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Restraint or Seclusion - Role of Residents Enrolled in Graduate Medical Education Programs

Can residents or house staff write orders and/or evaluate a patient for restraint or seclusion for behavioral health reasons?  

Any examples are for illustrative purposes only.

Joint Commission standards require that a physician or other licensed practitioner responsible for the patient's care order restraint^ or seclusion^. When restraint or seclusion is used for the management of violent or self-destructive behavior an in-person (face-to-face) evaluation of the patient within one hour of the initiation of the restraint or seclusion is also required.

Four requirements must be met for a resident (a physician in a graduate medical education program) to order restraint or seclusion or conduct the required face-to-face evaluation of a patient in restraint or seclusion for the management of violent or self-destructive behavior:
  • State law permits residents to perform these two activities under the auspices of a graduate medical education program.
  • The graduate medical education program has provided relevant education and training for the resident in performing these two activities. Graduate medical education programs accredited by the Accreditation Council on Graduate Medical Education would be expected to be in compliance with this requirement; the organization should be able to demonstrate compliance with any residency review committee citations related to this requirement.
  • In the judgment of the graduate medical education program, the resident is able to competently perform these two activities.
  • The health care organization in which the resident provides patient care permits residents to perform these two activities.
These responsibilities, as all other patient care activities performed by the participants in graduate medical education programs, are to be appropriately supervised. 

^Please see the glossary of the accreditation manual for definition of terms. 
Manual: Critical Access Hospital
Chapter: Provision of Care Treatment and Services PC
Last reviewed by Standards Interpretation: July 19, 2022 Represents the most recent date that the FAQ was reviewed (e.g. annual review).
First published date: April 11, 2016 This Standards FAQ was first published on this date.
This page was last updated on July 19, 2022 with update notes of: Review only, FAQ is current Types of changes and an explanation of change type: Editorial changes only: Format changes only. No changes to content. | Review only, FAQ is current: Periodic review completed, no changes to content. | Reflects new or updated requirements: Changes represent new or revised requirements.
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