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APPENDIX
SPECIAL NOTE
For your convenience, we have provided the April 2010 edition of the FDA’s guide to bed safety. This information from the
FDA’s brochure, published by Hospital Bed Safety Workgroup, is replicated verbatim; the latest version is available at
http://www.fda.gov.
A Guide to Bed Safety Bed Rails in Hospitals, Nursing Homes and Home Health Care: The Facts
Bed Rail Entrapment Statistics
Today there are about 2.5 million hospital and nursing home beds in use in the United States. Between 1985 and January
1, 2009, 803 incidents of patients* caught, trapped, entangled, or strangled in beds with rails were reported to the U.S. Food
and Drug Administration. Of these reports, 480 people died, 138 had a nonfatal injury, and 185 were not injured because staff
intervened. Most patients were frail, elderly or confused.
* In this brochure, the term patient refers to a resident of a nursing home, any individual receiving services in a home care
setting, or patients in hospitals.
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 moved.
• 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.
Summary of Contents for 15003P
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