Using Restraint within Legal Guidelines

While some difficult situations require an immediate decision about using restraints, most develop over a longer period of time and using this five-step framework will help you make an informed decision. (b) restraint is managed in a manner that prevents or minimizes physical harm; If, at any time during a physical restraint, the student expresses or shows significant physical distress, including, but not limited to, breathing difficulties, the student will be released immediately from the restraint and school staff will be required to take steps to obtain medical assistance. (5) Individual assessment of the student. The principal conducts a weekly review of chain data to identify students who have been handcuffed several times during the week. When such students are identified, the principal shall convene one or more review teams that he or she considers appropriate to assess the progress and needs of each student. The assessment shall include at least the following: the Program has obtained consent to use vulnerable restraint systems in an emergency in accordance with 603 CMR 46.03 (1) (b) and such use has been authorized in writing by the Client; The care facility will continue to be responsible for the health and safety of all residents, including those who use physical restraints. This includes monitoring the resident while using a physical restraint, as well as ensuring that the use of the physical restraint does not pose a risk to the safety of the resident. If the resident using a physical restraint shows an interaction with the physical restraint that could endanger the resident, the facility must immediately assess the incident. Based on this assessment, the facility may determine that continued use of physical restraint is warranted or take steps to address the unsafe situation, including eliminating physical restraint or using another method to ensure safety. When responding to an incident, the facility must involve the resident or substitute decision-maker responsible and the attending physician.

The law gives the attending physician the responsibility to determine the presence of a medical symptom that justifies the use of physical restraint. Before the request for physical restraint can be granted, the physician must assess the request in light of the resident`s physical and psychological needs. The use of a device as a physical restraint is considered medical treatment and verification by the attending physician is essential. (b) Prevent or minimize harm to the student from the use of physical restraint. The law provides for a procedure for requesting physical restraint. To apply for restraint, you must follow these steps: (7) Report any restraining-related injuries to the ministry. If the physical restraint has caused injury to a student or program employee, the program will send a copy of the written report required by 603 RMC 46.06 (4) no later than three business days after the restraint is administered. The Program must also send the ministry a copy of the physical restraint records maintained by the client in accordance with subsection 46.06(2) of 603 PMF during the 30-day period preceding the date of the notified restriction. The division shall decide whether additional measures of the programme are warranted and, if so, notify the programme of any necessary measures within 30 calendar days of receipt of the required written report(s). In order to improve practice and minimize constraints, a flexible and varied approach to staff development is important.

Building on standard training, organizing specialized training, and providing opportunities for employees to support each other and share learning are useful approaches. It`s also important for managers to “get down to earth,” model reflective practice (learning from difficult situations), and build a library of good resources. A written prescription from the attending physician containing statements and findings about medical symptoms is sufficient evidence of the medical necessity of physical restraint. (3) Restrictions on the use of restraints. Physical restraint in a public education program is limited to the use of appropriate force necessary to protect a student or other member of the school community from imminent and serious physical attack or harm. Engaging in dialogue on risk management and minimizing constraints depends on whether or not relationships between residents, loved ones and staff are positive. (b) an analysis of the circumstances that led to each restriction, including factors such as the time of day, day of the week, previous events and persons involved; (1) Scope. 603 CMR 46.00 governs the use of physical restraints by students in publicly funded elementary and secondary school programs, including all Massachusetts public school districts, charter schools, virtual schools, collaborative education programs, and the special school day approved under CMR 603 CMR 28.09: Approval of public or private special day and residential education programs in accordance with 603 WRC 18.05(5)(h). Educational programs in facilities run by the Department of Youth Services, Department of Mental Health, Department of Public Health, or county reformatories are subject to the restraint, isolation, and downtime requirements of these agencies.

In some circumstances, restraint is the right thing to do, and failure to do so on these occasions could be considered negligence. Restraint may be applied: If the resident is allowed to participate in their care planning, it is up to the resident to make the decision regarding physical restraint. Although a family member disagrees with the resident`s decision, the choice is always up to the responsible resident.

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