Prevalence and predictors of bedrail use in an acute hospital.
OBJECTIVE
to determine the prevalence and predictors of bedrail use in an acute hospital.


DESIGN AND SETTING
overnight survey in a University teaching hospital.


SUBJECTS
Three-hundred and twenty-seven beds and patients in 14 wards.


METHODS
data were collected on bedrail use and on the bed system, ward and patient characteristics. Medical, nursing and physical therapy notes were examined and the night and day nurses and, if necessary, the doctors and therapists caring for the patient interviewed to determine patients' diagnoses, functional and cognitive status.


RESULTS
there were 133 (40.7%) beds with one or more raised rails. Independent predictors of bedrail use were use of electric profiling beds, confusion, reduced alertness and any difficulty with transferring from bed. The most common reported indication for bedrail use was 'to prevent rolling out of bed' (59%); 'to prevent getting out of bed' was recorded in 11% of cases. Use of bedrails was judged inappropriate in 27/133 (20.3%) patients and in 14/43 (32.6%) patients with abnormal mental status; misuse was particularly common in those with confusion or agitation [13/34 (38.2%)]. Failure to use bedrails was potentially inappropriate in 32/194 (16.5%) of those without bedrails.


CONCLUSION
this study using individual patient data shows that the use of electric profiling beds, abnormal mental states and difficulty transferring from bed are the main predictors of bedrail use in acute hospitals. Inappropriate use of bedrails is common in those with cognitive impairment or with agitation.
['O Flatharta|Tomás|T|', 'Haugh|Jennifer|J|', 'Robinson|Stephanie M|SM|', "O'Keeffe|Shaun T|ST|"]
D000058:Accidental Falls D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001513:Beds D003072:Cognition Disorders D004867:Equipment Design D005260:Female D019538:Health Care Surveys D006742:Hospital Bed Capacity D006785:Hospitals, University D006801:Humans D008297:Male D008875:Middle Aged D051346:Mobility Limitation D061214:Patient Safety D011482:Protective Devices D011595:Psychomotor Agitation D012149:Restraint, Physical D019564:Unnecessary Procedures D055815:Young Adult
bedrails delirium dementia older people restraints