The order shall specify the reasons for use, duration and type of restraint.

2)         In the case of an emergency, the restraint shall only be used to protect a client from harming himself/herself or others.  The physician shall be notified, immediately after the restraint is applied and the client's needs are met.  The physician may order continued use of restraints while steps are taken to mitigate the need for restraints or to locate a more appropriate health care setting for the client.  In no case may restraints be used for more than 48 hours.

3)         In either case, when restraints are used, a trained, licensed healthcare professional who is knowledgeable in restraint application and use shall be available at the facility at all times the restraint is in use.  Further, a client wearing a restraint shall have it released for a few minutes at least once every two hours, or more often if necessary.  The client's position shall be changed at these times.

b)         No chemical, medication, or tranquilizer shall be employed by a facility as a restraint or confinement in lieu of or in addition to any physical restraint.  Such chemicals, medications or tranquilizers may only be employed as part of a duly prescribed therapeutic medical treatment program authorized by the client's physician and documented in the client's integrated care plan and medical record.