A nurse must be aware that keeping an aggressive patient in a seclusion or restraint requires an order from the doctor. The renewal of such order for…

When a patient aged 19 years old is placed in seclusion or restraint, the renewal of the order must be

done every 4 hours. This requirement is based on the guidelines provided by the Joint Commission

and the Centers for Medicare & Medicaid Services (CMS), which regulate the use of seclusion and

restraints in healthcare settings.

Initial Order: The use of seclusion or restraint must be ordered by a licensed independent

practitioner (LIP), such as a physician.

Time Limits: For adults aged 18 and older, the order must be renewed every 4 hours.

Renewal Process: This renewal must involve an assessment of the patient's condition and the need

for continued seclusion or restraint.

Documentation: The rationale for using seclusion or restraint and the patient's response to the

intervention must be documented thoroughly in the patient's medical record.

Reference:

The Joint Commission: Standards for Behavioral Health Care

Centers for Medicare & Medicaid Services (CMS): Conditions of Participation for Hospitals, 42 CFR

482.13(e)