Regulation .04 Procedures in the Use of Seclusion.
Regulation .04 Procedures in the Use of Seclusion.LinkCopy Citation
A.
A facility shall have a written policy specifying the method used to ensure that a patient whose primary language or method of communication is nonverbal is able to effectively communicate distress during a seclusion.
B.
A facility shall ensure that all staff at the facility who are authorized to participate in a seclusion of patients are trained in the method specified in the written policy in accordance with §A(1) of this regulation.
C.
A physician who is responsible either for the care of the patient or for assessment of the appropriateness of seclusion or, when the appropriate physician is not readily available to assess the patient, a registered nurse shall conduct a clinical evaluation of the patient to determine whether an emergency situation is present.
D.
Before instituting seclusion, the physician or registered nurse shall assess whether less restrictive or alternative approaches have been determined to be ineffective to ensure the safety of the patient, staff, or others.
E.
When a physician, as identified in §C of this regulation, is immediately available, the physician shall be responsible for determining a patient's need for seclusion and make the decision whether to seclude.
F.
Authorization in the Absence of a Physician.
(1)
When a physician, as identified in §C of this regulation, is not immediately available, a registered nurse shall determine a patient's need for seclusion and may initiate and direct the use of seclusion.
(2)
Within 2 hours of the implementation of the seclusion, a physician shall give a written or verbal order for any seclusion initiated by a registered nurse and, at that time, shall make the clinical determination to continue or discontinue the seclusion.