New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 42 - MECHANICAL RESTRAINTS AND SAFEGUARDING EQUIPMENT
Subchapter 3 - APPLICATION AND IMPLEMENTATION
Section 10:42-3.4 - Implementation standards: community programs for persons with developmental disabilities

1. The IDT shall review the client record to identify potential areas of increased risk in the application of mechanical restraints for the individual due to medical conditions, mental health status, physical functioning, or other personal characteristics. If potential areas of increased risk are identified, the IDT shall obtain an opinion from a physician that the technique to be employed is not medically contraindicated for the individual prior to an initial restraint authorization.

2. In an emergency situation, the authorizing personnel shall be responsible for authorizing the use of a mechanical restraint.

3. Whenever possible, the emergency restraint order shall be immediately signed by the authorizing personnel. However, the use of mechanical restraint may be authorized over the telephone by the authorizing personnel in accordance with the following:

4. An emergency restraint order shall be effective for not more than one hour. If a new order is issued, all authorization shall be renewed.

5. Emergency restraint orders shall include documentation of the type of mechanical restraint authorized, the length of time to be applied, the reason for restraint, and any special instruction for utilizing the restraint. Each restraint order must be signed and dated by the authorizing personnel.

6. Individuals placed in highly restrictive forms of mechanical restraints shall be under continual observation by staff trained to recognize signs of physical distress.

7. While in mechanical restraint the individual shall be checked by a staff member every 15 minutes. The check shall document the following:

8. The individual shall be released immediately if he or she appears to be in physical distress or the individual's behavior no longer presents a risk, unless otherwise specified in the individual's behavior support plan. In the event the individual cannot be released within 10 minutes, efforts to loosen or change the position of the restraint must be attempted. Documented attempts to release each limb separately for a 10-minute period shall be made.

9. The use of mechanical restraints, such as jumpsuits or open-faced helmets does not require 15-minute checks. The individual does not have to be removed from the restraint for a 10-minute period during each hour of use since it does not restrict range of motion.

10. The nature, reasons for and notation of each staff check shall be recorded in the client record.

11. The individual's personal hygiene and nutritional needs shall be met while in restraint.

12. An unusual incident report shall be completed if the use of the restraint is unauthorized, improperly implemented, or causes injury to the individual.

13. Whenever a mechanical restraint is used pursuant to 10:42-2.2(a)1, a special meeting of the IDT must be held to review current programming and alternatives. If the recurrence of the behavior that required the use of the restraint may be anticipated, a behavior support plan shall be considered, and if appropriate, developed or modified to address the behavior.

14. When mechanical restraints are used for an individual three times in any contiguous six-month period and are not included in a behavior support plan, the IDT shall forward the results of their review conducted pursuant to (a)13 above to a Division HRC within 15 working days.

15. A Division HRC shall review the pertinent circumstances surrounding the utilization of the emergency mechanical restraints reported by the IDT. The results of the Division HRC review shall be forwarded to the Assistant Commissioner or designee within 10 days.