JCAHO restraints standards are approved

Revisions become effective Jan. 1, 1999

The Standards and Survey Procedures Committee of the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, has approved the revised restraint standards developed by the task force assigned to that issue. The approval followed three public hearings held around the country, a broad field review of the standards, and a review by an in-house committee.

The Committee also approved:

• standards for in-hospital resuscitation services;

• a standard that addresses the identification and management of sentinel events;

• revisions to the organ procurement standards to ensure they conform with recent revisions to the revised Hospital Medicare Conditions of Participation;

• field evaluation of standards related to pain management;

• revisions to the intent statement for the Environment of Care standards that describe requirements for fire drills in outpatient care buildings classified as business occupancies;

• citation of the American Osteopathic Association physician database as a designated equivalent source for primary source verification of selected credentials information.

Restraint standards spell out applicability

The Joint Commission’s new restraint standards specify that patients of any age are eligible for restraint if they are:

• hospitalized in an acute care hospital on other than a psychiatric unit;

• in the emergency department, even if awaiting transfer to psychiatric unit or hospital;

• awaiting transfer from med-surg care unit to psychiatric hospital or unit;

• in medical observation beds;

• receiving subacute services — unless requested, such services are surveyed under Joint Commission subacute survey protocol;

• undergoing same-day surgical or other ambulatory care procedures;

• undergoing rehabilitation as an outpatient or inpatient.

The nature of a device used to restrain a patient does not in itself determine whether these standards apply. It is:

• the device’s intended use — physical restriction;

• its involuntary application;

• the identified patient need.

These criteria determine whether the device use triggers these standards.

Source: Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL.