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North Carolina Department of Public Instruction Exceptional Children DivisionDOCUMENTATION OF SECLUSION or RESTRAINT (Please circle which one applies) Student: Date: Child is EC Program: YesorNoStaff
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How to fill out documentation of seclusion or

01
To fill out documentation of seclusion, follow these steps:
02
Begin by gathering all necessary information about the seclusion event, including the date, time, and location.
03
Write a detailed description of the circumstances that led to the seclusion. Include any relevant information about the individual involved and their behavior.
04
Document the duration of the seclusion, noting the start and end times.
05
Describe the actions taken during the seclusion, such as interventions or attempts to de-escalate the situation.
06
Record any observations made during the seclusion, such as the individual's behavior, emotional state, or any physical restraints used.
07
Include any relevant documentation or reports from witnesses or other staff members who were present during the seclusion.
08
Sign and date the documentation to indicate its accuracy and completeness.
09
File the completed documentation in the appropriate location for future reference and review.

Who needs documentation of seclusion or?

01
Documentation of seclusion is typically needed by healthcare providers, mental health facilities, or organizations that provide residential or inpatient care.
02
It is required for regulatory compliance, ensuring accountability, and maintaining a comprehensive record of the events that occurred during a seclusion episode.
03
This documentation may also be requested by legal entities or used for internal reviews, quality improvement, or communication among healthcare professionals.
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Documentation of seclusion or is a record of any incidents of seclusion or restraint applied to an individual, including the circumstances surrounding the use of such interventions.
All healthcare providers, caregivers, or facilities that use seclusion or restraint techniques are required to file documentation of seclusion or.
Documentation of seclusion or should be completed with accurate and detailed information about the incident, including the reasons for the intervention, the duration, and any outcomes.
The purpose of documentation of seclusion or is to ensure transparency, accountability, and monitoring of the use of seclusion or restraint techniques, as well as to track trends and identify areas for improvement.
Information that must be reported on documentation of seclusion or includes the date and time of the incident, the individuals involved, the reason for seclusion or restraint, the duration, any interventions used, and any outcomes or follow-up actions.
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