Restraint standard revised for nurse practitioners

Complying with the standards on the use of restraints in a hospital setting now may be a little bit easier after the Joint Commission revised the rules on who can issue orders.

The Joint Commission on Accreditation of Healthcare Organizations’ recently revised Standard TX.7.1.5 in the Comprehensive Accredi-tation Manual for Hospitals now allows licensed independent practitioners (LIPs) to delegate to physician assistants and nurse practitioners the writing of restraint and seclusion orders. Also, the revision allows the physician to delegate the performance of in-person evaluations of patients in restraint and seclusion. The revised standard takes effect July 1, 2002.

The Centers for Medicare & Medicaid Services offers this clarification of the Interpretive Guide-lines for Rule 482.13 (d)(2): "An LIP is any practitioner permitted by law and by the hospital as having the authority under his/her license to independently order restraints, seclusion, or medications for patients. This provision is not to be construed to limit the authority of the doctor of medicine or osteopathy to delegate tasks to other qualified health care personnel (i.e. physician assistants and nurse practitioners) to the extent recognized under state law or a state’s regulatory mechanism."