Safety and fall prevention

• Prevents falls: 

  Raising the side rails creates a physical barrier to prevent patients, especially those with limited mobility or cognitive impairment, from falling out of bed. 
• Provides stability: 

  The rails give a firm handhold, reducing the risk of slipping or losing balance when moving or attempting to get up. 
• Helps confused patients: 

  For disoriented individuals, rails can provide a sense of guidance and a physical boundary, helping to keep them in a secure area. 

Mobility and independence

• Assists with repositioning: 

  The handholds make it easier for patients to turn, adjust their position, and pull themselves up in bed. 
• Aids in getting in and out of bed: 

  They provide a stable point to hold onto for support when transferring from the bed to a chair or standing up, which can reduce strain on caregivers. 
• Supports self-adjustment: 

  Patients can use the rails to help them sit up or adjust their body without assistance, promoting a degree of independence. 

Comfort and support

• Increases comfort and security: 

  Having a handrail can provide patients with a feeling of stability and safety, which can lead to a greater sense of comfort. 
• Can hold personal items: 

  Many bed rails include pouches or storage options for items like a call button, phone, or water bottle, keeping them within easy reach. 

Full-length rails

• Cover the entire length of the bed to prevent the patient from rolling out. 
• Ideal for individuals at a higher risk of falling, especially those with cognitive decline, and are often used when caregivers are needed. 
• Some can have their foot-end reduced to allow for independent exiting. 

Half-length rails

• Provide support for only half the length of the bed, typically at the head end. 
• They help with sitting up and adjusting position but don’t prevent a patient from sliding out the foot end. 
• A good balance between safety and the ease of getting in and out of bed. 

Transfer handles / Assist bars

• Smaller, sturdier bars that attach to the bed frame.
• Designed to provide a handhold for support when moving into or out of bed.
• They do not provide protection from falling out of bed and are easily removable. 

Other features and types

• Adjustable: 

  Many rails are adjustable in length, height, or position to suit different needs. 
• Split rails: 

  Rails that can be split, with some sections designed to be removed or lowered more easily. 
• Flip-down: 

  Some designs can flip down for easier caregiver access to the patient. 
• With a pouch: 

  Some half-length or head rails include an attached pouch to hold personal items. 

Hospital bed rails

• Integrated systems: 

  Hospital beds often have built-in, full-length side rails that are raised and lowered as needed. 
• Support: 

  They can provide support for repositioning and for getting in and out of bed. 
• Risk of entrapment: 

  Full-length rails can pose an entrapment risk if a patient’s body gets caught between the rail and the mattress. 
• Risk of falls: 

  They are not recommended for patients who may try to climb over them, as this can result in a more serious fall from a greater height. 

Homecare bed rails

• Compatibility: 

  Ensure the rail is designed for the specific bed type (e.g., home beds, adjustable beds, platform beds). 
• Individual needs: 

  A risk assessment should be performed to determine the most appropriate type of rail for the individual’s age, size, weight, and medical condition. 
• Types: 

  Look for options like half-length rails, bedside handles, or crossbar rails. 
• Safety features: 

  Choose rails with features like non-slip grips and locking mechanisms to prevent accidental movement. 
• Adjustability: 

  Adjustable height and length offer customization, while swing-away or removable options provide flexibility. 
• Alternative safety measures: 

  Consider beds that lower to the floor or use floor pads as a safer alternative to high side rails for confused patients who may climb. 

Key considerations for both

• Always follow manufacturer specifications: 

  It is crucial to follow the manufacturer’s guidelines for installation and maintenance to prevent injuries like entrapment. 
• Consider the purpose: 

  Bed rails are primarily for support, not to prevent a confused patient from getting out of bed. 
• Ask a professional: 

  A competent person should conduct a risk assessment before selecting and installing bed rails. 

Installation guidelines

• Read the manufacturer’s instructions:

  Always refer to the specific instructions provided with the bed rails for the most accurate installation method. 
• Align with attachment points:

  Securely attach the rails to the designated points on the bed frame. 
• Tighten fasteners:

  Ensure all fasteners and straps are tight and properly secured according to the manufacturer’s directions. 
• Position correctly:

  If the rails are adjustable, set them to the appropriate height for the user. The top of the rail should be high enough to prevent falls but low enough to allow comfortable egress. 

