Hospital In-Patient Multi-Disciplinary s2

0cd48bcd1f7d948ab78f4d3bef58501f.doc Version No 2.0 Version Date 01/01/2010 Review Date 01/01/2011

SURNAME NHS No _ _ _ / _ _ _ / _ _ _ _ HOSPITAL

FORENAME MALE / FEMALE WARD

ADDRESS D.O.B GP/Consultant

RISK ASSESSMENT / REVIEW REGARDING USE OF BED RAILS Although the use of bed rails reduces the risk of patients falling out of bed they are not, unfortunately, without risks themselves. Patients have been known to have been strangled by the rails, suffocated by bed rail covers, fallen over the top of the rails and sustained head injuries/fractures which have subsequently led to death. In addition, poorly maintained/fitted rails also pose a risk. Therefore, prior to a decision being made to use bed rails, the following factors must be considered in order to enable an informed decision regarding the appropriateness of bed rails to be made. Circle the appropriate answers

1. Confusion, restlessness agitation. Is the patient likely to attempt Yes No If “yes” then not appropriate to use bed to climb over the top of the rails or out of the top/bottom of the rails bed? Refer to the guidelines on next page

2. Confusion, restlessness, agitation. Is the patient likely to “thrash” Yes No If “yes” and bed rail covers not an option, around and injure themselves on the rails? If “yes” consider use then not appropriate to use bed rails of bed rail covers.

3. If bed rail covers are to be used, is there any risk of the patient Yes No If “yes” then not appropriate to use bed getting stuck against them and suffocating? rails

4. Patient size. Is their head or body small enough to pass through Yes No If “yes” to a, b, c, or d, then not and become trapped in the: appropriate to use bed rails a. Bed rail bars? b. The lower bed rails, bar and Mattress? c. The end of the bed rails and the headboard or footboard d. Any other gap present See MHRA advice in Bed Rail Policy If “no” ensure corrective action taken 5. Have the bed rails been fitted correctly? Yes No prior to use If “no” ensure corrective action taken 6. Is the bed rail the correct type for the bed? Yes No prior to use

7. Does the bed rail appear to be in good maintained order, i.e. no Yes No If “no” ensure corrective action taken missing parts, secure, etc? prior to use

8. Will the patient agree not to use the bed rail to pull themselves up Yes No If “no” ensure corrective action taken into a sitting position or to roll over? prior to use If “no” consider other actions to promote 9. Does the patient agree to the use of bed rails? Yes No safety If “yes” document reason for request 10 Has the patient requested to have bed rails? Yes No below

 Usually has double bed to self Yes No

 Other reasons (please list)

11 Discussed with carer /relative as appropriate Yes No

of 3 Remember: . Bed rails may not be available on discharge. . To discontinue use as soon as possible. Their continued use must be reassessed on a minimum of a weekly basis or if the patient’s condition changes. In addition each time they are used it must be considered whether they still remain necessary and whether the patient still consents to continued use.

. To use the bed in the lowest position. . To inspect bed rails every time they are raised. . Alternative strategies to reduce risks of falling out of bed, for example: - Use of Hi Low bed - Bed at lowest position with mattress/duvet on floor at side to minimise risk of harm - Move furniture away from bedside.

Based on the above assessment are the bed rails to be used? Yes  No 

Signature: Date: _ _ / _ _ / _ _ _ _ Time:

GUIDELINES FOR USE OF BED RAILS

Does it appear patient may climb over bed rails?

YES  NO  NOT SURE 

Do not use bed rails Consider other problems Get a second opinion Lower bed frame / which could be caused by use and start again Consider use of Hi Low bed/ other measures

Is patient restless?

YES  NO  PATIENT CALM 

Use bed rails and Consider need for bed rail Use bed rails bed rail covers covers

After 1 hour’s use does the patient feel caged in?

YES  NO 

Remove bed rails Continue but monitor

of 3 NAME: D.O.B. _ _ / _ _ / _ _ _ _ NHS NO _ _ _ / _ _ _ / _ _ _ _ _

REVIEW OF USE OF BED RAILS

Date Time Reviewed/Decision/Reasons Signature Designation