Bed rail use becomes more restrictive at hospital

This article submitted by Michael Jacobson on 1/26/00.

A couple years ago, tight restrictions on the use of bed rails in nursing homes became a hot topic across Minnesota. The state government limited their use to patients with documented needs and levied substantial fines on facilities who used rails without the proper docu-mentation.

Since August, similar requirements have been required in the hospital as well, but the move is proceeding much more easily. "It's not as stringent as the nursing home, but there are restrictions," explained Bev Mueller, patient care administrator for the Paynesville Area Health Care System.

Bed rails cannot be used automatically in the hospital anymore, either. Mueller said there needs to be a reason to justify their use. For instance, bed rails most likely would be up after surgery as the patient regains his or her orientation.

Determination for their use is being done on a case-by-case basis. Some patients may need the bed rails for mobility. Bed rails can still be used to prevent falls.

However, they would not be used for keeping patients in bed. The proper tool for that are bed checks, according to Mueller. Using bed rails could cause a patient who is determined to get out of bed to attempt to climb over the rails in trying to leave. That could lead to a more severe fall.

Actually, an exception has been created for bed rail use in nursing homes. Either the resident or the resident's family can request that bed rails be used, and with a doctor's approval, they can.

As for the hospital, Mueller said it's gone well. "It's probably been hardest on the staff," she added.

For years, according to Mueller, bed rail use was ingrained into the nursing staff. "The last thing you did before you left the room was pull up the rails," explained Mueller.

The assessment for each patient is done by the nursing staff in consultation with the physician.

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