N.H. Admin. Code § Cor 502.03 - Medical Use of Restraints
(a) An
emergency response shall include use of restraints only to the extent
authorized by this section
(b)
Restraints shall:
(1) Not be imposed longer
than is necessary to resolve a personal safety emergency regardless of the
length of the time identified in the order; and
(2) Not exceed 2 hours unless there is
documented authorization by a physician or APRN.
(c) Restraints shall be used only as a last
resort when no other intervention in an emergency situation is feasible to
protect the immediate safety of the resident or others.
(d) Restraints shall never be used explicitly
or implicitly as punishment for the behavior of the resident.
(e) Residents in restraints shall be afforded
privacy through practices including:
(1) The
use of a single room;
(2)
Minimizing external stimuli such as noise, nearby movement, and approaches by
other residents; and
(3) Continuous
staff observation to assure the conditions in (2) above are met.
(f) Authorization for the use of
restraints shall be as follows:
(1) A
physician or APRN may write an order for the use of restraints; or
(2) A physician or APRN may authorize the use
of restraints via telephone when the order:
a. Follows deliberate and comprehensive
consultation between the physician or APRN and a trained APRN or registered
nurse (RN) who has personally evaluated the resident by reviewing:
1. The assessments of the resident that have
been performed;
2. The safety
issues involved; and
3. The
potential antecedents to the restraint(s);
b. Is for a period not to exceed 2 hours;
and
c. Is countersigned by the
ordering physician or APRN within 24 hours of the time such treatment was
ordered.
(g)
A physician or APRN may authorize in writing, or verbally by telephone, the
extension of an order of restraint(s) if he or she, or a trained APRN or
registered nurse (RN), has personally examined, observed, and assessed the
resident for whom the seclusion or restraint is ordered.
(h) Following an examination and assessment
as required by (g) above such authorization shall expire unless it is renewed
by telephone order for an additional 4 hours. Any further extensions of
restraints shall require a personal examination or observation by a physician
or APRN.
(i) If the condition of
the resident does not improve to meet the criteria for termination, the
physician or APRN may renew the order as specified in (h) above, provided that
no resident shall remain in restraints for more than 24 hours from the time
such procedure was initiated unless a physician or APRN personally examines,
observes, and assesses the resident and renews the order in writing.
(j) Staff shall continually monitor the
individual during periods of restraint to ensure that:
(1) In the judgment of the staff, all
reasonable measures are in place to ensure that the resident's health and
safety is protected during the period of restraint;
(2) The resident receives meals and regular
opportunities to move and to utilize the bathroom;
(3) All other basic physiological needs are
identified and met; and
(4) The
restraint is discontinued as soon as the resident's status or condition has
improved to the extent that a personal safety emergency no longer exists,
regardless of the length of time identified in the order.
(k) Only during incidents requiring immediate
action shall restraints be utilized without the authorization of a physician or
APRN.
Notes
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No prior version found.