Section 0940-05-16-.25 - USE OF RESTRICTIVE BEHAVIOR MANAGEMENT IN HOSPITALS(1) The use of restrictive behavioral interventions to treat maladaptive behaviors must follow the following guidelines:(a) The facility must have clearly defined, written rules for patients that set limits of behavior. Patients must be given copies of these rules upon admission;(b) The use of restrictive contingencies must be under the supervision of a clinical professional and must be included as part of the patient's treatment plan. If, as part of the treatment philosophy, the patient group is involved in setting consequences, this must be subject to the approval of the treatment team;(c) Patients must not be denied food, treatment activities, religious activities, mail, or contact with family as consequences of behavior;(d) Positive and/or non-restrictive procedures must be attempted prior to implementing a restrictive contingency;(e) Contributing environmental factors that may promote maladaptive behaviors must be identified and a program to eliminate or minimize these effects must be implemented.(f) As the intrusiveness of the procedure increases, so should the frequency and intensity of review increase;(g) Positive or desirable behavior must be taught to the patient in conjunction with the implementation of the restrictive procedure;(h) Staff must be adequately trained in the implementation of the procedure; and(i) Behavior-modification procedures which use painful stimuli must be implemented only with the written, informed consent of the patient or guardian. The patient's record must reflect the clinical justification of such procedures and the consideration of less-aversive interventions.Tenn. Comp. R. & Regs. 0940-05-16-.25
Original rule filed May 26, 1988; effective July 11, 1988.Authority: T.C.A. § 33-2-504.