(405 ILCS 5/2-108) (from Ch. 91 1/2, par. 2-108)
Sec. 2-108. Use of restraint. Restraint may be used only as a therapeutic
measure to prevent a recipient from causing physical harm to himself or
physical abuse to others. Restraint may only be applied by a person who has
been trained in the application of the particular type of restraint to be
utilized. In no event shall restraint be utilized to punish or discipline a
recipient, nor is restraint to be used as a convenience for the staff.
(a) Except as provided in this Section, restraint shall be employed only
upon the written order of a physician, clinical psychologist, clinical social
worker, clinical professional counselor, advanced practice psychiatric nurse, or registered nurse with supervisory responsibilities. No restraint
shall be ordered unless the physician, clinical psychologist, clinical social
worker, clinical professional counselor, advanced practice psychiatric nurse, or registered nurse with supervisory responsibilities, after personally
observing and examining the recipient, is clinically satisfied that the use of
restraint is justified to prevent the recipient from causing physical harm to
himself or others. In no event may restraint continue for longer than 2 hours
unless within that time period a nurse with supervisory responsibilities, advanced practice psychiatric nurse, or a
physician confirms, in writing, following a personal examination of the
recipient, that the restraint does not pose an undue risk to the recipient's
health in light of the recipient's physical or medical condition. The order
shall state the events leading up to the need for restraint and the purposes
for which restraint is employed. The order shall also state the length of time
restraint is to be employed and the clinical justification for that length of
time. No order for restraint shall be valid for more than 16 hours. If
further restraint is required, a new order must be issued pursuant to the
requirements provided in this Section.
(b) In the event there is an emergency requiring the immediate use
of restraint, it may be ordered temporarily by a qualified person only
where a physician, clinical psychologist, clinical social worker, clinical professional counselor, advanced practice psychiatric nurse, or
registered nurse with supervisory responsibilities is not immediately
available. In that event, an order by a nurse, clinical psychologist, clinical
social worker, clinical professional counselor, advanced practice psychiatric nurse, or physician shall be obtained pursuant to the requirements of
this Section as quickly as possible, and the recipient shall be examined by a
physician or supervisory nurse within 2 hours after the initial employment of
the emergency restraint. Whoever orders restraint in emergency situations shall
document its necessity and place that documentation in the recipient's record.
(c) The person who orders restraint shall inform the facility director or
his designee in writing of the use of restraint within 24 hours.
(d) The facility director shall review all restraint orders daily and shall
inquire into the reasons for the orders for restraint by any person who
routinely orders them.
(e) Restraint may be employed during all or part of one 24 hour
period, the period commencing with the initial application of the
restraint. However, once restraint has been employed during one 24 hour
period, it shall not be used again on the same recipient during the next
48 hours without the prior written authorization of the facility director.
(f) Restraint shall be employed in a humane and therapeutic manner and
the person being restrained shall be observed by a qualified person as often
as is clinically appropriate but in no event less than once every 15 minutes.
The qualified person shall maintain a record of the observations.
Specifically, unless there is an immediate danger that the recipient
will physically harm himself or others, restraint shall be loosely
applied to permit freedom of movement. Further, the recipient shall be
permitted to have regular meals and toilet privileges free from the
restraint, except when freedom of action may result in physical harm to
the recipient or others.
(g) Every facility that employs restraint shall provide training in the
safe and humane application of each type of restraint employed.
The facility shall not authorize the use of any type of restraint by an
employee who has not received training in the safe and humane application
of that type of restraint. Each facility in which restraint is used shall
maintain records detailing which employees have been trained and are
authorized to apply restraint, the date of the training and the type of
restraint that the employee was trained to use.
(h) Whenever restraint is imposed upon any recipient whose primary mode
of communication is sign language, the recipient shall be permitted to have
his hands free from restraint for brief periods each hour, except
when freedom may result in physical harm to the recipient or others.
(i) A recipient who is restrained may only be secluded at the same time
pursuant to an explicit written authorization as provided in Section 2-109
of this Code. Whenever a recipient is restrained, a member of the facility
staff shall remain with the recipient at all times unless the recipient has
been secluded. A recipient who is restrained and secluded shall be
observed by a qualified person as often as is clinically appropriate but in
no event less than every 15 minutes.
(j) Whenever restraint is used, the recipient shall be advised of his
right, pursuant to Sections 2-200 and 2-201 of this Code, to have any
person of his choosing, including the Guardianship and Advocacy Commission
or the agency designated pursuant to the Protection and Advocacy for
Persons with Developmental Disabilities Act notified of the restraint. A recipient
who is under guardianship may request that any person of his choosing be
notified of the restraint whether or not the guardian approves of the notice.
Whenever the Guardianship and Advocacy Commission is notified that a recipient
has been restrained, it shall contact that recipient to determine the
circumstances of the restraint and whether further action is warranted.
(Source: P.A. 101-587, eff. 1-1-20.)
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