- Bed rails, also known a safety rails or side rails, are adjustable metal or rigid plastic bars that attach to the bed. Bed rails are used in nursing homes to prevent residents from falling out of bed. However, the use of bed rails should never be automatically considered as they may pose more dangers to resident safety in a nursing home.
Why are bed rails dangerous for nursing home residents?
Bed rails present a safety risk, particularly when a resident is elderly or disoriented. Disoriented residents may view a bed rail a a barrier to climb over, may slide between raised, segmented bed rails, or may go to the end of the bed to get around a raised bed rail. When exiting the bed like this, the resident is at risk for entrapment entanglement or falling from a greater height posed by the raised bed rail, with a possibility of suffering a greater injury than if she had fallen from the height of a lower be without raised bed rails.
Some nursing home residents, particularly frail, older ones with Alzheimer's, can be trapped between a bedrail and the bed mattress, which can lead to injury and even death. Strangling, suffocating, bodily injury or death can occur when residents or parts of their body are caught between rails or between the bed rails and mattresses.
Nursing home residents can get stuck between the bed rail and the bed mattress. There have been 828 incidents of residents getting caught, trapped, entangled, or strangled in hospital beds between 1985 and 2010, according to the Food and Drug Administration. About 350 bedrail-related deaths have been reported to the Food and Drug Administration since 1995, but this is only a fraction of the actual number of injuries and deaths.
What nursing home residents are at greatest risk of injury from bed rails?
The residents at risk are those who have conditions such as agitation, delirium, confusion, or bladder or bowel incontinence that can cause them to move about the bed or try to exit from the bed.
A nursing home resident is at low risk if: (1) she transfers safely to and from the bed to a wheelchair without assistance, (2) ambulates to and from the bathroom without falling, and (3) has not fallen, or is unlikely to fall, out of bed.
What you can do to prevent injuries from bedrails in a nursing home
If you have a loved one in a nursing home bed that has a bedrail, check for a gap between the mattress, the bed frame and the bed rail. See if by pushing the mattress to the far side of the bed you can make a gap that is big enough to put four fingers bewteen that and the rail. If you can, the gap is too big. It's up to family members to check that the mattress is tight against bedframe and the bedrail.
The resident's chart should include a risk-benefit analysis that identifies why other interventions are not appropriate. The documentation should describe the attempts to use less restrictive care interventions and if indicated, their failure to meet the resident's needs.
The resident's Care Plan should include educating the resident about bed rail dangers to enable the resident to make an informed decision and address options for reducing the risks of bed rails.
What you can do to prevent falls withou a bed railing
You should consider putting the resident in an adjustable height bed that can go very low to the floor for sleeping and raised for transfers and activities of daily living, or an alternative such as a concave mattress. The bed can be raised to give care during the day and lowed when the resident is sleeping.
- Another way to minimize the risk of falling is to put a high impact mat next to the bed. Move furniture far enough away from the bed to avoid risk of injury.
- If dangers still exist, you should consider using a bed alarm to alert the nursing staff when your loved one is leaving the bed.
- If you have any questions, I welcome your phone call
- If you want more information about the dangers posed by bed rails in nursing homes or hospitals, I welcome your phone call on my toll-free cell at 866-889-6882. You are welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com. If you know someone who might be interested in this article, please share it with them.