Report - Disability Rights Texas

# Provision Assessment of Status Compliance
use of restraint was apparent in all eight (100%) cases.
In eight (100%), the method and type (e.g., medical, dental, crisis intervention) of
restraint was indicated on the restraint checklist.
In eight (100%), the names of staff involved in the restraint episode were
indicated on the restraint checklist.
The Restraint Checklist documented observations of the individual and actions taken by
staff while the individual was in restraint, including:
All eight were of short duration. None required observations at least every 15
minutes. For two of the Individuals (involving seven of the eight restraints) the
restraints occurred “back to back to back.” In these instances the specific
behaviors of the individual that required continuing restraint were noted.
Because of the short duration of restraint episodes there was no obvious need
for staff to provide, during the restraint, opportunities to exercise restrained
limbs, to eat as near meal times as possible, to drink fluids, and to use a toilet or
bed pan.
In eight (100%), the level of supervision provided during the restraint episode
was recorded on the restraint checklist.
In eight (100%), the date and time the individual was released from restraint
was recorded on the restraint checklist.
In four (50%), the results of assessment by a licensed health care professional
were documented as to whether there were any restraint‐related injuries or
other negative health effects. This was not documented on the Restraint
Checklist for the four restraints of Individual #77.
In eight records (100%) restraint debriefing forms (FFADs) had been completed.
Crisis intervention chemical restraint of Individuals #46 and #77 was included in
Sample C.1. The documentation for each restraint did not include an
“Administration of Chemical Result Consult” required by policy. The
documentation of chemical restraint of Individual #46 did not include the
required “Chemical Restraint Clinical Review” which is part of the FFAD process.
The documentation of chemical restraint of Individual #77 did include the
required “Chemical Restraint Clinical Review”, although this review was not
completed until two weeks after the chemical restraint occurred.
The Facility demonstrated significant improvement towards achieving compliance with
this Provision. There are still issues which need to be addressed, primarily with medical
staff. As a result, this Provision is not in substantial compliance.
C7
Within six months of the Effective
Date hereof, for any individual
According to Facility documentation, during the six‐month period prior to the on‐site
review, a total of two individuals were placed in restraint more than three times in any
Rio Grande State Center, November 19, 2012
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