<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.21.13.05" title_num="10" subtitle_num="21" chapter_num="13" heading="Placement of a Patient in a Seclusion Room.">
  <paragraph num="A.">
    <text>When possible, staff shall advise a patient, in a nonthreatening manner, that continuation of a specific behavior may result in the use of seclusion.</text>
  </paragraph>
  <paragraph num="B.">
    <text>When a physician or registered nurse determines that the use of seclusion is appropriate, staff involved shall make a reasonable effort to verbally persuade the patient to enter the seclusion room.</text>
  </paragraph>
  <paragraph num="C.">
    <text>For patient's safety and the safety of others:</text>
    <paragraph num="(1)">
      <text>Staff shall place the patient in the seclusion room in as dignified a manner as the situation permits, using the least amount of physical force necessary;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>As necessary, additional staff shall participate in the placement of a patient in seclusion;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The patient shall be free from prone restraint; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The patient shall be free from restraint that:</text>
      <paragraph num="(a)">
        <text>Applies pressure to the individual’s back;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Obstructs the airway of the individual or impairs the individual’s ability to breathe;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Obstructs a staff member’s view of the individual’s face; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Restricts the individual’s ability to communicate distress.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Unless a physician or registered nurse determines that it is unsafe to do so, staff shall permit the patient to wear all or a portion of the patient's own clothes or another form of attire.</text>
  </paragraph>
  <paragraph num="E.">
    <text>Staff shall search the patient for potentially harmful objects.</text>
  </paragraph>
  <paragraph num="F.">
    <text>If staff determines a need for objects to be removed pursuant to §E of this regulation, staff shall ask the patient, in a nonthreatening manner, to surrender the objects.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Unless contraindicated for safety reasons, staff shall permit the patient to wear eyeglasses, hearing aids, dentures, or prosthetic devices.</text>
  </paragraph>
  <paragraph num="H.">
    <text>Staff shall inspect the seclusion room for potentially dangerous conditions and, as appropriate, shall fully secure the room.</text>
  </paragraph>
  <paragraph num="I.">
    <text>If a patient is confined to a room in a manner that meets the definition of seclusion in accordance with Regulation .02B of this chapter, the patient is considered to be subject to seclusion, regardless of whether the room used is typically used as a seclusion room.</text>
  </paragraph>
</regulation>