481—63.28(135C) Crisis intervention. If a facility utilizes physical restraints, the facility shall have written policies that define the uses of physical restraints, designate the administrator or designee as the person who may authorize their use, establish a mechanism for monitoring and controlling their use, and provide staff with proper training. (I, II)
	63.28(1) Temporary physical restraint of residents shall be used only under the following conditions: (I, II)
	a. 	An emergency to prevent injury to the resident or to others; or (I, II)
	b. 	For crisis intervention, but shall not be used for punishment, for the convenience of staff or as a substitution for supervision or programming; (I, II) and
	c. 	No staff person shall use any restraint that obstructs the airway of the resident. (I, II)
	63.28(2) Authorization for the use of physical restraints must be prior to or immediately after application of the restraint. (I, II)
	63.28(3) Prone restraint is prohibited. Staff persons who find themselves involved in the use of a prone restraint when responding to an emergency must take immediate steps to end the prone restraint. (I, II)
	63.28(4) The rationale and authorization for the use of physical restraint and staff action and procedures carried out to protect the resident’s rights and to ensure safety shall be clearly set forth in the resident’s record by the responsible staff persons. (I, II)
	63.28(5) The primary care provider, the interdisciplinary team and the resident’s responsible party shall be notified of any restraints administered. (I, II, III)
	63.28(6) The facility shall provide to the staff a department-approved training program by qualified professionals on physical restraint techniques. (I, II)
	a. 	The facility shall keep a record of training for review by the department and shall include attendance. (II, III)
	b. 	Only staff with documented training in physical restraint and techniques shall be authorized to assist with physical restraint of a resident. (I, II)
	c. 	Under no circumstances shall a resident be allowed to actively or passively assist in the restraint of another resident. (I, II)
	63.28(7) Residents shall not be kept behind locked doors. (I, II)
	63.28(8) Mechanical restraint is prohibited. Staff persons who find themselves involved in the use of a mechanical restraint when responding to an emergency must take immediate steps to end the mechanical restraint. (I, II)
[ARC 3740C, IAB 4/11/18, effective 5/16/18]