Requirements relating to restraining by a physical device
 110. (1) Every licensee of a long-term care home shall ensure that the following requirements are met with respect to the restraining of a resident by a physical device under section 31 or section 36 of the Act: 1. Staff apply the physical device in accordance with any manufacturer’s instructions. 2. The physical device is well maintained. 3. The physical device is not altered except for routine adjustments in accordance with any manufacturer’s instructions.  O. Reg. 79/10, s. 110 (1). (2) Every licensee shall ensure that the following requirements are met where a resident is being restrained by a physical device under section 31 of the Act: 1. That staff only apply the physical device that has been ordered or approved by a physician or registered nurse in the extended class. 2. That staff apply the physical device in accordance with any instructions specified by the physician or registered nurse in the extended class. 3. That the resident is monitored while restrained at least every hour by a member of the registered nursing staff or by another member of staff as authorized by a member of the registered nursing staff for that purpose. 4. That the resident is released from the physical device and repositioned at least once every two hours. (This requirement does not apply when bed rails are being used if the resident is able to reposition himself or herself.) 5. That the resident is released and repositioned any other time when necessary based on the resident’s condition or circumstances. 6. That the resident’s condition is reassessed and the effectiveness of the restraining evaluated only by a physician, a registered nurse in the extended class attending the resident or a member of the registered nursing staff, at least every eight hours, and at any other time when necessary based on the resident’s condition or circumstances.  O. Reg. 79/10, s. 110 (2). (3) Where a resident is being restrained by a physical device when immediate action is necessary to prevent serious bodily harm to the resident or to others pursuant to the common law duty described in section 36 of the Act, the licensee shall ensure that, (a) the resident is monitored or supervised on an ongoing basis and released from the physical device and repositioned when necessary based on the resident’s condition or circumstances; (b) the resident’s condition is reassessed only by a physician, a registered nurse in the extended class attending the resident or a member of the registered nursing staff, at least every 15 minutes, and at any other time when reassessment is necessary based on the resident’s condition or circumstances; and (c) the provisions of section 31 of the Act are complied with before continuing to restrain a resident by a physical device when the immediate action is no longer necessary.  O. Reg. 79/10, s. 110 (3). (4) Following the application of a physical device pursuant to the common law duty referred to in section 36 of the Act, the licensee shall explain to the resident, or the resident’s substitute decision-maker where the resident is incapable, the reason for the use of the physical device.  O. Reg. 79/10, s. 110 (4). (5) Where a resident has been restrained by a physical device under section 31 of the Act, or pursuant to the common law duty referred to in section 36 of the Act, and the resident is released from the physical device or the use of the physical device is being discontinued, the licensee shall ensure that appropriate post-restraining care is provided to ensure the safety and comfort of the resident.  O. Reg. 79/10, s. 110 (5). (6) Every licensee shall ensure that no physical device is applied under section 31 of the Act to restrain a resident who is in bed, except, (a) to allow for a clinical intervention that requires the resident’s body or a part of the resident’s body to be stationary; or (b) if the physical device is a bed rail used in accordance with section 15.  O. Reg. 79/10, s. 110 (6); O. Reg. 363/11, s. 9. (7) Every licensee shall ensure that every use of a physical device to restrain a resident under section 31 of the Act is documented and, without limiting the generality of this requirement, the licensee shall ensure that the following are documented: 1. The circumstances precipitating the application of the physical device. 2. What alternatives were considered and why those alternatives were inappropriate. 3. The person who made the order, what device was ordered, and any instructions relating to the order. 4. Consent. 5. The person who applied the device and the time of application. 6. All assessment, reassessment and monitoring, including the resident’s response. 7. Every release of the device and all repositioning. 8. The removal or discontinuance of the device, including time of removal or discontinuance and the post-restraining care.  O. Reg. 79/10, s. 110 (7). (8) Every licensee shall ensure that every use of a physical device to restrain a resident pursuant to the common law duty referred to in section 36 of the Act is documented and, without limiting the generality of this requirement, the licensee shall ensure that the following are documented: 1. The circumstances precipitating the application of the physical device. 2. The person who made the order, what device was ordered, and any instructions relating to the order. 3. The person who applied the device and the time of application. 4. All assessment, reassessment and monitoring, including the resident’s response. 5. Every release of the device and all repositioning. 6. The removal or discontinuance of the device, including time of removal or discontinuance and the post-restraining care.  O. Reg. 79/10, s. 110 (8).