5122-26-16.2 [Effective until 1/1/2012] Physical restraint.

(A) The purpose of this rule is to state the specific requirements applicable to physical restraint.

(B) Physical restraint may be used as a response to an emergency only.

(1) Training for staff implementing physical restraint shall include but not be limited to:

(a) Current certification in CPR and first aid;

(b) The identification and utilization of less restrictive alternatives; and

(D) Documentation of each episode of the use of physical restraint shall be made in the clinical record and shall include:

(1) Reason for implementation of the physical restraint;

(2) Less restrictive interventions attempted first, if the situation allowed;

(3) Notation that a review and description of any known contraindications for the use of physical restraint was conducted;

(4) Explanation to the person for the reason for implementation of physical restraint and the required behaviors of the person which would indicate sufficient behavioral control so that the physical restraint could be discontinued;

(5) Upon conclusion of the physical restraint, assessment of the need for ambulating, fluid intake, toileting, and other needs;

(6) Results of a check for injury;

(7) Documentation of staff’s efforts to process the circumstances surrounding the physical restraint with the individual; and

(8) Notation of any concerns for the subsequent utilization of physical restraint.

(E) Clinically appropriate reason(s) for the inability to carry out any portion of paragraph (D) of this rule shall be documented in the clinical record.

Eff 1-1-91; 4-16-01 Rule promulgated under: RC Chapter 119. Rule authorized by: RC 5119.01(G), 5119.01(I), 5119.22, 5119.61(M)Rule amplifies: RC 5119.01(G), 5119.01(I), 5119.22, 5119.61(M) Replaces: 5122-26-16 RC 119.032 review dates: April 15, 2006

5122-26-16.2 [Effective 1/1/2012] Physical restraint

(A) The purpose of this rule is to state the specific requirements applicable to physical restraint.

(B) Physical restraint shall not be used unless it is in response to a crisis situation, i.e., where there exists an imminent risk of physical harm to the individual or others, and no other safe and effective intervention is possible. It shall be employed for the least amount of time necessary in order that the individual may resume his/her treatment as quickly as possible..

(1) Physical restraint must be authorized by a trained, qualified staff member in accordance with the requirements of the agency’s behavioral health accrediting body; or

(2) For an agency who has not achieved appropriate behavioral health accreditation, the agency must identify and approve staff who are qualified to authorize physical restraint.

Staff approved by the agency must have received all training in accordance with paragraph (F) of rule 5122-26-16 of the Administrative Code.

(D) Documentation of each episode of the use of physical restraint shall be made in the clinical record and shall include:

(1) The reason for implementation of the physical restraint;

(2) All prior attempts to use less restrictive interventions;

(3) Notation that any previously identified contraindication(s) to the use of physical restraint were considered and the rationale for continued implementation of physical restraint despite the existence of such contraindication(s);

(4) A review of all current medications;

(5) Explanation to the person for the reason for implementation of physical restraint and the required behaviors of the person which would indicate sufficient behavioral control so that the physical restraint could be discontinued;

(6) The condition of the person at routine intervals not to exceed fifteen minutes or more often if the person’s condition so warrants. Such documentation shall address attention to vital signs, circulation, range of motion, nutrition, hydration, hygiene, toileting, need for continued restraint, and other needs as necessary, and the appropriate actions taken; and

(7) Upon conclusion of the physical restraint, the results of a check of injuries shall be conducted.

The appropriate actions taken for any injuries noted shall also be documented.

(E) Clinically appropriate reason(s) for the inability to implement any portion of this rule shall be documented in the clinical record, and shall be addressed in any staff de-briefing of the episode and in the agency’s performance improvement process.

Replaces: 5122-26-16.2

Effective: 01/01/2012 R.C. 119.032 review dates: 01/01/2017 Promulgated Under: 119.03 Statutory Authority: 5119.22, 5119.61, 5119.611 Rule Amplifies: 5119.22, 5119.61, 5119.611 Prior Effective Dates: 1/1/91, 4/16/01