Use of bedrails is assessed by individual

This article submitted by Linda Stelling on 9/1/98.

The use of bedrails in nursing homes has been in newspapers and television reports recently.

Since April, 16 nursing homes have been fined for using bedside rails. The fines have ranged from $3,050 to $10,000 a day. A total of about $750,000 in fines has been issued. The reason cited for the fines was the unnecessary use of side rails on the beds of a few residents.

There were many nursing homes found to be in compliance, Mike Tripple, Department of Health, said. A total of 80 nursing homes have been surveyed, resulting in 16 citations.

Karen Ampe, Koronis Manor director of nursing, said the use of side rails on beds is assessed on an individual basis and documented. ďThey are a medical device and need to be looked at individually,Ē she added. ďIf there is a medical need, the resident uses bedrails to turn or get in and out of bed. Physical therapy doesnít issue canes or walkers if the person is unsafe with them or uses them improperly. The risks and benefits of all medical devices always need to be weighed.Ē

ďThe use of side bedrails creates more problems and hazards than people realize,Ē Ampe said. ďResidents can try to crawl over the railings, can get caught between the railing and the mattress and some could get their heads caught between the rails themselves. We have always felt we were protecting people by using side rails. Now studies show they can also be dangerous.Ē

ďIt is the goal of the nursing home employees to help the patient reach their highest level of function. ďTo take away the bedrails for some patients would make them dependent on staffing,Ē Ampe stressed.

Ampe said the first alert concerning the use of bedrails was issued in 1987.

ďAt the Koronis Manor, staff members are in the process of assessing each resident for side rail usage. We are being methodical, careful and slow, we do not want falls or injuries anymore than the families. There is a fine line between patientís safety and patientís rights it seems, according to the Department of Health. In most cases, patient safety over rides patientís rights,Ē Ampe said. The assessment includes risk factors, alternatives to side rails or restraint usage. Patient assessment also includes whether they are ambulatory, have they had recent falls, are they visually impaired, do they become frustrated easily.

ďNursing homes donít have money to spend on fines. We need our funds to provide staffing,Ē she added. ďAs an alternative to bedrails, bed alarms, restraint alternative mattress, bed rolls, and padding on floor in front of beds are available.

ďI donít believe the Department of Healthís intent is for us to suddenly remove all rails. I believe they want to see an assessment process in place that takes an indepth look at side rail usage on an individual basis. By making the resident more dependent could also increase the residentís case mix index and cost the families and welfare system more money. I donít think this is their intention,Ē Ampe added.

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