SECTION 415.274. Permitted Practices

(a) Escort or brief physical prompt. An individual may be assisted to move from one location to another when guidance is needed if the individual agrees verbally or with gestures and is able to cooperate with the staff member who is attempting to assist the individual to move.

(b) Activities of daily living. A staff member may assist an individual who is willing and able to cooperate with toileting, bathing, dressing, eating, or other personal hygiene activities that normally involve the use of touch.

(c) Immediate danger of harm. A staff member may escort, prompt, or move an individual who is unable to respond in the affirmative or negative or is unable to move due to his or her psychiatric or medical condition if there is an imminent danger of harm to the individual because of a circumstance in the individual's immediate environment.

(d) Immobilization during medical, dental, diagnostic, or surgical procedure. A positioning or securing device used to maintain the position of, limit mobility of, or temporarily immobilize an individual, with the individual's consent, during medical, dental, diagnostic, or surgical procedures and that is a standard part of the procedure is not considered a restraint. The care of the individual shall be based on a rationale that reflects consideration of the individual's medical needs and health status.

(1) Facility policies and procedures on the use of immobilization during medical, dental, diagnostic and surgical procedures shall address:

(A) the frequency of assessment of the individual during immobilization; and

(B) how the individual's circulation, hydration, elimination needs, level of distress and agitation, mental status, cognitive functioning, cardiac functioning, skin integrity, nutrition, exercise, and range of motion of extremities are to be assessed during immobilization.

(2) The plan for monitoring the individual and the rationale for the frequency of monitoring shall be documented in the individual's medical record.

Source Note: The provisions of this §415.274 adopted to be effective July 22, 2014, 39 TexReg 5581