Restraint and Seclusion

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We are revising our policy and procedures manual and would like your opinion on revising J-I-01 Restraint and Seclusion. We are considering changing our policy to limit nursing staff calls to the physician when an inmate is placed in custody-ordered restraints. The idea is that nursing staff would call the physician only in cases of chronic medical conditions. Would this revision be acceptable in terms of meeting the standards?

In the 2008 version of the standards, Compliance Indicator 2b of J-I-01 Restraint and Seclusion reads as follows: “If the restrained inmate has a medical or mental health condition, the physician is notified immediately so that appropriate orders can be given.” Therefore, to call the physician only in cases of chronic medical conditions would not meet the standard. Under your proposal, consider a situation where an inmate with a recent acute medical injury, such as a chest contusion, would be placed in custody ordered restraints and the physician would not be notified. NCCHC’s expectation is that the physician be notified so that he or she can work with custody staff in restraining an inmate with an acute injury—not just chronic medical conditions. Therefore, we do not advise a revision of your policy to exclude other medical or mental health conditions.

— From CorrectCare Volume 22, Issue 2, Spring 2008