Sec. 10.22.10.09. Use of Mechanical Restraint and Support

A. Use of Mechanical Restraint for Behavioral Purposes.

(1) A mechanical restraint may only be used:

(a) To prevent an individual from engaging in self-injurious behaviors such as head banging, teeth gnashing, and similar behavior;

(b) To prevent serious bodily harm to others; or

(c) As required by an individual's treating licensed health care practitioner to allow an individual to recuperate from surgery or injury.

(2) The licensee shall ensure that a mechanical restraint is designed and used:

(a) In a humane, safe, and effective manner; and

(b) Without intent to harm or create undue discomfort.

(3) If a mechanical restraint is being used for the purpose of §A(1)(a) and (b) of this regulation, the licensee shall:

(a) Meet the requirements in Regulations .05 and 06 of this chapter;

(b) Obtain written authorization from a licensed health care practitioner trained in applied behavior analysis for the use of the mechanical restraint, including the duration of its use and the circumstances under which the restraint is authorized;

(c) Document in the individual's record each use of mechanical restraint, including the reason for its use; and

(d) Require staff to check on the individual every 15 minutes.

(4) When a mechanical restraint is being used for the purpose of §A(1)(a) and (b) of this regulation, the licensee shall afford the individual the opportunity:

(a) To be escorted to the bathroom and offered fluids at least every 2 hours;

(b) For motion and exercise for a period of not less than 10 minutes during each 2 hours in which the restraint is used; and

(c) To be provided meals at regularly scheduled hours.

(5) A licensed health care practitioner who authorized the use of the mechanical restraint shall review the authorization at a minimum of every 90 days, and document its effectiveness and whether continuation is indicated.

B. Use of Mechanical Restraint for Medical Purposes. If a mechanical restraint is being used for the purpose of §A(1)(c) of this regulation, the licensee shall:

(1) Obtain written authorization from the individual's treating licensed health care practitioner; and

(2) Document in the individual's record the reason and guidelines for the use of the restraint, including the time frame the mechanical restraint is to be used.

C. Use of a Mechanical Support.

(1) A mechanical support may only be used if authorized by a licensed health care practitioner.

(2) The licensee shall ensure that a mechanical support is designed and used:

(a) In a humane, safe, and effective manner; and

(b) Without intent to harm or create undue discomfort.

(3) The licensee shall document in the individual's record the reason for use of the mechanical support, when it is to be used, and the directions for its use.

(4) The licensed health care practitioner who authorized the use of the mechanical support shall document its effectiveness and whether continuation is indicated, at least, on an annual basis.