Haw. Code R. § 11-175-57 - Right of freedom from seclusion and restraint

(a) Psychiatric facilities and residential treatment facilities which use seclusion or restraint shall:

(1) Use seclusion or restraint only;

(A) When necessary to prevent imminent harm to the consumer, others, or property when other means of control are not appropriate or effective;

(B) When part of a consumer's treatment plan; or

(C) When deemed necessary by a psychiatrist or psychologist to protect the rights of other consumers or staff.

(2) Document justification for any use of seclusion or restraint in the consumer's clinical record of the consumer;

(3) Terminate seclusion or restraint immediately when justification no longer exists;

(4) Document the names of the staff members who secluded the consumer or applied restraint in the clinical record;

(5) Use emergency seclusion or restraint no longer than one hour without telephoned authorization from a physician and no longer than twelve hours without written authorization of a physician who has personally examined the consumer;

(6) Use nonemergency seclusion or restraint only with authorization by a physician who has personally examined the consumer;

(7) State in policy and procedures that the person empowered to use seclusion or restraint in an emergency and responsible for ending an episode of seclusion or restraint is the person in charge of the unit;

(8) Require that written authorization for seclusion or restraint include;

(A) Conditions of seclusion or type of physical restraint;

(B) Duration of seclusion or restraint;

(C) Clothing to be removed, if any;

(D) Full justification for each use of seclusion or restraint, including why the measure is essential and why a less restrictive measure did not suffice; and

(E) The name of the authorizing physician.

(9) Review and renew if appropriate all orders for seclusion or restraint authorized by a psychiatrist or psychologist every 8 hours until terminated, except that seclusion or restraint of a consumer for longer than 72 consecutive hours shall require review and approval of the facility administrator,

(b) When a consumer is secluded or restrained, the consumer shall be;

(1) Personally examined and evaluated by a physician at least twice in each 24 hour period;

(2) Inspected at least once every 15 minutes by designated staff;

(3) Given the opportunity of hourly access to toilet facilities when awake; and

(4) Bathed as often as needed, but at least once every 24 hours;

(c) Any consumer in physical restraint shall be given the opportunity to sit or lie down and. to move freely for not less than 15 minutes during each 2-hour period during waking hours, unless medically contraindicated with justification documented in the clinical record.

(d) When seclusion or restraint is used as part of a treatment plan, the treatment plan shall include how this procedure is monitored and the expected therapeutic efficacy of the procedure.

Notes

Haw. Code R. § 11-175-57

[Eff. and comp DEC 30 1988; Comp OCT 19 2007] (Auth: HRS § 321-9) (Imp: HRS § 334E-2)