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An analysis of falls in the hospital: can we do without bedrails?
H C Hanger1, M C Ball, L A Wood
1Older Person's Health, The Princess Margaret Hospital, Christchurch, New Zealand.
Objectives:
To determine the effects of introduction of a bedrail policy, and an educational program, on patient falls and fall-related injuries.
Design:
A prospective "Before and After" design.
Participants And Setting:
All patients admitted during 1 calendar year in an assessment, treatment, and rehabilitation unit for older people.
Intervention:
A policy change for the use of bedrails (restricting their use) and an educational program about their effects.
Measurements:
Patient fall rates -- all falls and around the bed falls -- and patient and staff injuries.
Results:
There was a significant reduction in the number of beds with bedrails attached after the policy introduction (mean of 40/135 vs 18.5/135, respectively, P = .02), but the fall rate (either total or around the bed) did not change significantly. Serious injuries were significantly less common after the bedrail policy was introduced (P = .008), with fewer head injuries.
Conclusions:
Reducing the use of bedrails did not alter patient fall rates significantly, but it was associated with a reduction in serious injuries. Unless it can be shown that bedrails are beneficial, their continued use in older patients must be seriously questioned.
