R ESTRICTIVE M EASURES O VERVIEW Presented by : CCCW Behavior Support Oversight Committee (BSOC)
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Transcript of R ESTRICTIVE M EASURES O VERVIEW Presented by : CCCW Behavior Support Oversight Committee (BSOC)
WHAT WILL WE BE COVERING TODAY ?
Proactive and Behavior Support Plan overview.
Definitions of Restrictive Measures per DHS 94.
Emergency Restrictive Measures Plan. Roles of CCCW Interdisciplinary Teams, CCCW
Behavior Support Oversight Committee (BSOC), and DHS/DLTS
Restrictive Measures Approval Process (what needs to be included).
DISCLAIMER
We are putting the cart before the horse. Prior to even thinking about restrictive
measures, we need to have a behavior support plan in place.
Data documenting effectiveness or ineffectiveness.
Restrictive measures are the last resort option.
PROACTIVE SUPPORT PLANS
Designed to prevent the likelihood of negative, maladaptive behaviors from emerging, and places focus on positive behaviors, one’s strengths, and abilities.
Create an environment that is conducive of safe learning and expression, residents feel more comfortable and are more likely to respond favorably to staff support.
Evolve with the individual and are updated routinely as we learn more about each person’s abilities, improvement in certain life areas, and effective interventions and interactions.
PROACTIVE SUPPORT PLANS
Is the big picture plan. How do we support the individual throughout
the day - not just during crisis? More importantly, how do we assist the
individual in being more independent, by assisting in modifying behaviors?
Very clear step-by-step for consistency.
BEHAVIOR SUPPORT PLANS
Specific to each individual behavior. Define the behavior (what does it look like). Precursors, onset, severity, how often it occurs,
how long will it last - conclusion of the behaviors. Identified function of the behavior. Proactive prevention of behavior. Management of the behavior.
EFFECTIVENESS OF A PLAN
Data collection, Data collection, Data collection.
Review, Review, Review, Review. Team approach and input.
RELATIONSHIP OF INDIVIDUAL RIGHTS ANDRESTRICTIVE MEASURES
Access to Phone
Prompt Treatment
Visitors
Storage
Access to Funds
Religion
Voting
Medications and Treatment
RestraintIsolationSeclusionLeast Restrictive Treatment and Conditions
WHAT IS A RESTRICTIVE MEASURE?
The definition of Restrictive Measures applies to the forms of restraint, isolation, and protective equipment identified below: Manual Restraints Mechanical Restraint Medical Restraint Isolation/Seclusion Protective Equipment Mechanical Support
WHAT IS A RESTRAINT?
Any device, garment or physical hold that
Restricts the voluntary movement of a person’s body or access to any part of the body
And cannot be easily removed by the individual
MANUAL RESTRAINTS
“Hands on,” holding limbs or body contingent upon behavior
Restricting or preventing movement Not longer than 15 continuous minutes
Examples:
MANUAL RESTRAINT DOES NOT INCLUDE:
Medical restraints. Holding limbs or body to provide functional
movement and positioning. Holding limbs or body to prevent falling. Self-protective blocking or passive redirecting
aggressive behavior. Graduated guidance as part of an approved
intervention.
MECHANICAL RESTRAINT
A device applied to any part of a person’s body contingent upon behavior
Restricts or prevents movement or normal use/functioning of the body part
Cannot be easily removed by the individual Cannot impair hearing, vision, or speech
(DHS)
Examples:
MEDICAL RESTRAINT
Apparatus or procedure that restricts voluntary free movement
Cannot be easily removed by the individual Used prior to, during, or subsequent to a medical
procedure Or to protect during the time a medical condition
exists
Examples:
MEDICAL RESTRAINT CONT. – SHORT-TERM USE
MD writes an order for use during the first 10 days. Guardian is notified.
If restraint continues past the initial 10 days, then guardian consent is required.
If this occurs regularly or becomes long-term, then application for use is required.
ISOLATION/SECLUSION
Involuntary physical or social separation from others by actions of staff
Contingent upon behavior
Examples:
PROTECTIVE EQUIPMENT
Device that does not restrict movement but does prevent access
Applied to any part of a person’s body to prevent tissue damage as a result of behavior
Cannot be easily removed by the individual
Examples:
MECHANICAL SUPPORT
An apparatus Properly aligns a person’s body or helps
maintain balance Designed by a qualified professional in
accordance with principles of good body mechanics, concern for circulation, and allow for change in position.
Generally not a restraint, but could be if it meets the definition.
Examples:
EXCEPTIONAL MEASURES
Specific forms of restraint that are considered highly restrictive and present a higher level of risk
Requires an additional level of review - Oversight Committee
Waiving or modifying any process requirement is considered an exceptional measure, as well
EXCEPTIONAL FORMS OF …MANUAL RESTRAINT
Any form of horizontal restraint Physically forcing a person to lay in a
horizontal position
Takedowns Physically forcing a person to a prone
position on the ground, floor, or mat
EXCEPTIONAL FORMS OF …MECHANICAL RESTRAINT
Restraint vests, jackets, body wraps Seclusion Wrist or ankle restraints Removal of mobility aids Restraint chairs Bed enclosures