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Historical analysis of siderail use in American hospitals
1Boston College School of Nursing, Cushing Hall, 140 Commonwealth Ave., Chestnut Hill, MA 0216-3812, USA. brushb@bc.edu
Purpose:
To explore the social, economic, and legal influences on siderail use in 20th century American hospitals and how use of siderails became embedded in nursing practice.
Design:
Social historical research.
Methods:
Numerous primary and secondary sources were collected and interpreted to illustrate the pattern of siderail use, the value attached to siderails, and attitudes about using siderails.
Findings:
The persistent use of siderails in American hospitals indicates a gradual consensus between law and medicine rather than an empirically driven nursing intervention. Use of siderails became embedded in nursing practice as nurses assumed increasing responsibility for their actions as institutional employees.
Conclusions:
New federal guidelines, based on reports of adverse consequences associated with siderails, are limiting siderail use in hospitals and nursing homes across the United States. Lowering siderails and using alternatives will depend on new norms among health care providers, hospital administrators, bed manufacturers, insurers, attorneys, regulators, and patients and their families.
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