26 Tex. Admin. Code § 320.127 - Restraint Off Facility Premises or for Transportation
(a) All
off-premises transport. A registered nurse or physician assistant, as
appropriate to the individual's clinical condition and the requirements of this
subchapter, shall accompany the staff member(s) transporting an individual off
premises when it has been clinically determined that during the time away from
the facility the individual may require:
(1)
medical attention;
(2)
administration of medication; or
(3) restraint.
(b) Excursion off facility premises. A staff
member may not restrain an individual being transported off facility premises
unless the individual meets the criteria for a behavioral emergency, a
physician orders the restraint, and transport is medically necessary with
documented clinical justification.
(1) If
restraint is required while an individual is on an excursion off facility
premises, the staff member initiating the restraint shall contact a registered
nurse to assist in obtaining a physician's order for the restraint as soon as
feasible within the applicable timeframes prescribed in this
subchapter.
(2) The staff members
on the excursion shall implement, monitor, document, and report, in accordance
with the requirements of this subchapter, any episode of restraint that occurs
off premises.
(c)
Restraint initiated prior to transportation. A staff member may not restrain an
individual being transported prior to departure unless the situation meets the
criteria for a behavioral emergency or the individual has been determined and
documented manifestly dangerous in accordance with Chapter 415, Subchapter G of
this title (relating to Determination of Manifest Dangerousness) within one
month prior to transportation, a physician orders the restraint, and transport
is medically necessary with documented clinical justification.
(1) If a behavioral emergency exists and a
physician orders restraint prior to departure, at least one of the staff
members accompanying the individual to the destination facility shall be a
registered nurse.
(2) A female
staff member shall accompany a female individual.
(3) If the duration of transport exceeds the
maximum allowable duration of restraint on the original order, and a behavioral
emergency continues to exist, or the person has been determined manifestly
dangerous within one month prior to transportation, the registered nurse may
either obtain a physician's telephone order to renew the restraint or obtain a
new order for restraint, and renewal, as soon as feasible but within the
applicable timeframes prescribed in this subchapter.
(4) Staff members accompanying the individual
from the originating facility shall implement, monitor, document, and report,
in accordance with the requirements of this subchapter, a restraint that is
ordered and implemented prior to transportation. If transportation is for the
purposes of transfer to another facility, staff members at the originating
facility must fax the required documentation to the destination facility on the
day of transport. Staff members at the destination facility are responsible for
filing the documentation in the individual's medical record at the destination
facility.
(d) Restraint
initiated during transportation. If restraint is required following departure,
a registered nurse shall obtain a physician's order from the originating
facility for any restraint as soon as feasible within the applicable timeframes
prescribed in this subchapter. If a registered nurse is not present during
transportation, the staff member initiating any restraint shall contact a
registered nurse to obtain a physician's order for the restraint as soon as
possible within the applicable timeframes prescribed in this subchapter.
(1) If an individual is restrained during
transportation, the staff member accompanying the individual shall implement,
monitor, document, and report the episode of restraint in accordance with the
requirements of this subchapter, and shall ensure that all documentation
required under this subchapter relating to the restraint, including the
physician's order, is transmitted to the destination facility within 24 hours
following the time the individual is delivered to the destination
facility.
(2) Staff members at the
originating facility shall document and report restraint that is ordered and
implemented during transportation. Staff members at the destination facility
shall maintain documentation of the restraint at the destination
facility.
(e) Comfort
during transportation. The staff members shall provide an individual in
restraint during transport the care required under § 415.266(c) of this
title (relating to Observation, Monitoring, and Care of the Individual in
Restraint or Seclusion Initiated in Response to a Behavioral
Emergency).
Notes
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No prior version found.