(a) Voluntary use of protective and supportive devices. A protective or supportive device that is easily removable by the individual without a staff member's assistance is not restraint.
  (1) A protective or supportive device may only be used with the consent of the individual.
  (2) A supportive device must allow greater freedom of mobility than would be possible without the use of the device.
  (3) Use of a protective or supportive device shall be based upon a prior order of a physician, physician's assistant, or advanced practice registered nurse.
  (4) If an individual uses a protective or supportive device, the individual's treatment team shall include an occupational or physical therapist and the individualized treatment plan shall specify that a protective or supportive device is to be used and shall:
    (A) include any special considerations for the use of the device based on the findings of the comprehensive initial assessment performed at admission or intake;
    (B) include an outcome oriented goal;
    (C) describe the specific type of device to be used;
    (D) specify who is responsible for applying the device;
    (E) describe the plan for monitoring the individual; and
    (F) reflect periodic assessment, intervention, and evaluation by the treatment team, including the physical therapist, on an ongoing basis.
  (5) The facility shall have written policies and procedures that address the proper implementation of this subsection and monitoring requirements with reference to individuals with particular types of protective and supportive devices.
(b) Involuntary use of protective and supportive devices. A protective or supportive device that is not easily removable by the individual without a staff member's assistance constitutes a restraint, and becomes subject to the requirements for restraint or seclusion, as applicable, described in this subchapter.
(c) Protective devices for wound healing. After a wound has healed, the continued use of a protective device constitutes a mechanical restraint and becomes subject to the requirements for restraint or seclusion, as applicable, described in this subchapter.

Source Note: The provisions of this §415.276 adopted to be effective July 22, 2014, 39 TexReg 5581