[wiggle,wiggle,squirm,punt] It may point to just that, a training issue which, if true, may force a law which would press all schools to comply with mandatory CPR training, Manatory that life guards be hired, etc.>>>>
Those laws already exist. If you are caring for children in Tx, whether in a home, center, or RTC; staff MUST be certified in CPR/ First Aid.
If you provide a pool, a lifeguard certified in CPR/ First Aid is mandatory.
A certified lifeguard must be on duty during facility-sponsored [water] activities. Certification must be documented in the personnel record of facility staff used as lifeguards.
And training must be updated every year.
That's the law.
Why didn't this staff give CPR to this child when he collapsed?
Why wasn't his refusal to obey a 'staff order' met with de-escalation?
Staff with current training in cardiopulmonary resuscitation (CPR) must be available and accessible to children in care during all hours of operation. CPR training must be updated at least annually. Training must be conducted by a person certified to provide CPR training.
[Staff] training components [include]:
a. developing and maintaining an environment or milieu that supports positive constructive behaviors;
b. [assessing] causes of behaviors potentially harmful to self or others in children and adolescents including aspects of the environment or milieu;
c. [determining] early signs of behaviors that may become dangerous to [a child] or others;
(continued)
d. [understanding] strategies and techniques the child can use to avoid harmful behaviors;
e. teaching children to use the strategies and techniques to avoid harmful behavior and supporting the children?s efforts;
f. [learning] less-restrictive [intervention] strategies [for preventing] potentially harmful behaviors;
g. [learning] less-restrictive [intervention] strategies [for use] with oppositional children; and
h. [determining] strategies for [the] re-integration of children into the milieu after restraint or seclusion.
5. The remainder of the pre-service behavior intervention training for caregivers who are providing care in a home or facility whose policies allow for the use of any one type of restraint or seclusion must focus on the:
a. different roles and responsibilities of caregivers qualified in behavior intervention and caregivers who are not qualified in behavior intervention; and
b. safe implementation of the restraints and/or seclusion permitted by the rules in this chapter and by the child-care facility and/or child-placing agency?s policies and procedures.
http://www.dfps.state.tx.us/Child_Care/ ... oc95294304Further:
The evaluation must take place at each review of the child?s plan of service or treatment plan. The evaluation must focus on:
1. the frequency, patterns, and effectiveness of specific behavior interventions;
[9 restraints in 30 days... I'd say the intervention was not effective. Time to try something different.]
2. strategies to reduce the need for behavior interventions overall; and
3. specific strategies to reduce the need for use of personal, emergency medication, and/or mechanical restraint or seclusion, where applicable.
The psychiatrist or psychologist ordering personal restraint or the treatment team recommending personal restraint must first take into consideration any potential medical (including psychiatric) contraindications, including a child?s history of physical or sexual abuse. This consideration must be documented in the child?s records.
Orders and treatment team recommendations must include the circumstances under which the intervention may be used, instructions for observation of the child while in restraint, the behaviors that indicate the child is ready to be released from restraint, the number of times a child may be restrained in a seven-day period, and the amount of time the child may be restrained regardless of behaviors exhibited.
Only the minimal amount of reasonable and necessary physical force may be used to implement personal restraint. During any personal restraint, a caregiver qualified in behavior intervention must monitor the child?s breathing and other signs of physical distress and take appropriate action to ensure adequate respiration, circulation, and overall well-being. The caregiver monitoring the child should not be the same caregiver that is restraining the child. Appropriate action includes responding when a child indicates he cannot breathe.
Any personal restraint that employs a technique listed [below] is prohibited:
a. restraints that place a child face-down and place pressure on the child?s back;
b. restraints that obstruct the airways of the child or impair the breathing of the child;
c. restraints that obstruct the caregiver?s view of the child?s face; or
d. restraints that restrict the child?s ability to communicate.
Only a caregiver qualified in behavior intervention may apply personal restraint.
If an emergency health situation occurs during personal restraint, the child must be released immediately and treatment obtained.
As soon as possible after personal restraint is started, appropriate caregiver(s) must explain to the child in restraint the behaviors the child must exhibit to be released from the restraint or have the restraint reduced, and permit the child to make suggestions about what actions the caregiver(s) can take to help the child de-escalate.
If the child does not appear to understand what action he must take to be released from the restraint, the caregiver(s) must attempt to re-explain it every 15 minutes until understanding is reached or the child is released from restraint.
