b'Standard Requirements Non-violent (Medical) Violent (Behavioral)Within one hour byWithin one hour by QLP orWithin one hour by QLP or QLP or RegisteredRegistered Nurse (RN) trainedRegistered Nurse trained in Face-to-face Nurse trained in R/Sin R/S procedures. If conductedR/S procedures. If conducted procedures. by an RN, the QLP must beby an RN, the QLP must be consulted as soon as possible. consulted as soon as possible.Within 24 hours for New Order Needed the same occurrenceFor each occurrence For each occurrenceor a new order for each additional occurrenceEvery four (4) hours for adultsEvery four (4) hours for 18 years and older, adults 18 years and older,Re-evaluation by QLPEvery two (2) hours forEvery two (2) hours for for continued R/S Every 24 Hours children and adolescentschildren and adolescents ages 9- 17years ages 9- 17yearsEvery one (1) hour forEvery one (1) hour for children under 9 years of age children under Notification to guardianAs soon as possible, but no laterAs soon as possible, but no of R/S (includingAs soon as possible than 24 hours later than 24 hoursdocumentation)Education Documented X X XAlternatives methodsX X XDocumentedPerformanceMaintained by OA Maintained by InpatientMaintained by Inpatient Improvement Tool Psychiatry Unit Psychiatry UnitNCH Policy Description: Restraint and Seclusion v6Prior to Order Expiration Patient Bathroom Emergency ReleaseRN will notify practitioner directly and advise them ofHow to open the locked patient bathroom door when a the upcoming expiration time beginning on hour 21patient calls with an emergencyfrom when the order was placed and Q subsequent hour after, until order is addressed. RN should document communication. RN will personally notify the CC of expiration time. An assessment by RN and LP to evaluate the need for continued restraint must be done prior to every renewal order. Documentation and updated IPOC is required in the EMR for each renewal.When possible, ensure one practitioner is entering restraint orders per patient to avoid multiple renewals in the same 24-hour period.Patient bathroom doors have a secondary manual release allowing the door to swing into or out of the patient room:Rotate the inset upward to make it flush with the door jam and pull the handle toward you.42 Nicklaus Childrens Health System'