Use of Restraints A-06

PURPOSE:

The purpose of this policy is to provide standards for use of restraints, ensure restraints are utilized safely, and any resulting trauma is mitigated.

POLICY:

Individuals served have the right to be free from unreasonable, unsafe, or unwarranted use of restraints for the purposes of discipline, punishment, or staff convenience. Restraints may only be used as a last resort, when other less restrictive interventions have proven insufficient, and only to protect the health and safety of the individual being restrained or others. Methods of restraint that have the potential to cause physical injury or death are prohibited. Physical restraints may only be used if the community service provider (CSP) has written policies, procedures and training requirements governing their use.

DEFINITIONS:

Mechanical Restraint means the use of any device or object to limit an individual’s movement except a protective or stabilizing device ordered by an appropriately licensed professional or as required by law shall not be considered to be a mechanical restraint. For purposes of this policy, restraint devices utilized by law enforcement to carry out law enforcement duties will not be considered mechanical restraints.

Physical Restraint means the use of bodily force to substantially limit an individual’s movement; consensual, solicited, or unintentional contact or contact to provide comfort, assistance, or instruction shall not be construed as a physical restraint. Inappropriate physical restraint may include, but are not limited to: tape, blankets, tie-downs, and body carrier.

Chemical Restraint means the administration of medication for the purpose of behavioral restraint.

Imminent Risk of Harm means an immediate and impending threat of causing substantial physical injury to self or others.

PROCEDURES:

1. Restraint Usage:
   1. The use of restraints is strictly governed by Kansas Administrative Regulations (KAR) (30-63-22(8)). These guidelines should be reviewed and policies/procedures consistent with these regulations developed prior to the use of any restraint.
   2. Prior to use, restraints should be approved by a CSP Behavior Management Committee (BMC) consistent with KAR 30-63-23 unless an emergency situation presents where the individual would be in imminent risk of harm if not restrained.
      1. Individuals experiencing multiple emergency situations requiring restraint to avoid imminent risk of harm should be referred to the support team for review and/or determination if a behavior support plan should be developed.
   3. Documentation must be maintained for every instance detailing the name of the individual restrained, name of the individual employing the restraints, the reason for intervention, the length of time the intervention lasted, and the outcome/result of the intervention.
   4. Any unplanned/unapproved use of restraints shall be reported per Kansas Department for Aging and Disability (KDADS) policy regarding Adverse Incident Reporting.
   5. Within 48 hours of any incident involving the use of restraints, the CSP shall coordinate a debriefing with the staff involved. This review shall explore alternatives to reduce unnecessary use of restraint techniques and consider ways to mitigate any trauma experienced by the individual, staff and others exposed to the incident.
   6. The BMC shall monitor all instances where restraints were used to ensure appropriateness and protection of individual rights.
   7. Chemical and mechanical restraint may only be used if appropriate approval has been granted consistent with KAR 30-63-23.

2. Prohibited Restraints:
   1. The following methods of restraint are prohibited:
      1. Face down or prone restraints of all kinds, even those which are part of a specific intervention program,
      2. Restraints which might restrict or limit the individual’s ability to breathe, such as applying pressure around the neck or chest, and
      3. Any restraint which has the potential to cause harm to an individual based on their medical condition, physical size and strength or general health, etc.
   2. Restraints inconsistent with this policy should be reported to Sedgwick County Developmental Disability Organization (SCDDO) within one business day per SCDDO policy number G-06 and consistent with KDADS policy regarding Adverse Incident Reporting. SCDDO may request a corrective action plan for preventing further occurrences.