MO HB1779

Allows advanced practice registered nurses in collaborative practice arrangements with attending physicians to authorize physical or chemical restraint, isolation, or seclusion in psychiatric hospitals and dedicated psychiatric units, in addition to facility heads and physicians.

Requires physician review of restraint orders issued by advanced practice registered nurses within 24 hours or the next regular working day, and mandates documentation in the clinical record.

Sets time limits requiring physician review if restraint extends beyond 4 hours for patients under 18 or 8 hours for patients 18 and older, or if total restraint exceeds 4 hours in a 24-hour period for minors or 8 hours for adults.

Permits use of security escort devices during transport of civilly detained patients when determined necessary by facility head, attending physician, or advanced practice registered nurse, and requires their use for patients committed under certain statutes unless determined unnecessary.

Restricts use of restraint or seclusion in developmental disabilities facilities to emergency intervention systems approved by the division and identified in the individual support plan, with required staff training.