Rule 290-9-37-.22 - Use of Personal Restraints and Quiet Time(1) The Community Living Arrangement shall have and enforce effective procedures to minimize to the greatest extent possible the use of personal restraints. The use of personal restraints shall be specified in the individual service plan and shall be used as a safety intervention solely for the purposes of protecting the safety of the resident or other persons in the residence after a hierarchy of appropriate interventions have been utilized in the situation and the resident continues to be a danger to self or other persons in the residence.(2) Prior to the use of personal restraints, Community Living Arrangements shall have evidence that an appropriate plan is in place in the event emergency care is required.(3) All interventions utilized but not effective prior to the use of personal restraints must be documented in the sequence used and identified as to the staff member conducting the intervention.(4) The length of time permitted to use personal restraints for any one episode shall not exceed one hour. Consecutive periods of personal restraints, which have the effect of restraining the resident in excess of one hour, are not permitted.(5) In the event that personal restraints are used, the resident shall be cared for in the following way: (a) During the use of personal restraints, the door to the room shall be left open. The physical and emotional status of the resident shall be checked at least every 15 minutes by staff members trained in the use of personal restraint, and a written record of these checks and all other activities shall be made. The personal restraint pressure sites should be checked every 15 minutes for evidence of swelling or abrasion;(b) When personal restraints are used, the resident shall be spoken to, checked for indications of obvious physical distress, offered water, and provided an opportunity to meet his or her need to urinate and defecate as needed or at least one time during the episode unless the resident is asleep or his or her condition does not permit; and(c) The resident shall be provided an opportunity to eat if the application of personal restraints occurs during meals. If the resident is unable to participate in the meal, the resident will be offered food immediately following the personal restraint episode.(6) In all cases, the resident shall be released from personal restraints when that resident's demeanor evidences that he or she is no longer a danger to himself or herself or to others. A resident shall not remain in personal restraints longer than 15 minutes beyond which time he or she is no longer a danger to himself or herself or to others but in no event, shall the total time exceed one hour.(7) Notification of the use of personal restraints shall be given by telephone to the resident's representative or legal guardian, if any, and to the regional MHDDAD office within 24 hours of the use of personal restraints and shall be documented in the resident's file. In the event the resident's representative or legal guardian, if any, cannot be reached, that fact shall be documented in the resident's file, and a report shall be faxed or mailed to the resident's representative or legal guardian, if any.(8) In the case of an accident or adverse change in the condition of a resident resulting from the use of personal restraints, procedures specified in Section .24 of these rules shall apply.(9) The use of quiet time shall be specified in the individual service plan and shall be used under the supervision and observation of staff.(10) All interventions utilized prior to the use of quiet time must be documented in the sequence used and identified as to the staff member conducting the intervention.(11) The length of time permitted for the use of quiet time shall not exceed 15 minutes per episode.(12) Every use of quiet time shall be conducted in an unlocked, well-lighted, well-ventilated area with a means of observation available. The area to be used for quiet time shall be identified within the Community Living Arrangement's policy for the utilization of quiet time.(13) The Community Living Arrangement shall maintain documentation reflecting that the residence monitors and evaluates all aspects of its use of personal restraints and quiet time to ensure that the Community Living Arrangement takes all appropriate steps to minimize or eliminate the need for personal restraints and quiet time to be used in the residence at all.Ga. Comp. R. & Regs. R. 290-9-37-.22
O.C.G.A. Secs. 31-7-1et seq., 37-1-22.
Original Rule entitled "Use of Personal Restraints and Quiet Time" adopted. F. Oct. 24, 2002; eff. Nov. 13, 2002.