Current through Register Vol. 63, No. 9, September 1, 2024
(1) Only the following facilities shall be
certified pursuant to this rule and the procedures found OAR
309-008-0100 to
309-008-1600 to use seclusion or
restraint:
(a) Community hospitals licensed
by the Public Health Division;
(b)
Regional acute care facilities for adults certified by the Division pursuant to
OAR 309-032-0850 through
309-032-0890; and
(c) Nonhospital facilities certified by the
Division pursuant to OAR
309-033-0500 through
309-033-0550.
(2) Applications. Certification
for the use of seclusion and restraints must be accomplished by submission of
an application, and by the application process described in OAR
309-008-0100 to
309-008-1600. Continued
certification is subject to hospital or facility reviews at frequencies
determined by the Division.
(3)
Requirements for Certification. In order to be certified for the use of
seclusion and restraint, the Division must be satisfied that the hospital or
facility meets the following requirements:
(a) Medical staffing. An adequate number of
nurses, direct care staff, Licensed Independent Practitioners (LIP) or
physician assistants shall be available at the hospital or facility, to provide
emergency medical services which may be required. For hospitals, a letter from
the chief of the medical staff or medical director of the hospital or facility,
ensuring such availability, shall constitute satisfaction of this requirement.
For nonhospital facilities, a written agreement with a local hospital, to
provide such medical services may fulfill this requirement. When such an
agreement is not possible, a written agreement with a local physician to
provide such medical services may fulfill this requirement.
(b) Direct Care Staff Training. A staff
person must be trained and able to demonstrate competency in the application of
restraints and implementation of seclusion during the following intervals:
(A) A new staff person must be trained within
the six months prior to providing direct patient care or as part of
orientation; and
(B) Subsequently
on a periodic basis consistent with the hospital or facility policy.
(c) Documentation in the staff
personnel records must indicate the training and demonstration of competency
were successfully completed.
(d)
Trainer Qualifications. Individuals providing staff training must be qualified
as evidenced by education, training, and experience in techniques used to
address a person's behaviors.
(e)
Training Curriculum. The training required for direct care staff must include:
(A) Standards for the proper use of seclusion
and restraints as described in OAR
309-033-0730;
(B) Identification of medication side
effects;
(C) Indicators of medical
problems and medical crisis;
(D)
Techniques to identify staff and patient behaviors, events, and environmental
factors that may trigger circumstances that require the use of a restraint or
seclusion;
(E) The use of
non-physical intervention skills;
(F) Choosing the least restrictive
intervention based on an individualized assessment of the person's medical, or
behavioral status or condition;
(G)
The safe application and use of all types of restraint or seclusion used in the
hospital or facility, including training in how to recognize and respond to
sign of physical or psychological distress;
(H) Clinical identification of specific
behavioral changes that indicate that restraint or seclusion is no longer
necessary;
(I) Monitoring the
physical and psychological well-being of the patient who is restrained or
secluded, including but not limited to respiratory and circulatory status, skin
integrity, vital signs, and any special requirements specified by the hospital
or facility policies and procedures; and
(J) The use of first aid techniques and
certification in the use of cardio-pulmonary resuscitation, including periodic
recertification.
Statutory/Other Authority: ORS
426.005,
426.060,
426.110(2),
426.232 &
426.236
