Section R432-150-14 - Restraint Policy(1) Each resident has the right to be free from physical restraints imposed for purposes of discipline or convenience, or not required to treat the resident's medical symptoms.(2)(a) The licensee shall have written policies and procedures regarding the proper use of restraints.(b) The licensee shall ensure physical and chemical restraints are only used to assist residents to attain and maintain optimum levels of physical and emotional functioning.(c) The licensee shall ensure physical and chemical restraints are not used as substitutes for direct resident care, activities, or other services.(d) The licensee shall ensure restraints do not unduly hinder evacuation of the resident in the event of fire or other emergency.(e) If use of a physical or a chemical restraint is implemented, the licensee shall ensure the resident, next of kin, and the legally designated representative is informed of the reasons for the restraint, the circumstances that allow the restraint to be discontinued, and the hazards of the restraint, including potential physical side effects.(3) The licensee shall develop and implement policies and procedures that govern the use of physical and chemical restraints. The licensee shall ensure these policies promote optimal resident function in a safe, therapeutic manner and minimize adverse consequences of restraint use and incorporate and address the following:(a) resident assessment criteria that includes: (i) appropriateness of use;(iii) purpose and nature of the restraint;(iv) less restrictive alternatives before the use of more restrictive measures; and(v) behavior management and modification protocols including possible alterations to the physical environment;(b) examples of the types of restraints and safety devices that are acceptable for the use indicated and possible resident conditions when the restraint may be used; and(c) physical restraint guidelines for periodic release and position change or exercise, with instructions for documentation of this action.(4) The licensee shall ensure emergency use of physical and chemical restraints comply with the following: (a) a physician, a licensed health practitioner, the director of nursing, or the health services supervisor authorizes the emergency use of restraints;(b) the attending physician is notified as soon as possible, but at least within 24 hours of the application of the restraints;(c) the director of nursing or health services supervisor is notified no later than the beginning of the next day shift of the application of the restraints; and(d) the resident's record the circumstances necessitating emergency use of the restraint is documented and the resident's response.(5) The licensee shall ensure:(a) physical restraints are authorized in writing by a licensed practitioner and incorporated in the resident's plan of care;(b) the interdisciplinary team reviews and documents the use of physical restraints, including simple safety devices, during each resident care conference, and upon receipt of renewal orders from the licensed practitioner;(c) the resident care plan indicates the type of physical restraint or safety device, the length of time to be used, the frequency of release, and the type of exercise or ambulation to be provided;(d) staff application of physical restraints ensures minimal discomfort to the resident and allow sufficient body movement for proper circulation;(e) staff application of physical restraints do not cause injury or allow a potential for injury;(f) leather restraints, straight jackets, or locked restraints are prohibited;(g) chemical restraints are authorized in writing by a licensed practitioner and incorporated into the resident's plan of care in conjunction with an individualized behavior management program;(h) the interdisciplinary team reviews and documents the use of chemical restraints during each resident care conference and upon receipt of renewal orders from the licensed practitioner;(i) each resident receiving chemical restraints is monitored for adverse effects that significantly hinder verbal, emotional, or physical abilities; and(j) any medication given to a resident is administered according to the requirements of professional and ethical practice and according to the policies and procedures of the facility.(6) The licensee shall initiate gradual drug dosage reductions as outlined in Subsection R432-150-15(13)(c).(7) The licensee shall include criteria for admission and retention of residents who require behavior management program in the facility policy.Utah Admin. Code R432-150-14
Amended by Utah State Bulletin Number 2024-01, effective 12/12/2023