APPENDIX 1 SAFE USE OF BED RAILS

Assessment of bed side safety rails

If NO, action to be taken where appropriate

Questions to consider

Yes

No

Patient assessment  

1) Have alternative methods of bed management been considered?  

2) Are they likely to try and get out of bed or climb over the rails?

3) Has the occupant been assessed for the use of bed rails, including mobility, weight, build, size, psychological assessment, etc?   Is there any history of falls from bed?

4) Has the occupant been assessed for the use of bed rail covers?  

5) Has interaction with other equipment (e.g. hoists) been considered?  

6) Has interaction with the work environment (e.g. restricted access) been considered?  

7) Has the bed occupant been assessed according to special requirements of patient care?  

Procurement

8) Does the supplier or manufacturer provide suitable information regarding its use?  

9) Does the manufacturer provide advice on any contra-indications for its use/foreseeable mis-use?  

10) Are the bed rails suitable for the bed type (e.g. is the bed rail intended for use on a divan bed, can the bed rail be robustly secured to the bed)?  

11) Are spacings between the bed rail, mattress and bed surround appropriate (see diagram) to prevent entrapment, in particular: - between the end of the bed rail and the headboard; between the mattress and bed rail; and, between the mattress and lowest rail of the bed rail when compressed by the bed occupant. 

12) Is the bed rail of sufficient height when used with a pressure-relieving mattress (see diagram)?  

13) Have the bed rails been assessed for other types of injury to the bed occupant (e.g. finger traps, sharp edges)?  

14) Have the bed rails been assessed for the risk of injury to staff?  

15) If covers are provided, are they compatible with the bed rails (e.g. can they be robustly secured in the correct position, so that the bed occupant is unable to pull them off or move them during the night)?  

16) Does the supplier or manufacturer provide after sales support/maintenance?

17) Have users been consulted?  

18) Have bed rails been evaluated, e.g. ease of use?  

Fitting and maintenance

19) Have staff been provided with suitable training for each type of bed rail?  

20) Have the bed rails been fitted correctly?  

21) Are the bed rails secure, rigid and close to the mattress?  

22) Are the bed rails in good working order, e.g. do mechanisms for adjusting/gaining access to the bed work correctly?  

23) Have covers/bumpers been fitted? If so: - are they the correct type for the bed/bed rails? - have they been fitted correctly?

24) Are maintenance procedures in place and are they adhered to?  

25) Have staff received training in using the bed rail? 

Assessment of bed side safety rails  

If NO, action to be taken where appropriate 

Questions to consider  

Yes  

No  

1) Has the occupant been assessed for the use of bed rails, including mobility, weight, build, psychological assessment, etc?

2) Has the occupant’s condition changed and has the bed rail assessment been reviewed to ensure that bed rails remain the best option?

3) Are the bed rails suitable for the bed type and mattress? 

4) Are the bed rails suitable taking account of the patient care required?  

5) Are the bed rails suitable when used in conjunction with other equipment (e.g. hoists, medical equipment, etc.)? 

6) Have the bed rails been fitted correctly? 

7) Are the bed rails secure, rigid and close to the mattress? 

8) Are the bed rails in good working order, e.g. do mechanisms for adjusting/gaining access to the bed work correctly? 

9) Are spacings between the bed rail, mattress and bed surround appropriate (see diagram) to prevent entrapment, in particular: between the end of the bed rail and the headboard; between the mattress and bed rail; and, between the mattress and lowest rail of the bed rail when compressed by the bed occupant.

10) Is the rail of sufficient height when used with a pressure-relieving mattress (see diagram)? 

11) Are covers/bumpers the right type and correctly fitted?

12) Are the bed rails maintained in good order?