Section 29-6274. THE USE OF RESTRAINT

 

6274.1The facility shall not administer any form of restraint unless the resident is physically endangering himself/herself or others and no other intervention has been or is likely to be effective in averting the danger.

 

6274.2The facility shall not administer any form of restraint as a method of discipline.

 

6274.3The facility shall train staff in the acceptable and safe methods of restraint and the need to minimize the use of restraint. Only staff who received specific training in the acceptable and safe methods of restraint shall utilize restraint. The facility shall document such training within each staff person's personnel record.

 

6274.4The facility shall develop and follow written policies and procedures regarding the use of restraint, including:

 

(a)A list of the less restrictive interventions that shall be utilized, if appropriate, prior to the use of restraint;

 

(b)A list of the approved methods of restraint;

 

(c)For each form of restraint, a list of the least to most restrictive methods of restraint;

 

(d)A requirement that staff utilize the least restrictive method of restraint appropriate under the circumstances;

 

(e)The maximum duration for each form of restraint;

 

(f)The justification for each form of restraint;

 

(g)The procedures for administering each form of restraint;

 

(h)A list of the staff authorized to approve, administer, and monitor restraint;

 

(i)A description of the staff training on the utilization and administration of each form of restraint, which shall occur every six (6) months and be documented in a report maintained at each facility; and

 

(j)Procedures requiring a member of the staff who is not administering the restraint to monitor the resident being restrained.

 

6274.5The facility shall document in the resident's case record any restraint and shall include the following:

 

(a)The nature of the behavior warranting restraint;

 

(b)The date of the behavior warranting restraint;

 

(c)The restraint administered, including the duration of the restraint;

 

(d)The date the restraint was administered;

 

(e)An explanation of less restrictive intervention used prior to the restraint or the reason why such interventions were not utilized;

 

(f)The name and title of the person(s) who ordered, administered, and monitored the restraint; and

 

(g)The resident's response to the restraint.

 

6274.6The facility shall administer restraint in a manner that is least likely to cause personal injury or pain.

 

6274.7The facility shall immediately release a restrained resident who exhibits any sign of significant physical distress during restraint and immediately shall provide the resident with any necessary medical assistance.

 

6274.8The facility shall release a restrained resident as soon as it is safe to do so.

 

6274.9The facility shall notify the contracting entity and the licensing agency, the resident's parent(s), guardian(s) or custodian(s), the resident's guardian ad litem and, where applicable, the CSSD, as soon as possible but in no event later than twenty-four (24) hours by oral methods and in writing no later than the next business day, of any use of restraint.

 

source

Final Rulemaking published at 48 DCR 8675, 8738 (September 21, 2001).