Triumph, LLC
Planned Use of Restrictive Intervention
PLANNED USE OF RESTRICTIVE INTERVENTION
Before
1. PART OF THE PCP
Permission to use physical restraint as an intervention to address a goal on the
child/youth’s PCP must first be approved by the Child and Family Team and the Intervention Advisory
Committee.
2. LAST RESORT
Make all efforts to de-escalate the child/youth. If this has been ineffective and they
are in eminent risk to harm themselves or others or if the safety of the child or other children is at risk,
and as a last resort, restrictive intervention techniques may be used.
****Risk of property destruction is not a reason to use restrictive interventions****
3. GET A WITNESS
Another staff member must be present or within line of sight (who is currently
certified in NCI Core Plus and First Aid/CPR).
4. GET APPROVAL
If possible, permission to employ the restrictive intervention must be given
verbally from the Program Manager or their QP designee if they are not present.
During
1. MONITOR WELL-BEING
During the time of the intervention, staff will monitor the child’s physical
and psychological well-being. The observing staff member should consider the safe use of the
technique and should ask staff to discontinue if there is concern for the child’s well-being.
2. DISCONTINUE ASAP
Once the child/youth has been removed from the situation or sufficiently
under control the intervention must be discontinued. Physical restraints should be under 15 minutes.
3. NEW APPROVAL
If a physical restraint needs to continue past 15 minutes, a new approval must be
given from the Program Manager either verbally or in writing. Restraints should never last more than 1
hour for children under 9 years old or no more than 2 hours for children 10 years and older.
After
DEBRIEF After the episode has ended and the child/youth is calm, staff will review the incident with
them and talk through what happened, how it could have been avoided and what can be done in the
future to avoid this from happening again.
NOTIFICATIONS
 Immediately after the incident, the child/youth’s legally responsible person will be contacted and
informed about the restrictive intervention and debriefing.
 Within 24 hours, the members of the Child and Family Team will be contacted and informed
about the incident for proper care coordination and planning.
DOCUMENTATION
 Staff who employed the restrictive intervention must write up the incident on the QM02 and
QM04 forms as soon as possible and before the end of the day of the incident.
 The Program Manager will review the reports and debrief the incident with the staff members
involved in the intervention.
 Reports will be submitted to the Program Director and the Quality Improvement Specialist.
Effective: 07-01-10
Day Treatment
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