Safety guidelines

• Check for gaps:

  Regularly inspect the bed rails and mattress to ensure there are no gaps that could cause entrapment. The FDA recommends spaces be less than

  

  4344 and three-fourths

  434

  inches in most areas and less than

  

  2382 and three-eighths

  238

  inches in others, such as under the rail at the ends. 
• Inspect for damage:

  Check for any visible damage, such as cracks or bends, and ensure all latches are secure. 
• Verify user compatibility:

  Confirm that the age, size, and weight of the person using the bed rails are appropriate for the product. 
• Avoid overreliance:

  Bed rails should not be the only fall prevention measure. Consider using other safety equipment like fall mats or alarms. 
• Monitor the user:

  Check on patients regularly, especially those with cognitive impairments, to ensure they are not at risk of falling. 
• Train caregivers:

  Ensure all caregivers are trained in the proper use of the bed rails. 
• Seek help if needed:

  If you have any doubts or are unsure about any part of the process, contact the manufacturer for assistance. 

Before you buy

• Assess the user’s needs: 

  The rail’s design depends on the individual’s mobility and fall risk. 

  • Length: Full-length rails offer maximum protection for those with very limited mobility, while half-length rails can be better for those who are more independent. 
  • Type: Consider specific features like ergonomic grips for better holding, padded surfaces for comfort, or a trapeze bar for users with limited upper body strength. 
  • Weight: Ensure the rail has a sufficient weight capacity to support the user safely. 
• Check for compatibility:

  • Bed: Not all rails fit all beds. Check the manufacturer’s guidelines to ensure the rail is compatible with your specific bed model. 
  • Mattress: The rail must be compatible with the mattress type and thickness. Using the wrong combination can create a dangerous gap where a user could become trapped. 
• Evaluate safety features:

  • Look for a secure locking mechanism to prevent accidental movement. 
  • Check for non-slip grips and padding to reduce the risk of injury. 
  • Ensure the product meets current FDA safety standards. 

Installation and use

• Prioritize caregiver access: 

  Choose a rail that allows for easy lowering and adjustment to facilitate patient care and transfers. 
• Inspect the installation: 

  After setup, perform a safety check to make sure the rails are sturdy and there are no gaps where entrapment could occur. 
• Consider accessories: 

  Think about additional accessories like storage pouches or rail covers for extra comfort and convenience. 
• Get professional help if needed: 

  If you are uncertain about installation or selection, consult with a healthcare professional or the manufacturer. 

Purpose and function

• Preventing falls: The primary purpose is to reduce the risk of a person falling out of bed. 
• Aiding mobility: They assist with repositioning, or getting into and out of bed. 
• Types: They can be full-length, half-length, or a single bar, and are sometimes used to help a person stand up or brace themselves. 

Safety risks and concerns

• Entrapment: A person can become trapped between the mattress and the rail, or within the rail structure itself. 
• Falls: Patients may attempt to climb over the rails, which can lead to falls. 
• Restraint: Using all four side rails to prevent a patient from getting out of bed can be considered a restraint. 
• Limited mobility: Rails can limit a person’s ability to move freely. 

Safe usage and maintenance

• Risk assessment: A competent person should perform a risk assessment that considers the user, bed, mattress, and rails to determine if rails are the right solution. 
• Proper fit: Ensure the rail is suitable for the specific bed and mattress. The top of the rail should be at least 4 inches higher than the mattress surface. 
• Regular inspection: Routinely check for any wear and damage, and tighten any loose parts. 
• Cleaning and maintenance: Clean the rails regularly and lubricate any moving parts. 
• Testing: Test all locking mechanisms regularly. 
• Alternatives: Consider alternatives like netting, inflatable bumpers, or ultra-low beds to mitigate risks. 

Regulations and guidelines

• Regulations and guidelines, such as those from the FDA, provide information and dimensional guidance to prevent entrapment. 
• Some facilities, like assisted living facilities in California, have strict regulations on the use of bed rails, allowing them only for mobility assistance.