CONNECTICUT
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Standard or
Definition
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CT 99-210
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Restraint
Definition
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Physical Restraint – means any mechanical or personal
restriction that immobilizes or reduces the free movement of a person’s arms,
legs or head.
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Restraint
Exclusions
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The term does not include:
- briefly holding a person in order to calm or comfort
the person;
- restraint involving the minimum contact necessary to
safely escort a person from one area to another;
- medical devices…..;
- helmets or other protective gear to protect from
injuries due to a fall; and
- helmets, mitts, etc to
protect from self-injury when part of a treatment plan and is the least
restrictive intervention.
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Chemical Restraint
Definition
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No provider or assistant may use a psychopharmacologic
agent on a person at risk without that persons consent except as emergency
intervention to prevent immediate or imminent injury to the person or to
others. …The use of
psychopharmacologic agents, alone or in combination, may be used only in doses
that are therapeutically appropriate and not as a substitute for other
appropriate treatment.
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Seclusion
Definition
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Seclusion means the confinement of a person in a room,
whether alone or with staff supervision, in a manner that prevents the person
from leaving.
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Seclusion
Exclusions
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Except that in the case of seclusion at Long School,
the term does not include the placing of a single child or youth in a secure
room for the purpose of sleeping.
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Criteria for
Restraint and Seclusion
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Emergency intervention to prevent immediate or imminent
harm to self or others, not for discipline or convenience, or substitute for
less restrictive alternative, or as provided for in an education plan
pursuant to 10-76d.
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Monitoring
Requirements
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- Any person at risk who is physically
restrained shall be continuously monitored by a provider or assistant. Any person at risk who is involuntarily
placed in seclusion shall be frequently monitored by a provider or assistant
for signs of physical distress.
- Must be documented in the record, does allow
for video monitoring if within sufficient physical proximity to be able to
respond.
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Ordering and
Initiation
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No specific credentialing, time parameters, or other standards required.
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In-person
Assessment
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Each person so restrained or secluded shall be regularly
evaluated by a provider or assistant for indications of physical
distress. The provider or assistant
conducting the evaluation shall enter each evaluation in the person’s medical
or educational record.
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Debriefing
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None.
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Family &
Guardian Notification
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None.
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Notification of
Rights and Restraint and Seclusion Policies and Procedures at admission
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None.
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Training
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Require training of all providers and assistant providers
of care, education or supervision of persons at risk in the use of seclusions
and restraint on persons at risk. Such
training shall include but not be limited to: Verbal defusing or
de-escalation; prevention strategies; types of physical restraint; the
differences between life threatening physical restraint and other varying
levels of physical restraint; the differences between permissible physical
restraint and pain compliance techniques; monitoring to prevent harm to a
person physically restrained or in seclusion and recording and reporting
procedures on the use of restraints and seclusion.
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Documentation
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Sec 4 – (1) record each instance of the use of physical
restraint or seclusion on a person at risk and the nature of the emergency
that necessitated its use.
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Reporting
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Must report annual statistics to the commissioner if the
use of such restraint or seclusion results in physical injury to the person,
the institution or facility shall report the incident to the commissioner of
the state agency that has jurisdiction or supervisory control over the
institution or facility.
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Quality Improvement
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Sec 4 - (2) include such information (refers to
documentation requirements above) in an annual compilation on its use of such
restraint and seclusion. Sec. 5 “(1)
establish monitoring and internal reporting of the use of physical restraint
and seclusion on persons at risk”
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