2 APPENDIX
The Benefits and Risks of Bed Rails
Potential benefits of bed rails include:
•
Aiding in turning and repositioning within the bed.
•
Providing a hand-hold 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.
Meeting Patients' Needs for Safety
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.
•
Keep the bed in the lowest position with wheels locked.
•
When the patient is at risk of falling out of bed, place mats next to the bed, as long as this does not create a greater risk of accident.
•
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.
•
Use a proper size mattress or mattress with raised foam edges to prevent patients from being trapped between the mattress and rail.
•
Reduce the gaps between the mattress and side rails.
The FDA's Brochure
6