1. A. Staff authorized under the provisions of Regulation .05B of this chapter may use a restraint:

   1. (1) Only during an emergency in which the behavior of the patient places the patient or others in serious threat of violence or injury;
   2. (2) If ordered by a physician in writing; or
   3. (3) If at the direction of a registered nurse, if a physician's order is obtained within 2 hours of the action.

2. B. Staff may not use a restraint:

   1. (1) As a mode or course of treatment;
   2. (2) As punishment, coercion, discipline, or retaliation;
   3. (3) For the convenience of staff;
   4. (4) To prevent damage or destruction to property; or
   5. (5) To prevent serious disruption of the therapeutic environment.

3. C. Staff shall use a restraint:

   1. (1) In a humane, safe, and effective manner;
   2. (2) Without intent to harm or create undue discomfort to the patient; and and
   3. (3) For the shortest possible length of time, regardless of the length of time in the physician's order.

4. D. Staff authorized under the provisions of Regulation .05B of this chapter may order the use of a restraint only if the physician, following a clinical evaluation of the patient, determines that:

   1. (1) The patient's behavior poses an emergency situation; and
   2. (2) Less restrictive or alternative approaches have been determined to be ineffective to ensure the safety of the patient, staff, or others.

5. E. The approaches referred to in §D(2) of this regulation may include, but are not limited to:

   1. (1) Clinical interventions;
   2. (2) Quiet room;
   3. (3) Medication or medications;
   4. (4) Deescalation techniques;
   5. (5) Trauma-informed care interventions;
   6. (6) Calling the hospital's response team for assistance; and
   7. (7) Consulting the patient's care plan for personalized strategies.

Authority: Health-General Article, §§10-101(g) and 10-701, Annotated Code of Maryland

Effective date: October 25, 1993 (20:21 Md. R. 1654)

Regulation .01 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .02B amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .03 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .05 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .06D amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .08D amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .09 amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation 10D amended effective February 14, 2026 (52:23 Md. R. 1139)

Regulation .12D, F amended effective February 14, 2026 (52:23 Md. R. 1139)