Or. Admin. Code § 309-033-0732 - Time Limits

(1) The maximum time limit for each restraint or seclusion order - before consideration of a renewal, and up to a maximum of 24 hours - is as follows:

(a) 4 hours for adults 18 years of age or older;

(b) 2 hours for children and adolescents 9 to 17 years of age; or

(c) 1 hour for children under 9 years of age.

(2) Orders may be renewed according to time limits for a maximum 24 hours verbally or in writing, or through an electronic medical record. After each 24 hours of continuous restraint or seclusion, and prior to further extension of the restraint or seclusion, an examination and second opinion must occur by a second Licensed Independent Practitioner (LIP).

(3) The LIP responsible for the care of the patient shall examine a person within 24 hours of the administration of seclusion or restraint and the person must be examined by a registered nurse every two hours until such time as the LIP examines the person and either makes new orders for seclusion nor restraint or for releasing the patient from seclusion or restraint. The LIP must document reasons for the use of the seclusion or restraint over the LIP's signature.

(4) A LIP shall not order physical restraint on an as required basis, i.e. a LIP shall not make "P.R.N." orders for physical restraint.

(5) No form of restraint shall be used as punishment, for the convenience of staff, or as a substitute for activities, treatment, or training.

(6) Medication will not be used as a restraint but will be prescribed and administered according to acceptable medical, nursing, and pharmaceutical practices.

(7) Patients shall not be permitted to use restraint on other patients.

(8) Physical restraint must be used in accordance with sound medical practice to assure the least risk of physical injury and discomfort. Any patient placed in physical restraint shall be protected from self-injury and from injury by others.

(9) 15 Minute Checks:

(a) A patient in restraint or seclusion must be checked at least every 15 minutes;

(b) Include circulation checks, during waking hours adequate range of motion, and partial release of restraint to permit motion and exercise without endangering the patient or staff;

(c) Attention must be paid to the patient's basic personal needs (such as regular meals, personal hygiene, and sleep) as well as the person's need for good body alignment and circulation;

(d) Staff must document that the patient was checked, and appropriate attention paid to the person's needs;

(e) The patient must be released as soon as the patient is assessed by a registered nurse or LIP to not present imminent dangerousness to themselves or others.

Notes

Or. Admin. Code § 309-033-0732

MHS 13-2014, f. & cert. ef. 9-29-14; BHS 9-2023, amend filed 04/04/2023, effective 4/7/2023

Statutory/Other Authority: ORS 426.005, 426.060, 426.110(2), 426.232, 426.236 & 430.041

Statutes/Other Implemented: ORS 426.005 - 426.395