Editing Infection Control and Safety (section)

=== Legal and regulatory requirements ===

* Requires an '''order from a physician or other licensed independent practitioner'''. '''PRN or standing restraint orders are prohibited.'''
* In an emergency, a trained registered nurse may apply a restraint and must obtain the order as soon as possible, generally within one hour.
* '''Violent or self-destructive behavior:''' a face-to-face evaluation by the physician, other licensed independent practitioner, or a trained registered nurse is required '''within one hour''' of initiation. Order time limits are '''4 hours for adults 18 and older, 2 hours for ages 9 through 17, and 1 hour for children under 9'''. Orders may be renewed within these limits for up to 24 hours, after which a new in-person evaluation is required before a new order.
* '''Nonviolent, non-self-destructive (medical or surgical) restraint,''' such as protecting an endotracheal tube: the order is renewed according to hospital policy and at minimum the need is reassessed and the order renewed at least once each calendar day.
* Use the '''least restrictive''' device that is effective, obtain informed consent or notify the family per policy, and discontinue at the earliest possible time. Discontinuation does not require a new order.