WAC 246-322-180   Patient safety and seclusion care.  (1) The licensee shall assure seclusion and restraint are used only to the extent and duration necessary to ensure the safety of patients, staff, and property, as follows:

     (a) Staff shall not inflict pain or use restraint and seclusion for retaliation or personal convenience;

     (b) Staff shall document all assaultive incidents in the clinical record and review each incident with the appropriate supervisor;

     (c) Staff shall observe any patient in restraint or seclusion at least every fifteen minutes, intervening as necessary, and recording observations and interventions in the clinical record;

     (d) Staff shall notify, and receive authorization by, a physician within one hour of initiating patient restraint or seclusion;

     (e) A physician shall examine each restrained or secluded patient and renew the order for every twenty-four continuous hours of restraint and seclusion; and

     (f) A mental health professional or registered nurse shall evaluate the patient when secluded or restrained more than two continuous hours, and reevaluate the patient at least once every eight continuous hours of restraint and seclusion thereafter.

     (2) The licensee shall provide adequate emergency supplies and equipment, including airways, bag resuscitators, intravenous fluids, oxygen, sterile supplies, and other equipment identified in the policies and procedures, easily accessible to patient-care staff.

     (3) When research is proposed or conducted involving patients, the licensee shall:

     (a) Document an initial and continuing review process by a multidisciplinary treatment team;

     (b) Require approval by the patient prior to participation;

     (c) Allow the patient to discontinue participation at any time; and

     (d) Ensure policies and procedures are in accordance with Title 42 Code of Federal Regulations, chapter 1, Part 2, 10/1/89 edition.

     (4) The licensee shall prohibit the use of any patient for basic maintenance of the hospital or equipment, housekeeping, or food service in compliance with the Federal Fair Labor Standards Act, 29 USC, paragraph 203 et al., and 29 CFR, section 525 et al., except:

     (a) Cleaning or maintaining the patient's private living area, or performing personal housekeeping chores; or

     (b) Performing therapeutic activities:

     (i) Included in and appropriate to the comprehensive treatment plan;

     (ii) As agreed to with the patient;

     (iii) Documented as part of the treatment program; and

     (iv) Appropriate to the age, physical, and mental condition of the patient.

     (5) The licensee shall assure the safety and comfort of patients when construction work occurs in or near occupied areas.



[Statutory Authority: Chapter 71.12 RCW and RCW 43.60.040. 95-22-012, § 246-322-180, filed 10/20/95, effective 11/20/95.]