An analysis of falls in the hospital: can we do without bedrails?

Abstract

Objectives: To determine the effects of introduction of a bedrail policy, and an educational program, on patient falls and fall-related injuries.

Design: A prospective "Before and After" design.

Participants and setting: All patients admitted during 1 calendar year in an assessment, treatment, and rehabilitation unit for older people.

Intervention: A policy change for the use of bedrails (restricting their use) and an educational program about their effects.

Measurements: Patient fall rates -- all falls and around the bed falls -- and patient and staff injuries.

Results: There was a significant reduction in the number of beds with bedrails attached after the policy introduction (mean of 40/135 vs 18.5/135, respectively, P = .02), but the fall rate (either total or around the bed) did not change significantly. Serious injuries were significantly less common after the bedrail policy was introduced (P = .008), with fewer head injuries.

Conclusions: Reducing the use of bedrails did not alter patient fall rates significantly, but it was associated with a reduction in serious injuries. Unless it can be shown that bedrails are beneficial, their continued use in older patients must be seriously questioned.