D.C. Mun. Regs. tit. 22, r. 22-B3216

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-B3216 - FREEDOM FROM RESTRAINTS

3216.1

Each resident has the right to be free from unnecessary physical and chemical restraints.

3216.2

Each facility shall have written policies which define its approach to the use of physical and chemical restraints.

3216.3

If the facility employs a chemical or physical restraint, the facility shall include in the resident's interdisciplinary care plan a program to reduce or eliminate the use of the restraint.

3216.4

Physical restraints shall only be applied if:

(a) The facility has explored or tried less restrictive alternatives to meet the resident's needs and such trials have been documented in the resident's medical record as unsuccessful;

(b) The restraint has been ordered by a physician, to treat a medical symptom, for a specified period of time;

(c) The resident is released, exercised and toileted at least every two (2) hours, except when a resident's rest would be unnecessarily disturbed;

(d) The use of the restraint does not result in a decline in the resident's physical, mental, psychosocial or functional status; and

(e) The use of the restraint is assessed and re-evaluated when there is a significant change in the resident's condition, and on an ongoing basis until the need for the restraint no longer exists.

3216.5

In an emergency and when alternative actions are not successful, the placement of an appropriate physical restraint may be authorized by a registered nurse only to protect the resident from immediate injury to himself or herself or to protect others, in which case a written order of a physician or nurse practitioner shall be obtained by a licensed nurse within four hours.

3216.6

Chemical restraints shall not be administered unless:

(a) Ordered by a physician or nurse practitioner after thorough interdisciplinary assessment and care planning, including an evaluation of alternatives to the use of chemical restraints and behavioral interventions to manage and improve behavioral symptoms, which must be carried out and documented in the resident's medical record;

(b) The use of the chemical restraint does not result in a decline in the resident's physical, mental, psychosocial or functional status; and

(c) The use of the restraint is re-evaluated periodically until the need for the restraint no longer exists.

D.C. Mun. Regs. tit. 22, r. 22-B3216

Notice of Final Rulemaking published at 49 DCR 473 (January 18, 2002); as amended by Notice of Final Rulemaking published at 49 DCR 6824 (July 19, 2002)