§ 13.7. Chemical restraints.
(a) Definition. Chemical restraint shall mean the use of drugs or chemicals for the specific and exclusive purpose of controlling acute or episodic aggressive behavior by a patient/resident. Drugs administered on a regular basis, as part of the treatment plan and for the purposes of treating the symptoms of mental, emotional or behavioral disorders and for assisting the patient/resident in gaining self control over his impulses, are not to be considered chemical restraints.
(b) Procedures.
(1) No chemical restraints may be administered except upon the order of the physician.
(2) A telephone order may be accepted for medication intended for use as a chemical restraint in an emergency situation only. A physician shall examine the patient/resident within 1 hour of the telephone order with due attention being paid to prior mental and physical status and his history. Until a physician arrives, appropriate staff shall monitor the patient’s/resident’s physical well being.
(3) In a nonemergency situation, a physician shall examine the patient/resident prior to ordering medication as a chemical restraint with due attention being paid to the patient’s/resident’s prior mental and physical status and his history before drugs are administered. Medication shall be administered at intervals and dosages whereby adequate attention can be rendered to the patient’s/resident’s mental, physical and motor responses and vital signs.
(4) Once the level of medication appropriate to the circumstances has been determined, the patient’s/resident’s vital signs must be monitored at appropriate intervals, and the patient/resident followed and seen by a physician at periods appropriate to the circumstances, but at least every 12 hours. For mental health facilities monitoring of vital signs shall be conducted at least once in every 30 minute period.
(5) Proper documentation relating to the effect of the medication shall be recorded by appropriate personnel.
(6) The Superintendent/Director or his designee is responsible for monitoring all medications administered to a patient/resident for the purpose of chemical restraint.
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