20 CAR § 413-803 – Standard — Physical restraints

(a) The facility may employ physical restraints only:
1. (1) As an integral part of an individual program plan that is intended to lead to less restrictive means of managing and eliminating the behavior for which the restraint is applied;
2. (2) As an emergency measure, but only if absolutely necessary to protect the client or others from injury; or
3. (3) As a health-related protection prescribed by a physician, but only if absolutely necessary during the conduct of a specific medical or surgical procedure, or only if absolutely necessary for client protection during the time that a medical condition exists.
(b) Authorizations to use or extend restraints as an emergency measure must be:
1. (1) In effect no longer than twelve (12) consecutive hours;
2. (2) Obtained as soon as the client is restrained or stable; and
3. (3) The facility must not issue orders for restraint on a standing or as needed basis.
(c) A client placed in restraint must be checked at least every thirty (30) minutes by staff trained in the use of restraints, released from the restraints as quickly as possible, and a record of these checks and usage must be kept.
(d) Restraints must be designed and used so as not to cause physical injury to the client and so as to cause the least possible discomfort.
(e) Opportunity for motion and exercise must be provided for a period of not less than ten (10) minutes for each two-hour period in which restraint is employed, and a record of such activity must be kept.
(f) Barred enclosures must not be more than three feet (3’) in height and must not have tops.