Hospital Bed Safety to Reduce Entrapment - Revised FDA Brochure
Tuesday, April 13th, 2010Author: Wade M. Thomas
The FDA recently updated a document on their website that deals with Hospital Bed Safety on April 5, 2010. I’ll give the link here at the beginning of the article for you to download and use at your hospital.
There are about 2.5 million hospital and nursing home beds in use in the U.S. From 1985 through 2008, it was reported to the FDA that 803 patients/residents were caught, trapped, entangled, or strangled in beds with rails. 480 people died, 138 had a nonfatal injury and 185 were not injured because the staff intervened. MOST OF THE PATIENTS WERE FRAIL, ELDERLY OR CONFUSED.
A more detailed look at hospital bed safety can been seen on the FDA website below:
A lot of hospitals still don’t know about ( or else do know but have decided not to do anything about ) the bed safety issue with their old hospital beds. There is a test kit available that the FDA suggests facilities use to test their beds with from National Safety Technologies. You can find the test kit at this address: http://www.nst-usa.com/Pages/B4000Main.html
Patient Safety
Patients who have problems with memory, sleeping, incontinence, pain, uncontrolled body movement, or who get out of bed and walk unsafely without assistance, must be carefully assessed for the best ways to keep them from harm, such as falling. Assessment by the patient’s health care team will help to determine how best to keep the patient safe. Historically, physical restraints (such as vests, ankle or wrist restraints) were used to try to keep patients safe in health care facilities. In recent years, the health care community has recognized that physically restraining patients can be dangerous. Although not indicated for this use, bed rails are sometimes used as restraints. Regulatory agencies, health care organizations, product manufacturers and advocacy groups encourage hospitals, nursing homes and home care providers to assess patients’ needs and to provide safe care without restraints.
The Benefits and Risks of Bed Rails
Potential benefits of bed rails include:
- Aiding in turning and repositioning within the bed.
- Providing a hand-hold for getting into or out of bed.
- Providing a feeling of comfort and security.
- Reducing the risk of patients falling out of bed when being transported.
- Providing easy access to bed controls and personal care items.
Potential risks of bed rails may include:
- Strangling, suffocating, bodily injury or death when patients or part of their body are caught between rails or between the bed rails and mattress.
- More serious injuries from falls when patients climb over rails.
- Skin bruising, cuts, and scrapes.
- Inducing agitated behavior when bed rails are used as a restraint.
- Feeling isolated or unnecessarily restricted.
- Preventing patients, who are able to get out of bed, from performing routine activities such as going to the bathroom or retrieving something from a closet.
Meeting Patients’ Needs for Safety
Most patients can be in bed safely without bed rails. Consider the following:
- Use beds that can be raised and lowered close to the floor to accommodate both patient and health care worker needs.
- Keep the bed in the lowest position with wheels locked.
- When the patient is at risk of falling out of bed, place mats next to the bed, as long as this does not create a greater risk of accident.
- Use transfer or mobility aids.
- Monitor patients frequently.
- Anticipate the reasons patients get out of bed such as hunger, thirst, going to the bathroom, restlessness and pain; meet these needs by offering food and fluids, scheduling ample toileting, and providing calming interventions and pain relief.
When bed rails are used, perform an on-going assessment of the patient’s physical and mental status; closely monitor high-risk patients. Consider the following:
- Lower one or more sections of the bed rail, such as the foot rail.
- Use a proper size mattress or mattress with raised foam edges to prevent patients from being trapped between the mattress and rail.
- Reduce the gaps between the mattress and side rails.
Which Ways of Reducing Risks are Best?
A process that requires ongoing patient evaluation and monitoring will result in optimizing bed safety. Many patients go through a period of adjustment to become comfortable with new options. Patients and their families should talk to their health care planning team to find out which options are best for them.
Patient or Family Concerns About Bed Rail Use
If patients or family ask about using bed rails, health care providers should:
- Encourage patients or family to talk to their health care planning team to determine whether or not bed rails are indicated.
- Reassure patients and their families that in many cases the patient can sleep safely without bed rails.
- Reassess the need for using bed rails on a frequent, regular basis.
Wade Thomas is a Hospital Falls Consultant to hospitals primarily in the State of Florida and a Nursing Home Falls Consultant for Nursing Homes in the State of Florida. He works to provide education, training, and fall prevention products that will help any hospital to decrease their fall rates and more importantly, their falls with injuries rates. He attends the annual USF/VA VISN8 Patient Safety Conference in Clearwater Beach, Florida and also attends the State of Florida annual Florida Health Care Association show for nursing home directors and administrators. To contact Mr. Thomas for more information on how he or one of his associates can work with your hospital, please email WadeThomas at AOL.com
Copyright 2010 - Wade M. Thomas & MedicalNurseTraining.com - Please feel free to share this article with your friends and colleagues. Please leave the entire article and author’s biography box intact. Thank You.