Current through Register Vol. 39, No. 6, September 16, 2024
(a) Seclusion, physical restraint and
isolation time-out may be employed only by staff who have been trained and have
demonstrated competence in the proper use of and alternatives to these
procedures. Facilities shall ensure that staff authorized to employ and
terminate these procedures are retrained at least annually and have
demonstrated competence.
(b) Prior
to providing direct care to people with disabilities whose
treatment/habilitation plan includes restrictive interventions, staff including
service providers, employees, students or volunteers, shall complete training
in the use of seclusion, physical restraint and isolation time-out and shall
not use these interventions until the training is completed and competence is
demonstrated.
(c) A prerequisite
for taking this training is demonstrating competence by completion of training
in preventing, reducing and eliminating the need for seclusion, physical
restraint and isolation time-out.
(d) The training shall be competency-based,
include measurable learning objectives, measurable testing (written and by
observation of behavior) on those objectives and measurable methods to
determine passing or failing the course.
(e) Formal refresher training shall be
completed by each service provider periodically (minimum annually).
(f) Content of the training that the service
provider plans to employ shall be approved by the Division of MH/DD/SAS
pursuant to Paragraph (g) of this Rule.
(g) Acceptable training programs shall
include, but not be limited to, presentation of:
(1) refresher information on alternatives to
the use of seclusion, physical restraint and isolation time-out;
(2) guidelines on when to intervene
(understanding imminent danger to self and others);
(3) emphasis on safety and respect for the
rights and dignity of all persons involved (using concepts of least restrictive
interventions and incremental steps in an intervention);
(4) strategies for the safe implementation of
seclusion, physical restraint and isolation time-out;
(5) the use of emergency safety interventions
which include continuous assessment and monitoring of the physical and
psychological well-being of the client and the safe use of restraint throughout
the duration of the restrictive intervention;
(6) prohibited procedures;
(7) debriefing strategies, including
importance and purpose; and
(8)
documentation methods and procedures.
(h) Service providers shall maintain
documentation of initial and refresher training for at least three years.
(1) Documentation shall include:
(A) who participated in the training and the
outcomes (pass/fail);
(B) when and
where they attended; and
(C)
instructor's name.
(2)
The Division of MH/DD/SAS may request and review this documentation at any
time.
(i) Instructor
Qualifications and Training Requirements:
(1)
Trainers shall demonstrate competence by scoring 100% on testing in a training
program aimed at preventing, reducing and eliminating the need for seclusion,
physical restraint and isolation time-out.
(2) Trainers shall demonstrate competence by
scoring 100% on testing in a training program teaching the use of seclusion,
physical restraint and isolation time-out.
(3) Trainers shall demonstrate competence by
scoring a passing grade on testing in an instructor training program.
(4) The training shall be competency-based,
include measurable learning objectives, measurable testing (written and by
observation of behavior) on those objectives and measurable methods to
determine passing or failing the course. The content of the instructor training
the service provider plans to employ shall be approved by the Division of
MH/DD/SAS pursuant to Subparagraph (i)(6) of this Rule.
(5) The content of the instructor training
the service provider plans to employ shall be approved by the Division of
MH/DD/SAS pursuant to Subparagraph (i)(6) of this Rule.
(6) Acceptable instructor training programs
shall include, but not be limited to, presentation of:
(A) understanding the adult
learner;
(B) methods for teaching
content of the course;
(C)
evaluation of trainee performance; and
(D) documentation procedures.
(7) Trainers shall be retrained at
least annually and demonstrate competence in the use of seclusion, physical
restraint and isolation time-out, as specified in Paragraph (a) of this
Rule.
(8) Trainers shall be
currently trained in CPR.
(9)
Trainers shall have coached experience in teaching the use of seclusion,
physical restraint and isolation time-out at least two times with a positive
review by the coach.
(10) Trainers
shall teach a program on the use of seclusion, physical restraint and isolation
time-out at least once annually.
(11) Trainers shall complete a refresher
instructor training at least every two years.
(j) Service providers shall maintain
documentation of initial and refresher instructor training for at least three
years.
(1) Documentation shall include:
(A) who participated in the training and the
outcome (pass/fail);
(B) when and
where they attended; and
(C)
instructor's name.
(2)
The Division of MH/DD/SAS may request and review this documentation at any
time.
(k) Qualifications
of Coaches:
(1) Coaches shall meet all
preparation requirements as a trainer.
(2) Coaches shall teach at least three times
the course which is being coached.
(3) Coaches shall demonstrate competence by
completion of coaching or train-the-trainer instruction.
(l) Documentation shall be the same
preparation as for trainers.
Authority
G.S
143B-147;
Temporary Adoption Eff.
February 1, 2001;
Temporary Adoption Expired October 13,
2001;
Eff. April 1, 2003;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. May 1, 2018.
