Sec. 10.21.13.06. Clinical Interventions During Seclusion

A. While the patient is secluded, in order to provide appropriate clinical care, at a minimum, clinically trained staff shall:

(1) Observe the patient at least every 15 minutes, and document each observation by the observer;

(2) Unless contraindicated by circumstances as assessed and documented by a physician or registered nurse, at least hourly, make and document personal contact with the patient for the purpose of determining if the patient has any special needs which need attention;

(3) Unless contraindicated by circumstances as assessed and documented by a physician or registered nurse, offer or provide the following:

(a) Toilet facilities, at least every 2 hours;

(b) Bathing and oral hygiene, at least once during a 24-hour period;

(c) Meals, at the regularly scheduled hours and under the supervision of nursing personnel; and

(d) Fluids, at least every 2 hours; and

(4) As clinically indicated, record temperature, pulse, blood pressure, and respirations.

B. At least once every 2 hours, a physician or registered nurse shall assess the appropriateness of continuing the seclusion and document the factors supporting the assessment in the patient's medical record.

C. Unless circumstances suggest a medical problem may exist, staff may not disrupt a patient's sleep during the night to implement the clinical procedures described in §§A and B of this regulation.