NPSA BED RAILS LITERATURE REVIEW

Of the abstracts retrieved in the initial search, 24 papers [ 7 , 13 , 14 , 45—65 ] were identified as meeting the inclusion criteria Figure 1. Sign In or Create an Account. There appear to be a number of interlocking issues that influence practitioners and policy makers. A subsequent meta-analysis confirmed decrease in falls NS rate ratio 0. Excess mortality following hip fracture in patients with diabetes according to age: A subsequent meta-analysis confirmed decrease in falls NS rate ratio 0. Case-control study comparing 98 hospital patients who fell with non-fallers matched for length of stay.

One study described an apparently significant reduction in serious injuries [ 47 ] but only if minor or suspected head injuries, where nurses checked neurological observations, were defined as serious injuries. A search was made for articles published between 1 January and 30 June using the MeSH terms: Continue group pre 1. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. None of the studies found any significant changes to overall injuries, fractures or subdural haematoma. Additionally, most studies were based on reports from frontline staff, a method limited by incomplete data and under-reporting [ 14 , 19—21]. Canadian Patient Engagement Network.

None of the studies found any significant changes to overall injuries, fractures or subdural haematoma. Excess mortality following hip fracture in patients with diabetes according to age: The role of bedrails in falls prevention is controversial, with a prevailing orthodoxy that bedrails are harmful and ineffective.

npsa bed rails literature review

Where bedrails have been described as causing incontinence, confusion or reduced mobility [5, 55, 63, 70], this appears to arise from mistaking correlation for causation. Connelly, The effect of bedrails on falls and injury: None of these studies showed significant differences in overall injury or fracture rates but were likely to be underpowered to detect these, and the single significant finding that neurological observations were less likely to be recorded after bedrail reduction [ 47 ] may be a measure of nurses’ beliefs rather than of seriousness of injury.

Resistant syndrome of inappropriate antidiuretic hormone SIADH secondary to atonic bladder in an older woman. The single case—control study [ 49 ] five quality criteria met found that having one or more bedrails raised was associated with a significantly reduced risk of falling Table 2.

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npsa bed rails literature review

Case-control study comparing 98 hospital patients who fell with non-fallers matched for length of stay. The effect of bedrails on falls and injury: Changes in falls prevention policies in hospital in England and Wales.

Inevitably, these studies cannot provide information on the injuries which might have occurred if the devices had not been used, and few provide data to assess how npsz such injuries occur; one UK study [ 14 ] suggests deaths linked to bedrail entrapment in hospitals have been reported at the rate of around one per 20 million admissions, with minor direct injuries from bedrails estimated at 1, per 10 million admissions.

Overall, whilst the evidence base is of limited quantity and quality, it does not support the prevailing orthodoxy that bedrail use should be eliminated or strictly curtailed on the basis of bedrail effect on falls, injury in falls or direct injury, and suggests wholesale bedrail reduction may increase the risk of falls.

We intended the review to provide a resource to inform clinical practice and to identify gaps for future research. Five such studies were identified; [ 745—48 ] all succeeded in reducing bedrail use.

The single case—control study [ 49 ] showed a significantly lower rate of falls in patients with bedrails raised, which needs to be interpreted with caution as only length of stay was controlled for, and other uncontrolled differences between the groups might account for the reduced rate of falling. Case-control and cohort studies of the brd between falls and bedrail use. Two studies met eight of a possible total of ten quality criteria [ 4648 ] two met seven quality criteria [ 747 ] and one met five quality criteria [ 45 ].

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Serious injury is defined as fractures, dislocated joints, subdural haematoma, lacerations requiring suturing. Both healthcare staff and the general public are encouraged to report patient safety incidents, whether they result in harm or not.

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One study described an apparently significant reduction in serious injuries [ 47 ] but only if minor or suspected head injuries, where nurses checked neurological observations, were defined as serious injuries.

Reivew injury is defined as fractures, dislocated joints, subdural haematoma, lacerations requiring suturing. Patient Safety Power Play: By extending its focus beyond RCTs and the few studies where standardised outcomes can be calculated to include observational or quasi-experimental studies, revisw provides an inclusive analysis which allows users to see the range and the limitations of evidence often used by those advocating strongly against bedrail use.

Five described injury rates in falls from bed with and without bedrails [ 1452546365 ] but only the multi-hospital study [ 14 ] found significant differences, with falls raila bed with bedrails raised significantly less likely to result in injuries, particularly head injuries see Appendix 3 in the supplementary data on the journal’s website revview More on this topic Prevalence and predictors of bedrail use in an acute hospital.

Add comment Close comment form modal. The studies of injury or death from bedrail entrapment or failure describe incidents generally linked to problems with maintenance, assembly or outmoded equipment design rather than to bedrail use itself.

Changes in falls prevention policies in hospital in England and Wales. You must accept the terms and literaature. The studies of injury or death from bedrail entrapment or failure describe incidents generally linked to problems with maintenance, assembly or outmoded equipment design rather than to bedrail use itself.

Addition of bed alarms, non-slip floors and shoes, transfer rails, exercise.