Rules for Removing Restraints in Hospitals

What are the rules for removing restraints in hospitals?

For example, let’s say a patient is on restraints and requires an MRI. Can you remove the restraints for the purpose of performing the MRI, and return the patient to restraints, once it’s complete, and not meet discontinuation criteria? 

Rules for Removing Restraints in Hospitals

The practice of temporarily releasing the patient from restraint in order to perform care is consistent with CMS regulations in tag A-0169:

“A temporary, directly supervised release, however, that occurs for the purpose of caring for a patient’s needs (e.g., toileting, feeding, or range of motion exercises) is not considered a discontinuation of the restraint or seclusion intervention.  As long as the patient remains under direct staff supervision, the restraint is not considered to be discontinued because the staff member is present and is serving the same purpose as the restraint or seclusion.”

One word of caution. An MRI is unique and requires cooperation of the patient to remain still. If the patient can provide that cooperation and remain still for as long as the MRI takes, without anesthesia, then CMS or TJC would potentially question the need for reapplication of the restraint. Conversely, other diagnostic tests of short duration that require less cooperation from the patient are more clear-cut, and yes, you can reapply the restraint. 

Patton Healthcare Consulting

Patton Healthcare Consulting provides a complete range of Joint Commission and CMS Compliance Assistance and a full range of pre-survey and post survey services.

We serve more than 350 hospitals, behavioral health care organizations, ambulatory clinics and home care companies nationwide—hospitals ranging from critical access hospitals to the largest health systems. Contact us at (888) PHC-INC1 for more information.