| (a) Observation.
(1) A staff member of the same gender as the individual
shall maintain continuous face-to-face observation of an individual
in mechanical restraint, unless the individual's history or other
factors indicate this would be contraindicated (e.g., sexual or physical
abuse perpetrated by someone of the same gender, in which case a staff
member of the opposite gender may be used).
(2) A staff member who is not physically applying personal
restraint shall maintain continuous face-to-face observation of an
individual in personal restraint.
(3) A staff member shall maintain continuous face-to-face
observation of an individual in seclusion for at least one hour. After
one hour, the staff member may monitor the individual continuously
using simultaneous video and audio equipment in close proximity to
the individual.
(b) Monitoring. A staff member shall ensure adequate
respiration and circulation of the individual in restraint at all
times.
(1) Respiratory status, circulation, and skin integrity
must be monitored continuously and documented every 15 minutes (or
more often if deemed necessary by the ordering physician). Cardiac
status must be monitored and documented hourly (or more often if deemed
necessary by the ordering physician).
(2) An assigned staff member must perform range of
motion exercises for each extremity, one extremity at a time, for
at least five minutes no less frequently than every 60 minutes that
an individual is in mechanical restraint.
(c) Care. A staff member must provide for the hygiene,
hydration, nutrition, elimination needs, and safety of an individual
in restraint or seclusion. The individual in restraint or seclusion
shall be provided:
(1) bathroom privileges at least once every two hours
(or more frequently, if requested and not contraindicated, or otherwise
required by the individual's circumstances and physical or medical
needs);
(2) an opportunity to drink water or other appropriate
liquids every two hours (or more frequently, if requested and not
contraindicated, or otherwise required by the individual's circumstances
and physical or medical needs);
(3) an opportunity to bathe at least once daily (or
more frequently, if clinically indicated or in the presence of incontinence);
(4) medications and medical equipment as ordered;
(5) regularly scheduled meals and snacks served on
dishes that are appropriate for safety; and
(6) an environment that is free of safety hazards,
adequately ventilated during warm weather, adequately heated during
cold weather, and appropriately lighted.
|
