Current through Register Vol. 39, No. 6, September 16, 2024
(a) Seclusion shall
be used only under one of the following conditions:
(1) on an emergency basis when it is
necessary to prevent immediate harm to the client or to others; or
(2) on a non-emergency basis if that
seclusion will resolve the precipitating crisis.
(b) Emergency seclusion shall last no longer
than is necessary to control the client.
(c) Seclusion shall not exceed seven days
without the review and approval of an internal committee in accordance with
Paragraph (e) of this Rule.
(d)
Observations or reviews of any client in seclusion shall be made as follows:
(1) any client placed in seclusion shall be
observed no less frequently than every 30 minutes;
(2) a clinician may extend this interval up
to 60 minutes if such an observation would not affect the health, safety, or
welfare of the client;
(3)
documentation for extending the observation shall be placed in the client's
record;
(4) observations by a
clinician shall be made at least daily or, if the clinician is not present at
the facility, observations by a health professional shall be reported by
telephone to a clinician; and
(5)
reviews by an internal committee shall be made in accordance with Paragraph (e)
of this Rule.
(e)
Committee review:
(1) If it appears that
seclusion may be indicated for a period to exceed seven days:
(A) an internal committee consisting of a
clinician, a nurse or member of the medical staff, and a member of the
administrative staff shall review the use of seclusion and interview the
client; and
(B) continued use shall
not exceed the initial 7 days without the approval of this committee.
(2) Following its initial review,
the committee shall review the case at intervals not to exceed 30
days.
(f) If a client is
placed in seclusion, his or her client record shall contain the following
documentation:
(1) the rationale and
authorization for the use of seclusion, including placement in seclusion
pending review by the responsible clinician;
(2) a record of the observation of the client
as required in Subparagraph (d)(1) of this Rule;
(3) each review by the responsible clinician
as required in Subparagraph (d)(4) of this Rule, including a description of the
client's behavior and all significant changes that may have occurred;
and
(4) each review by the internal
committee as required in Paragraph (e) of this Rule.
Authority
G.S.
148-19(d);
Eff.
January 4, 1994;
Readopted Eff. March 1,
2019.
