.23 Use of Restraints.

A. Policy and Procedures. The center shall have a policy and procedure on the use of any device or medication for the specific purpose of restricting the participant's freedom of motion or movement within the center.

B. A participant has the right to be free of restraints used in violation of this chapter

C. Improper Use of Chemicals or Drugs. Chemicals or drugs may not be used for participants in the following ways:

(1) In excessive dose, including duplicate drug therapy;

(2) For excessive duration, without adequate monitoring;

(3) Without adequate indications for its use; or

(4) In the presence of adverse consequences which indicate the dose should be reduced or discontinued.

D. Improper Use of Physical Restraints. Participants may not be physically restrained:

(1) For discipline or convenience; or

(2) If a restraint is not ordered by a physician to treat the participant's symptoms or medical conditions.

E. Restraint Orders.

(1) All restraints shall be ordered by a physician and shall specify:

(a) The purpose of the restraint;

(b) The type of restraint to be used; and

(c) The length of time the restraint shall be used.

(2) A participant may not have an as-needed restraint order.

(3) Orders for the use of a restraint shall be time specific.

(4) A participant may not remain in a restraint for more than 2 hours without a change in position and toileting opportunity.

(5) If an order for the use of a restraint is to be continued, the order shall be renewed at least every 7 days by a physician.

(6) The health care provider shall provide training to staff in the appropriate use of the restraint ordered by the physician.

F. The program shall notify the participant's family or the participant's representative each time a restraint is used.