Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1.
Definitions.
For purposes of this part, the following terms have the
meanings given.
A. "Physical
restraints" means any manual method or physical or mechanical device, material,
or equipment attached or adjacent to the resident's body that the individual
cannot remove easily which restricts freedom of movement or normal access to
one's body. Physical restraints include, but are not limited to, leg
restraints, arm restraints, hand mitts, soft ties or vests, and wheelchair
safety bars. Physical restraints also include practices which meet the
definition of a restraint, such as tucking in a sheet so tightly that a
resident confined to bed cannot move; bed rails; chairs that prevent rising; or
placing a resident in a wheelchair so close to a wall that the wall prevents
the resident from rising. Bed rails are considered a restraint if they restrict
freedom of movement. If the bed rail is used solely to assist the resident in
turning or to help the resident get out of bed, then the bed rail is not used
as a restraint. Wrist bands or devices on clothing that trigger electronic
alarms to warn staff that a resident is leaving a room or area do not, in and
of themselves, restrict freedom of movement and should not be considered
restraints.
B. "Chemical
restraints" means any psychopharmacologic drug that is used for discipline or
convenience and is not required to treat medical symptoms.
C. "Discipline" means any action taken by the
nursing home for the purpose of punishing or penalizing a resident.
D. "Convenience" means any action taken
solely to control resident behavior or maintain a resident with a lesser amount
of effort that is not in the resident's best interest.
E. "Emergency measures" means the immediate
action necessary to alleviate an unexpected situation or sudden occurrence of a
serious and urgent nature.
Subp.
2.
Freedom from restraints.
Residents must be free from any physical or chemical
restraints imposed for purposes of discipline or convenience, and not required
to treat the resident's medical symptoms.
Subp. 3.
Emergency use of
restraint.
A. If a resident exhibits
behavior which becomes a threat to the health or safety of the resident or
others, the nurse or person in charge of the nursing home, if other than a
nurse, must take temporary, emergency measures to protect the resident and
other persons in the nursing home, and the physician must be called
immediately.
B. If a restraint is
needed, a physician's order must be obtained which specifies the duration and
circumstances under which the restraint is to be used.
C. The resident's legal representative or
interested family member must be notified when temporary emergency measures are
taken.
Subp. 4.
Decision to apply restraint.
The decision to apply a restraint must be based on the
comprehensive resident assessment. The least restrictive restraint must be used
and incorporated into the comprehensive plan of care. The comprehensive plan of
care must allow for progressive removal or the progressive use of less
restrictive means. A nursing home must obtain an informed consent for a
resident placed in a physical or chemical restraint. A physician's order must
be obtained for a physical or chemical restraint which specifies the duration
and circumstances under which the restraint is to be used, including the
monitoring interval. Nothing in this part requires a resident to be awakened
during the resident's normal sleeping hours strictly for the purpose of
releasing restraints.
Subp.
5.
Physical restraints.
At a minimum, for a resident placed in a physical restraint,
a nursing home must also:
A. develop a
system to ensure that the restrained resident is monitored at the interval
specified in the written order from the physician;
B. assist the resident as often as necessary
for the resident's safety, comfort, exercise, and elimination needs;
C. provide an opportunity for motion,
exercise, and elimination for not less than ten minutes during each two-hour
period in which a restraint is employed; and
D. release the resident from the restraint as
quickly as possible.
Statutory Authority: MS s
144A.04;
144A.08;
256B.431
