When bed rails ensnare residents, two issues are most likely to be at fault, according to a study out of Ireland. Mattresses may be the wrong size or their perimeters too compressible, or the bed rails themselves may be loose or poorly maintained, with bent or worn components allowing lateral movement.
The study, published online in the journal Age and Ageing, involved a large teaching hospital, but it’s point of the need for careful selection of people with whom bedrails are to be used, as well as the need for the monitoring and maintenance of bed systems, is valid for all healthcare environments where bed rails are used, according to one of the authors.
“On-going monitoring and maintenance of bedrails would avoid some of the problems identified in this study and should occur in all heathcare institutions,” says Shaun T. O’Keeffe.
The researchers assessed the four zones within bed systems that account for 80 percent of reported entrapment incidents and for which the U.S. Food and Drug Administration provides dimensional guidance. Zone 1 is any open space between the perimeters of the rail; zone 2 is the space under the rail or between the rail supports; zone 3 is the space between the inside surface of the bedrail and the mattress and zone 4 is a gap between the mattress and rail at the end of the rail.
Replacing older beds and their components may be costly and time-consuming, O’Keeffe says, but when new equipment is purchased, compliance with the dimensional guidelines must be part of the process. Additionally, he says, staff members should be educated as to the potential for resident entrapment and should use bed rails only when appropriate and necessary, and only when bed, rails and mattress are designed to be used with one another.