NRS 449A.221 “Mechanical restraint” defined. “Mechanical restraint” means the use of devices, including, without limitation, mittens, straps and restraint chairs to limit a person’s movement or hold a person immobile.
(Added to NRS by 1999, 3248)—(Substituted in revision for NRS 449.772)
NRS 449A.242 Mechanical restraint: Permissible use; report of use in emergency.
1. Except as otherwise provided in subsection 2, mechanical restraint may be used on a person with a disability who is a patient at a facility only if:
(a) An emergency exists that necessitates the use of mechanical restraint;
(b) A medical order authorizing the use of mechanical restraint is obtained from the patient’s treating physician or advanced practice registered nurse before the application of the mechanical restraint or not later than 15 minutes after the application of the mechanical restraint;
(c) The physician or advanced practice registered nurse who signed the order required pursuant to paragraph (b) or the attending physician or attending advanced practice registered nurse examines the patient not later than 1 working day immediately after the application of the mechanical restraint;
(d) The mechanical restraint is applied by a member of the staff of the facility who is trained and qualified to apply mechanical restraint;
(e) The patient is given the opportunity to move and exercise the parts of his or her body that are restrained at least 10 minutes per every 60 minutes of restraint;
(f) A member of the staff of the facility lessens or discontinues the restraint every 15 minutes to determine whether the patient will stop or control his or her inappropriate behavior without the use of the restraint;
(g) The record of the patient contains a notation that includes the time of day that the restraint was lessened or discontinued pursuant to paragraph (f), the response of the patient and the response of the member of the staff of the facility who applied the mechanical restraint;
(h) A member of the staff of the facility continuously monitors the patient during the time that mechanical restraint is used on the patient; and
(i) The patient is released from the mechanical restraint as soon as the behavior of the patient no longer presents an immediate threat to himself or herself or others.
2. Mechanical restraint may be used on a person with a disability who is a patient at a facility and the provisions of subsection 1 do not apply if the mechanical restraint is used to:
(a) Treat the medical needs of a patient;
(b) Protect a patient who is known to be at risk of injury to himself or herself because the patient lacks coordination or suffers from frequent loss of consciousness;
(c) Provide proper body alignment to a patient; or
(d) Position a patient who has physical disabilities in a manner prescribed in the patient’s plan of treatment.
3. If mechanical restraint is used on a person with a disability who is a patient at a facility in an emergency, the use of the procedure must be reported as a denial of rights pursuant to NRS 449A.263, regardless of whether the use of the procedure is authorized by statute. The report must be made not later than 1 working day after the procedure is used.
(Added to NRS by 1999, 3249; A 2017, 1766)—(Substituted in revision for NRS 449.779)
NRS 449A.251 Education and training of members of staff of facility.
1. Each facility shall develop a program of education for the members of the staff of the facility to provide instruction in positive behavioral interventions and positive behavioral supports that:
(a) Includes positive methods to modify the environment of patients to promote adaptive behavior and reduce the occurrence of inappropriate behavior;
(b) Includes methods to teach skills to patients so that patients can replace inappropriate behavior with adaptive behavior;
(c) Includes methods to enhance a patient’s independence and quality of life;
(d) Includes the use of the least intrusive methods to respond to and reinforce the behavior of patients; and
(e) Offers a process for designing interventions based upon the patient that are focused on promoting appropriate changes in behavior as well as enhancing the overall quality of life for the patient.
2. Each facility shall provide appropriate training for the members of the staff of the facility who are authorized to carry out and monitor physical restraint and mechanical restraint to ensure that those members of the staff are competent and qualified to carry out the procedures in accordance with NRS 449A.200 to 449A.263, inclusive.
(Added to NRS by 1999, 3250)—(Substituted in revision for NRS 449.782)