DHS 40.08(6)(c)11.11. Any other physical restraint that is not administered during an emergency, that is administered for longer than necessary to prevent immediate injury to a youth or others, or that is administered for a purpose other than to prevent immediate injury to a youth or others.

DHS 40.08(6)(d)(d) Immediately upon the termination of a physical restraint, a medical staff member, such as a physician, advanced practice nurse prescriber, physician assistant, advanced practice nurse, or registered nurse, shall conduct a follow-up assessment of the condition of the youth to ensure that the youth was not injured and shall document the finding of the assessment in the youth’s file. If a staff member who is a doctor or nurse is not present on site, a licensed treatment professional shall conduct the face-to-face assessment immediately upon termination of the physical restraint and notify a medical staff member.

DHS 40.08(6)(e)(e) If any injury is noted following a physical restraint, a staff member shall notify the youth’s legal representative, if any, and make a referral for medical care.

DHS 40.08(7)(a)(a) Following a seclusion or restraint, a staff member shall talk with the youth about each of the following:

DHS 40.08(7)(a)1.1. The circumstances that contributed to the seclusion or physical restraint and what could have been handled differently by the staff member.

DHS 40.08(7)(a)3.3. What modifications can be made in the youth’s services or treatment plan to prevent future seclusion and physical restraint.

DHS 40.08(7)(b)(b) The debriefing should occur within 24 hours following a seclusion and restraint, with the following exceptions:

DHS 40.08(7)(b)2.2. When the 24 hour period falls during non-programming time such as on a weekend or holiday, then debriefing shall occur on the next programming day.

DHS 40.08(7)(b)3.3. When a youth is suspended or discharged from programming following the incident and debriefing is contraindicated due to a serious risk of harm by the youth to others or to staff.

DHS 40.08(7)(c)(c) A program shall notify a youth’s legal representative, if any, of any seclusion or physical restraint on the same day that it was administered to the youth. The program shall document in the youth’s file any situation in which notification has been attempted and the program has been unable to contact the legal representative.

DHS 40.08(7)(d)(d) Each administration of seclusion or physical restraint shall be documented in the youth’s chart and shall specify all of the following:

DHS 40.08(7)(d)4.4. Assessment of the appropriateness of the seclusion or physical restraint based on threat of harm to self or others.

DHS 40.08(7)(e)(e) A licensed treatment professional shall review all seclusion and physical restraint documentation prior to the end of the shift in which the intervention occurred and determine whether changes to the youth’s safety plan or treatment plan are necessary.

DHS 40.08(7)(f)(f) If seclusion or physical restraint is administered to a youth more than three times over a period of five days, or in a single instance for more than 30 minutes within 24 hours, the clinical coordinator, or designee, shall do all of the following:

DHS 40.08(7)(f)1.1. Convene staff to discuss the emergency situation that required seclusion or physical restraint, including the precipitating factors that led up to the intervention and any alternative strategies that might have prevented the use of seclusion or physical restraint in those situations.

DHS 40.08(7)(f)2.2. Convene staff to discuss the procedures, if any, to be implemented to prevent further administration of seclusion or physical restraint.

DHS 40.08(7)(f)4.4. Convene the youth’s interdisciplinary treatment team to review the individualized treatment plan and make any necessary revisions to reduce the need for and likelihood of further use of seclusion or physical restraint, and document the discussion and any resulting changes to the plan in the youth’s chart.