Safe Use of Bed Rails

Bed rails are tools that acute, community, and home care settings use to limit the danger of patients falling out of bed and harming themselves.

The most destructive issues are injuries and death due to asphyxiation from blocking the head, neck, or chest.

Most occurrences happened in community care settings, mainly nursing homes. Before using bed rails for an individual bed user, clinicians should carefully assess the benefits and hazards.

In general, bed rails prevent or lessen the risk of bed occupants falling and injuring themselves. They should not limit people's freedom by stopping them from leaving their beds on purpose, nor are they intended to constrain persons whose condition predisposes them to be unpredictable, repetitive, or violent movement.

Bed rails with a range of direct and indirect risks to bed occupants and the potential benefits of lowering the risk of falls. Entrapment and entanglement are hazards within gaps in the rails. They happen between the rails and the mattress or between the rails and the bed frame.

In cases where someone became entangled in bed rails, severe limb damage is likely.

Other bed rails incidents in which users became confused or disoriented and attempted to exit the bed by climbing over the bed rails. Users have then fallen from a greater height than would have been the case otherwise, enhancing the severity of their injuries.

There are numerous bed rails on the market, each with a unique fitting and functioning manner. Because of the various combinations of bed rails, beds, and mattresses, as well as the variances between bed occupants, a comprehensive, detailed, and personalized risk assessment is essential to avoid serious events.

According to local policy, companies should perform risk assessments before the initial prescription of bed rails and then review and record after each significant change in the bed occupant's condition, replacement of any part of the equipment combination, and regularly during its period of use.

Alternatives to bed rails could include:

• 'netting' or mesh bedsides;

• ultra-low-height mattresses that reduce the risk of injury from falls;

• alarm systems to inform care;

• givers when a person has changed from their typical position or wishes to get out of bed;

• fall mats that can soften the impact if the bed occupant falls;

Each of these methods may present new hazards while reducing the chance of bed fall injury or the risk from bed rails, and hence should be controlled carefully.

All bed rails must be connected to an appropriate bed base and used safely. Points to consider at the commencement of the fitting process will include:

• Can the bed rails be installed right?

• Do the employees know how to fit it correctly?

• Are mounting clamps, if present, utilized perfectly and in good condition?

• Is there a space between the bed rail and the side of the mattress, headboard, or footboard that could trap the head or body of the bed occupant?

• Is the bed rail solid and sturdy - may its shift away from the edge of the bed and mattress in use, posing an entrapment or fall hazard?

• Are extra-height bed rails required because the dimensions and overall height of the mattress(es) affect the effectiveness of the bed rail for the specific occupant?