Side Rails & Bed Injuries
As the population ages, people who are and people who believe they are unable to care for themselves adequately are moving into nursing homes and other long-term care facilities in increasing numbers. As unfortunate as it is to say, not every nursing home maintains the high standards of training and care of which they are required. Nursing home should be held accountable when they fail to treat and care for residents within the proper standard of care.
The following information outlines and details some of the statistics and problems regarding bed and rail injuries.
Bed Rail Entrapment Statistics
- Today there are about 2.5 million hospital and nursing home beds in use in the United States.
- Between 1985 and 2005, 691 incidents of patients caught, trapped, entangled, or strangled in beds with rails were reported to the U.S. Food and Drug Administration.
- Of these reports, 413 people died, 120 had a nonfatal injury, and 158 were not injured because staff intervened. Most patients were frail, elderly or confused.
Potential benefits of bed rails include:
- Aiding in turning and repositioning within the bed.
- Providing a handhold for getting into or out of bed.
Providing a feeling of comfort and security. - Reducing the risk of patients falling out of bed when being transported.
- Providing easy access to bed controls and personal care items.
Potential risks of bed rails may include:
- Strangling, suffocating, bodily injury or death when patients or part of their body are caught between rails or between the bed rails and mattress.
- More serious injuries from falls when patients climb over rails.
- Skin bruising, cuts, and scrapes.
- Inducing agitated behavior when bed rails are used as a restraint.
- Feeling isolated or unnecessarily restricted.
- Preventing patients, who are able to get out of bed, from performing routine activities such as going to the bathroom or retrieving something from a closet.
Most patients can be in bed safely without bed rails. Consider the following:
- Use beds that can be raised and lowered close to the floor to accommodate both patient and health care worker needs.
- When the patient is at risk of falling out of bed, place mats next to the bed.
- Use transfer or mobility aids.
- Monitor patients frequently.
- Anticipate the reasons patients get out of bed such as hunger, thirst, going to the bathroom, restlessness, and pain; meet these needs by offering food and fluids, scheduling ample toileting, and providing calming interventions and pain relief.
- When bed rails are used, perform an on-going assessment of the patient’s physical and mental status; closely monitor high-risk patients. Consider the following:
- Lower one or more sections of the bed rail, such as the foot rail.
- Reduce the gaps between the mattress and side rails.
- Use a proper size mattress or mattress with raised foam edges to prevent patients from being trapped between the mattress and rail.
- Lower one or more sections of the bed rail, such as the foot rail.
Concerns of nursing home resident or family about bed rail use:
If residents or families ask about using bed rails, health care providers should:
- Encourage residents or families to talk to their health care planning team to determine whether or not bed rails are indicated. .
- Reassure residents and their families that in many cases the resident can sleep safely without bed rails.
- Reassess the need for using bed rails on a frequent, regular basis.
A Guide to Bed Safety Bed Rails in Hospitals, Nursing Homes and Home Health Care: The Facts, U.S. Food and Drug Administration, Center for Devices and Radiological Health (March 9, 2006). http://www.fda.gov/cdrh/beds/