Seclusion and Restraint Episode Documentation

Documents the behavior leading to seclusion or restraint, less-restrictive interventions attempted, monitoring during the episode, and post-episode debriefing for regulatory compliance.

Submission Notice

• Documentation notice

Episode Details

• Date of episode
• Start time
• End time
• Episode type
• Location
  Document the unit, room, or area where the episode occurred.
• Staff role initiating the episode
  Enter the role or title only; do not enter unnecessary personal identifiers.

Precipitating Behavior and Risk

• Behavior leading to seclusion or restraint
  Describe observable actions and statements. Avoid speculation or diagnostic labels.
• Immediate safety risk
• Other risk details

Less-Restrictive Measures Tried

• Measures attempted before seclusion or restraint
• Were the less-restrictive measures effective?
• Why escalation was needed
  Explain why less-restrictive measures were insufficient.
• Other measures details

Seclusion or Restraint Details

• Restraint type
• Authorizing provider role
  Enter the provider role/title only if required by policy.
• Authorization time
• Duration in minutes
• Other restraint details

Monitoring and Patient Response

• Monitoring frequency
• Were vital signs monitored?
• Patient response during episode
  Document observable response, including signs of distress, calming, or escalation.
• Any injury or adverse event?
• Injury or adverse event details

Debriefing and Follow-Up

• Was a debriefing completed?
• Debriefing participants
• Follow-up actions
  Document care plan updates, safety planning, referrals, or monitoring changes.
• Audit trail notes
  Optional notes for compliance review, including any late entry or correction details.