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Clinton City Schools House Bill 1032 Documentation Form Circle Type of Incident Being Reported: Physical Restraint Mechanical Restraint Seclusion Use of Aversive Procedures Student ID: ___ Student
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How to fill out physical restraint procedures for

01
Begin by gathering all necessary forms and documentation related to physical restraint procedures.
02
Ensure that you have a clear understanding of the guidelines and protocols for physical restraint in your specific setting.
03
Start by identifying the need for physical restraint. This may involve assessing the individual's behavior, risk to themselves or others, and the level of intervention required.
04
Ensure that all individuals involved in the restraint procedure are properly trained and aware of their roles and responsibilities.
05
Follow proper protocols for obtaining informed consent if necessary.
06
Prepare the physical environment by removing any potential hazards or objects that could cause harm.
07
Communicate clearly with the individual and other staff members involved in the procedure, explaining each step and providing reassurance.
08
Implement proper techniques for physical restraint, ensuring safety and minimizing the risk of injury.
09
Monitor the individual closely throughout the restraint procedure, checking for any signs of distress or discomfort.
10
Once the restraint is no longer necessary, follow proper procedures for safely releasing the individual and documenting the procedure.
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Finally, debrief with all staff members involved in the restraint procedure, discussing what went well and identifying any areas for improvement.

Who needs physical restraint procedures for?

01
Physical restraint procedures may be needed for individuals who exhibit behaviors that pose a risk to themselves or others.
02
This can include individuals with certain cognitive or developmental disabilities, mental health conditions, or other impairments that may affect their ability to safely interact with their environment.
03
Physical restraint procedures are designed to ensure the safety and well-being of both the individual and those around them.
04
It is important to note that physical restraint should only be used as a last resort when all other less restrictive interventions have been attempted and deemed ineffective or insufficient.
05
The decision to use physical restraint should always be made by qualified professionals and in accordance with applicable laws, regulations, and ethical guidelines.
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Physical restraint procedures are designed to manage and control individuals who pose a risk of harm to themselves or others, ensuring safety in situations where verbal de-escalation is ineffective.
Staff members, licensed professionals, or organizations that utilize physical restraints on individuals are required to file physical restraint procedures.
Physical restraint procedures should be filled out by documenting the specific circumstances, the individuals involved, the type of restraint used, the duration, and any observable behaviors before, during, and after the restraint.
The purpose of physical restraint procedures is to provide a clear framework for safely managing potentially dangerous situations while ensuring the rights and dignity of individuals are respected.
The report must include details such as the reason for restraint, the type of restraint utilized, the assessment of the individual's behavior, and any injury sustained during the procedure.
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