(a) Original order. A physician may order restraint or seclusion in response to a behavioral emergency for a period of time not to exceed:
  (1) 15 minutes for personal restraint;
  (2) one hour for mechanical restraint or seclusion for individuals under the age of 9;
  (3) two hours for mechanical restraint or seclusion for individuals ages 9 - 17; and
  (4) four hours for mechanical restraint or seclusion for individuals age 18 and older.
(b) Order continuing use of restraint or seclusion. If the original order has not yet expired and the registered nurse has evaluated the individual face-to-face and determined the continuing existence of a behavioral emergency, the registered nurse must contact the physician. The physician shall conduct a face-to-face evaluation before issuing an order that continues the use of the restraint or seclusion. A physician may renew the original order provided it would not result in the use of:
  (1) personal restraint beyond 15 minutes total from the time of initiation of the original personal restraint;
  (2) mechanical restraint or seclusion beyond two hours total from the time of initiation of the original mechanical restraint or seclusion, for individuals under age 9;
  (3) mechanical restraint or seclusion beyond four hours total from the time of initiation of the original mechanical restraint or seclusion, for individuals ages 9 - 17; or
  (4) mechanical restraint or seclusion beyond eight hours total from the time of initiation of the original mechanical restraint or seclusion, for individuals age 18 and older.
(c) Issuing and renewal documentation. The physician shall document the clinical justification for continuing the restraint or seclusion before issuing or renewing an order that continues the use of restraint or seclusion.

Source Note: The provisions of this §415.261 adopted to be effective July 22, 2014, 39 TexReg 5581