PDF Printer Version Today there are about 2.5 million hospital and nursing home beds in use in the United States. Between 1985 and January 1, 2009, 803 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, 480 people died, 138 had a nonfatal
injury, and 185 were not injured because staff intervened. Most patients were frail, elderly or confused. * In this brochure, the term patient refers to a resident of a nursing home, any individual receiving services in a home care setting, or patients in hospitals. Patient SafetyPatients who have problems with memory, sleeping, incontinence, pain, uncontrolled body movement, or who get out of bed and walk unsafely without assistance, must be carefully assessed for the best ways to keep them from harm, such as falling. Assessment by the patient’s health care team will help to determine how best to keep the patient safe. Historically, physical restraints (such as vests, ankle or wrist restraints) were used to try to keep patients safe in health care facilities. In recent years, the health care community has recognized that physically restraining patients can be dangerous. Although not indicated for this use, bed rails are sometimes used as restraints. Regulatory agencies, health care organizations, product manufacturers and advocacy groups encourage hospitals, nursing homes and home care providers to assess patients’ needs and to provide safe care without restraints. The Benefits and Risks of Bed RailsPotential benefits of bed rails include:
Potential risks of bed rails may include:
Meeting Patients' Needs for SafetyMost patients can be in bed safely without bed rails. Consider the following:
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:
Which Ways of Reducing Risks are Best?A process that requires ongoing patient evaluation and monitoring will result in optimizing bed safety. Many patients go through a period of adjustment to become comfortable with new options. Patients and their families should talk to their health care planning team to find out which options are best for them. Patient or Family Concerns About Bed Rail UseIf patients or family ask about using bed rails, health care providers should:
To report an adverse event or medical device problem, please call FDA’s MedWatch Reporting Program at 1-800-FDA-1088. For additional copies of this brochure, see the FDA’s Hospital Bed website. For more information about this brochure, contact Beryl Goldman at 610-335-1280 or by e-mail at . She has volunteered to answer questions. For information regarding a specific hospital bed, contact the bed manufacturer directly. Developed by the Hospital Bed Safety WorkgroupParticipating Organizations:
October 2000 Which of the following would you consider in a bed rail risk assessment?a risk assessment is carried out by a competent person taking into account the bed occupant, the bed, mattresses, bed rails and all associated equipment. the rail is suitable for the bed and mattress. the mattress fits snugly between the rails. the rail is correctly fitted, secure, regularly inspected and maintained.
Are bed rails unsafe?In reality, bed rails can be extremely harmful. Bed rails can cause: Strangulation or asphyxiation: Older adults can get trapped in the gap between the bed rail and the mattress. The individual can roll into that gap and be too weak, frail or confused to change position.
Which of the following is a danger associated with the use of Siderails?The following are potential risks of side rails:
Strangling, suffocating, bodily injury or death when residents or part of their bodies are caught between rails or between bed rails and mattresses. Falls with serious injuries when residents climb over side rails. Skin bruising, cuts and scrapes.
Do bed rails prevent falls?Conclusion. There is no scientific evidence comparing the use of bedrails in preventing falls among hospitalized older adults to no use of bedrails or any type of physical restraints.
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