Section 376.09. Mechanical restraints.

 

(1)   Types of mechanical restraints. Mechanical restraints include, but are not limited to, handcuffs with restraining belt or chain, restraining chains, leg restraints and leather and plastic restraints.

(2)   Use of mechanical restraints. Mechanical restraints may be used in any of the following situations if the superintendent determines that the use of mechanical restraints is necessary to protect staff, youth or the public or to maintain the security of the institution:

(a) To transport a youth within or outside an institution.

(b) For a youth who is in security status while the youth is outside the place of confinement or for a youth who is out of control.

(c) To protect staff, youth or other persons from a youth who poses an immediate risk of physical injury to others unless restrained.

(d) To protect a youth who poses an immediate threat of physical injury to self unless restrained.

(3)   Approval for use of mechanical restraints. A youth may be placed in mechanical restraints only with the authorization of the superintendent.

(4)   Prohibited use of mechanical restraints. Mechanical restraints may not be used in any of the following ways:

(a) When the use of mechanical restraints is medically contra-indicted.

(b) About the head or neck of a youth in a manner not prescribed by the manufacturer.

(c) In a way that causes undue physical discomfort or inflicts physical pain to a youth.

(d) As a method of punishment.

(e) To secure a youth to a motor vehicle.

(5)   Use of full body restraints. Full body restraints may be used only for the following reasons with authorization from the superintendent:

(a) To protect a youth who poses an immediate threat of physical injury to self unless placed in full body restraints.

(b) To protect a youth in a health emergency that requires full body restraints.

(c) To protect staff, youth or other persons from a youth who poses an immediate risk of physical injury to others unless placed in full body restraints.

(d) To immobilize a youth in full body restraints, because the youth's conduct significantly disrupts the security or function of the institution and less restrictive ways to control the behavior have failed.

(6)   Procedure for placing a youth in full body restraints. When staff place a youth in full body restraints sub. (5) (a) to (d) all of the following apply:

(a) The shift supervisor shall be present and shall notify the superintendent, a health services professional and the psychologist on call.

(b) A minimum of 3 staff shall be present when the youth is placed in full body restraints.

(c) A video and audio recording shall be made as directed by the superintendent.

(d) A staff psychologist or psychiatrist shall arrange for an on-site evaluation within 3 hours after the application of full body restraints unless the superintendent authorizes an extension, which may not exceed 8 hours.

(e) The psychologist or psychiatrist shall recommend to the superintendent whether the youth should remain in full body restraints and what actions should be taken to protect the youth.

(f) A health services professional shall conduct a physical examination as soon as possible, but not later than one hour after application of full body restraints. A physical examination shall be conducted every 4 hours thereafter by a health services professional.

(g) Staff shall directly observe a youth immobilized in full body restraints at least every 15 minutes.

(h) Youth may be partially released from full body restraints if it is safe to do so to perform bodily functions and for meals. Three staff members, one of whom shall be a supervisor, shall be present before and during the release.

(i) The youth shall be released immediately if it becomes apparent that full body restraints present a medical risk to the youth.

(7)   Record of use of full body restraints. A record must be kept of youth placed in full body restraints under sub. (5) (a) to (d) which shall include the following:

(a) The youth's full name and identifying number.

(b) The date and time of immobilization.

(c) Names of the staff members and supervisor present when the youth was placed in full body restraints.

(d) The reasons for placing the youth in full body restraints.

(e) The dates and times that the youth was observed by staff as required by sub. (6) (g) , the name of the staff making the observation and comments on the youth's condition and behavior while in full body restraints.

(f) The dates and times full body restraints were removed.

(g) Medication given and the time it was given.

(h) The dates and times that the youth was observed by clinical staff, a health services professional or a licensed psychologist or psychiatrist, the recommendations made by those persons and whether staff implemented the recommendations.

(8)   Release from full body restraints. The superintendent may authorize partial or complete release from full body restraints at any time.

(9)   Time in full body restraints. No youth may be immobilized in full body restraints for longer than 12 hours, unless the youth is examined by a psychologist, psychiatrist or the crisis intervention worker, who shall make a written recommendation to the superintendent as to whether the youth should continue to remain in full body restraints. An examination by a psychologist, psychiatrist or crisis intervention leader shall occur thereafter at least every 12 hours that a youth is in full body restraints. The superintendent may authorize the use of restraints for more than 12 hours. The superintendent shall notify the administrator of the decision to continue the use of full body restraints beyond 12 hours and every 12 hours thereafter.

(10)   Transfer to a mental health facility. Staff shall initiate a transfer to a mental health facility under s. 51.35 (3) , Stats., if appropriate. Staff shall not retain a youth in full body restraints under sub. (5) (a) to (d) for more than 24 hours, unless a transfer to a mental health facility has been initiated by the institution.

(11)   Monthly report on full body restraints. A monthly report concerning each incident involving the use of full body restraints under sub. (5) (a) to (d) shall be submitted by the superintendent to the administrator.

(12)   Supply of mechanical restraints. Institutions shall maintain a supply of commercially manufactured mechanical restraints approved by the department. The mechanical restraints shall be periodically examined and any excessively worn or defective mechanical restraints shall be removed from the supply and destroyed.

History: Cr. Register, June, 2000, No. 534 , eff. 7-1-00.