Clinical Timeout

Date of Last Review: 4/07
SME: Associate Director of Nursing

Staff, in response to a patient's behavior, may encourage the patient to go to a designated area away from milieu stimulation for a period of time as a preventative or de-escalative intervention to limit the use of seclusion or restraint.

Procedure:

1.0	Staff encouraging clinical time out shall explain to patient that clinical time out is voluntary.
2.0	The patient must be cooperative with direction.
3.0	Egress from the timeout area may not be blocked.
4.0	Clinical timeout may not exceed 30 minutes unless the patient and staff jointly agree to continue the process.
5.0	Use of each clinical timeout period must be documented in the medical record on the Clinical Time Out template in Sunrise with information regarding the conditions under which timeout occurred as well as the patient’s response.
6.0	Clinical Time Out must be documented on the Least Restrictive Alternative Form.
	6.1 Patient shall be monitored a minimum of every 15 minutes.
7.0	Timeout may not be used as punishment, for convenience of staff, or as a substitute for therapeutic intervention.  Time out should not be coerced or forced
8.0	A decision by the patient to decline, to begin, or to remain in clinical timeout or quiet time may not result in staff's use of restraint or seclusion unless the behavior has escalated to a point that justifies seclusion/restraint.  If seclusion/ restraint is justified, a new Least Restrictive Alternative Form must be implemented and an order for seclusion/restraint obtained.

Related Standards: