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Bed Rails / Asphyxiation

The Dangers of Resident Bed Rails in Nursing Homes—Policy Considerations (Part 6 of 9)

The Hospital Bed Safety Work Group included 7 recommended administrative and management policies that safety conscious healthcare facilities should always consider.

  1. As mentioned in previous posts in this series, the decision to use or discontinue the use of bed rails “should occur within the framework of an individual patient assessment.” Healthcare providers should understand that there is no “average patient” and that every individual under medical care is deserving of a tailored care plan.
  2. Because bed rails are medical tools used while a patient sleeps, the use of bed rails should take into account the patient’s sleep history and preferences, as well as other medical needs, comfort, and freedom of movement. This assessment should be the result of an interdisciplinary team. The interdisciplinary team should have a multitude of opinions and include both medical professionals and the patient and his or her family or legal guardian.

The individuals that make up the interdisciplinary team should be made up of, but not limited to:

  • Nursing, social services, and dietary personnel,
  • Physicians,
  • A medical director,
  • Rehabilitation and occupational therapists,
  • The patient at their family (or legal guardians)

The patient and their family play an important role in the bed environment. They have the ability to inform healthcare providers of the patient’s previous sleeping habits.

3.   The use of bed rails should only be based on necessity. The effectiveness of bed rails should be             reviewed on a regular basis. The patient’s medical chart should include a risk-benefit                                         assessment that identifies and explains why other interventions are not appropriate or                                   effective if such intervention attempts were previously used.

  4.    The use of bed rails for treatment of a medical symptom or condition should be accompanied                by a care plan designed for that symptom or condition. This plan should include investigations                    of less restrictive care interventions that can be implemented in the future.

5.   If a bed rail is used to aid a patient in his or her mobility and transferring, such as getting in to               and out of bed, then this should be incorporated and explained in the resident’s care plan. The                     patient should have a voice in the care planning to allow for customization and an increase in                       comfort. The care plan should also include educating the patient about the dangers bed rails                         pose, as well as for options for reducing the risk.

6.   The process of reducing or eliminating the use of bed rails should be undertaken                                       “incrementally.” An interdisciplinary team should use an individualized, systematic, and                               documented approach

7.   Finally, bed rails should not automatically use bed rails or any shape or size. Any physical                      restraints (such as chest, wrist, or ankle restraints) should be minimal and absolutely                                        necessary. A patient’s bed, mattress, and bed rails should be continually inspected, evaluated,                    maintained, and upgraded to reduce the risk factors associated with bed rails. If any incident                        does occur due to bed rail usage, the patient’s care plan should be immediately reassessed. 

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–Guiding Principles Regarding the Safe use of Bed Rails: Part 5 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.