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Bed rails are used extensively in care environments to prevent bed occupants falling out of bed and injuring themselves.

However, there have been serious incidents reported to MHRA. The majority of these involved third party bed rails used on domestic, divan and metal framed beds that have led to injury and death by asphyxiation after entrapment of the head or neck.

Most incidents occurred in community care environments, particularly in residential and nursing homes. These could have been prevented if adequate risk assessments and appropriate risk management had been carried out.

In general, manufacturers intend their bed rails to be used to prevent bed occupants from falling and sustaining injury. They are not designed or intended to limit the freedom of people by preventing them from intentionally leaving their beds; nor are they intended to restrain people whose condition disposes them to erratic, repetitive or violent movement.

The MHRA have a very helpful bulletin which identifies areas for safe practices, so that policies and procedures can be reviewed and put in place. This includes:

  • risk management
  • management responsibilities
  • meeting legal requirements
  • training
  • planned preventative maintenance.

It also identifies areas of good practice, such as:

  • checking and ensuring that a bed rail is necessary
  • the need for good communication between bed occupant and carers or staff
  • compatibility of the bed rail and bed, mattress and occupant combination
  • correct fitting and positioning of the bed rails initially and after each period of use
  • re-assessing for changing needs of the bed occupant.
  • the need for risk assessment before the provision and use of bed grab handles.

This bulletin is not intended to inform clinical decision making.

Download the MRHA Bulletin here