Which bed designs and patient characteristics increase bed rail use?

Area of Science:

• Geriatric Medicine
• Patient Safety
• Healthcare Design

Background:

• Bed rails have been debated since the 1950s, offering benefits like safety and mobility support but posing risks of entrapment and restraint.
• The contentious nature of bed rail design and application necessitates further investigation into their usage patterns.

Purpose of the Study:

• To investigate factors influencing bed rail usage on UK medical wards.
• To identify patient characteristics (mobility, cognitive status, age) and bed designs associated with bed rail use.

Main Methods:

• A survey of bed rail usage was conducted overnight across 18 UK hospitals.
• Data were collected from 1,799 occupied beds between July 2010 and February 2011.

Main Results:

• Eighty-six percent of occupied beds had rails, with 52% having raised rails.
• Rail use was significantly higher for electric profiling beds, ultra-low beds, patients over 80 years, and those with confusion or mobility impairment.
• The primary reason cited for raising rails was fall prevention, especially for confused patients.

Conclusions:

• Bed rails appear to be used frequently, with specific patient demographics and bed types showing higher likelihood of use.
• Evidence suggests potential inappropriate use of bed rails as restraints, particularly for confused patients or those requiring mobility assistance.
• Further research is needed to ensure appropriate application and mitigate risks associated with bed rail use.