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§415.253: Definitions

The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

(1) Advanced practice nurse--A registered nurse approved by the Texas Board of Nurse Examiners to practice as an advanced practice nurse.

(2) Behavioral emergency--A situation in which preventive, de-escalative, or verbal techniques have been considered and determined to be ineffective and it is immediately necessary to restrain or seclude an individual to prevent:

(A) imminent probable death or substantial bodily harm to the individual because the individual is attempting to commit suicide or serious bodily harm; or

(B) imminent physical harm to others because of acts the individual commits.

(3) Chemical restraint--The use of any chemical, including pharmaceuticals, through topical application, oral administration, injection, or other means, for purposes of restraining an individual and which is not a standard treatment for the individual's medical or psychiatric condition.

(4) Chief executive officer (CEO)--The highest ranking administrator of a facility or the administrator's designee.

(5) Clinical timeout--A procedure in which an individual, in response to verbal suggestion from a staff member, voluntarily enters and remains for a period of time in a designated area from which egress is not prevented.

(6) Clinically competent registered nurse--A registered nurse who has demonstrated the competencies required by this subchapter.

(7) Competence--Demonstrated knowledge, skill, and ability.

(8) Continuous face-to-face observation--Maintaining an in-person line of sight that is uninterrupted and free of distraction.

(9) Department--The Texas Department of Mental Health and Mental Retardation (TDMHMR).

(10) Emergency medical condition--A non-psychiatric medical condition manifesting itself by acute symptoms, including severe pain, of sufficient severity such that the absence of immediate attention could reasonably be expected to result in serious impairment to bodily functions, serious dysfunction of any bodily organ or part, or a threat to the health or safety of the woman or the unborn child.

(11) Episode--The time period from the initiation of restraint or seclusion until the release of the individual.

(12) Facility--An entity to which the subchapter applies, as identified in §415.252 of this title (relating to Application).

(13) Individual--Any person receiving mental health services from a facility.

(14) Initiation--The time at which a personal or mechanical restraint is applied to an individual or an individual is placed in seclusion.

(15) Legally authorized representative (LAR)--A person authorized by law to act on behalf of an individual with regard to a matter described in this subchapter, and who may include a parent, guardian, managing conservator of a minor individual, guardian of an adult individual, or person with activated power of attorney for health care decisions.

(16) Mechanical restraint--The application of a device restricting the movement of the whole or a portion of an individual's body to control physical activity, as described in §415.256 of this title (relating to Mechanical Restraint Devices).

(17) Personal restraint--The application of physical force alone restricting the free movement of the whole or a portion of an individual's body to control physical activity.

(18) Physical force--Pressure applied to an individual's body.

(19) Physician assistant--A physician assistant licensed under Chapter 155 of the Texas Occupations Code.

(20) Protective device--Device used voluntarily to prevent injury or to permit wounds to heal.

(21) Quiet time--A procedure in which an individual, on the individual's own initiative, enters and remains for a period of time in a designated area from which egress is not prevented.

(22) Restraint--The use of personal restraint or a mechanical device to involuntarily restrict the free movement of the whole or a portion of an individual's body in order to control physical activity.

(23) Seclusion--The involuntary confinement of an individual away from other individuals for any period of time in a hazard-free room or other area in which direct observation can be maintained and from which egress is prevented.

(24) Staff member--A person with direct care responsibilities, including full-time and part-time employees, contractors, and professionals granted privileges by the hospital.

(25) Substance use disorders--The use of one or more drugs, including alcohol, which significantly and negatively impacts one or more major areas of life functioning and which meets criteria described in the current Diagnostic and Statistical Manual for substance abuse or substance dependence.

(26) Supportive device--A device voluntarily used by an individual to posturally support the individual or to assist the individual who cannot obtain or maintain normal bodily functioning.

(27) Treating physician--The physician assigned by the facility and designated in the individual's medical record as the physician responsible for the coordination and oversight of the implementation of an individual's comprehensive treatment plan.


Source Note: The provisions of this §415.253 adopted to be effective January 1, 2004, 28 TexReg 11589