In 1999, the FDA partnered with various representatives from the hospital bed industry, national healthcare organizations, patient advocacy groups, and other federal agencies to form the Hospital Bed Safety Workgroup. The workgroup states its goal as improving “the safety of hospital beds for patients in all health care settings who are most vulnerable to the risk of entrapment.”
In 2006, the workgroup released a detailed report entitled “Clinical Guidance For the Assessment and Implementation of Bed Rails in Hospitals, Long Term Care Facilities, and Home Care Settings.”
These “guiding principles” outlined below stem from the 2006 report.
As mentioned in previous reports of this series, individuals at risk for entrapment are those patients who are frail or elderly, or those who have conditions such as agitation, delirium or dementia, confusion, pain, uncontrolled body movement, hypoxia, fecal impaction, and acute urinary retention.
Additionally, the absence of timely toileting, position change, and nursing care are factors that contribute to the risk of entrapment.
When planning patient care, healthcare providers should consider a number of items relating to the use of bed rails:
- Serious injuries that result from a fall from a bed are more likely to be the result of a bed with raised bed rails.
- Healthcare providers should assess the relative risk of using bed rails against foregoing such use on a case-by-case, patient-by-patient basis.
- When using bed rails as a form of patient restraint, healthcare providers should realize that bed rails could pose the same risk to patient safety as other types of patient restraints.
- When physical restraints are used simultaneously with bed rails, healthcare providers should consider:
- the risk to patient safety (for example, suffocation or accident suspension runs the risk of increasing);
- monitoring patients closer;
- developing a thorough care plan regarding toileting, turning a patient, etc.;
- continuous reassessment regarding the simultaneous use of both bed rails and other forms of physical restraint;
Decisions to continue or discontinue the use of bed rails should be made on an individualized assessment. The patient or the patient’s legal guardian should be consulted. The pros and cons of bed rail use should be raised, and all parties should be aware of the risks associated with bed rail usage.
It should be noted that the patients right to participate in care planning, including the patient’s right to make choices, should be weighed against the healthcare provider’s duty to provide care in accordance with the patient’s medical assessment. Additionally, professional standards of care and state and federal laws should play a part in assessing the use of bed rails.
The following report in this series will detail the specific policy considerations as included in “Clinical Guidance For the Assessment and Implementation of Bed Rails in Hospitals, Long Term Care Facilities, and Home Care Settings”.
To learn more, please check out our recent series of blogs discussing The Dangers of Resident Bed Rails in Nursing Homes:
- The Dangers of Resident Bed Rails in Nursing Homes–An Overview: Part 1 of 9
- The Dangers of Resident Bed Rails in Nursing Homes–Rates of Incidence: Part 2 of 9
- The Dangers of Resident Bed Rails in Nursing Homes–Types of Bed Rails: Part 3 of 9
- The Dangers of Resident Bed Rails in Nursing Homes—Anatomy of Entrapment Part 4 of 9
- The Dangers of Resident Bed Rails in Nursing Homes–Policy Considerations: Part 6 of 9
- The Dangers of Resident Bed Rails in Nursing Homes–Risk Intervention: Part 7 of 9
- The Dangers of Resident Bed Rails in Nursing Homes– Bed Rail Safety Guidelines: Part 8 of 9
- The Dangers of Resident Bed Rails in Nursing Homes–Conclusion: Part 9 of 9
The Kosieradzki • Smith Law Firm represents clients in cases involving catastrophic injury caused by nursing homes and other care facilities that fail to provide proper care, including the improper use of side rails. If you believe your loved one has been harmed because a nursing home and its employees cut corners, take action and contact the Kosieradzki • Smith Law Firm online or call us toll-free at (877) 552-2873 to set up a no-cost, no-obligation consultation.