North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-03 - Community Services › Chapter 75-03-17 - Psychiatric Residential Treatment Facilities for Children › Section 75-03-17-06 - Special treatment procedures

Current through Supplement No. 393, July, 2024
A facility shall have written policies and procedures
				  regarding implementation of special treatment procedures. Special treatment
				  procedures must be therapeutic and meaningful interventions and may not be used
				  for punishment, for the convenience of employees, or as substitute for
				  therapeutic programming. Upon admission, the facility shall inform the child
				  and the person who may lawfully act on behalf of the child of the facility
				  policy on restraint and seclusion procedures during an emergency safety
				  situation. The facility shall provide education to the children, providing each
				  child the opportunity to express the child's opinion and educating the child on
				  alternative behavior choices to avoid the use of special treatment procedures.
				  Alternatives to behaviors must be documented in each child's individual
				  person-centered treatment plan. The health, safety, and well-being of children
				  receiving care and treatment in the facility must be properly safeguarded. A
				  physician shall review the use of special treatment procedures.
1. Timeout. Employees shall supervise the use
				of timeout procedures at all times, and shall document the use of timeout
				procedures in the child's file. The use of the resident's bedroom for timeout
				is prohibited.
2. Physical escort.
				Employees shall supervise the use of physical escort procedures at all times
				and shall document the use of physical escort in the child's file.
3. Physical restraints.
a. Physical restraints must be ordered by a
				psychiatrist or other physician, a licensed psychologist, a licensed clinical
				social worker, or a nurse who holds advanced licensure in psychiatric nursing.
				Staff authorized to order physical restraint must be trained in the use of
				emergency interventions. A psychiatrist or other physician, a licensed
				psychologist, a licensed clinical social worker, or a nurse who holds advanced
				licensure in psychiatric nursing must review and sign the order within
				forty-eight hours after the ordered physical restraint. Physical restraints may
				be imposed only in emergency circumstances and must be used with extreme
				caution to ensure the immediate physical safety of the child, an employee, or
				others after all other less intrusive alternatives have failed or have been
				deemed inappropriate;
b. All
				physical restraints must be applied by employees who are certified in the use
				of restraints and emergency safety interventions; and
c. The facility shall have established
				protocols that require:
(1) Entries made in
				the child's file as to the date, time, employee involved, reasons for the use
				of, and the extent to which physical restraints were used, and which identify
				less restrictive measures attempted;
(2) Notification within twelve hours of the
				individual who lawfully may act on behalf of the child; and
(3) Face-to-face assessment of children in
				physical restraint completed by a psychiatrist or other physician, a licensed
				psychologist, a licensed clinical social worker, a nurse who holds advanced
				licensure in psychiatric nursing, or other licensed health care professional or
				practitioner who is trained in the use of safety, emergency interventions. The
				face-to-face assessment must be documented in the child's case file and include
				assessing the mental and physical well-being of the child. The face-to-face
				assessment must be completed as soon as possible, and no later than one hour
				after the initiation of physical restraint or seclusion.