This document and policy has been comprehensively updated to reflect:

A National Patient Safety Alert (Ref: NatPSA/2023/010/MHRA) issued 30/08/2023 PDF
MHRA’s updated guidance on the management and safe use of bed rails PDF
The Action’s Required from the National Patient Safety Alert: Medical beds, trolleys, bed rails, bed grab handles and lateral turning devices: risk of death from entrapment or falls (NatPSA/2023/010/MHRA)

Prescription and Use of Bed Rails

Key Points on Bedrails

Bed rails are used extensively in healthcare settings to reduce the risk of patients falling out of bed, but they also pose serious risks of entrapment and injury.
The MHRA has received numerous reports of adverse incidents involving bed rails, including deaths due to asphyxiation from entrapment.
Adequate risk assessment is critical before prescribing or using bed rails, considering the individual needs and characteristics of the bed occupant.
Bed rails should be properly fitted to the bed to avoid creating dangerous gaps that could lead to entrapment.
Certain patient populations, such as those with cognitive impairments or atypical body sizes, are at higher risk of entrapment and require extra precautions.
Alternatives to rigid bed rails, such as inflatable bumpers or low beds, should be considered to mitigate risks.
Ongoing maintenance and inspection of bed rails is essential to ensure they remain in good working condition.
Relevant legislation and standards, such as the Medical Devices Regulations and BS EN 60601-2-52, provide guidance on the safety requirements for bed rails.
Adverse incidents involving bed rails should be reported to the MHRA to help identify trends and promote safer practices.
Proper training for healthcare staff on the safe use and management of bed rails is crucial to prevent harm.

The Use of Bedrails

Bedrails should only be used to reduce the risk of a client accidentally slipping, sliding, or falling out of a bed, and not as a form of restraint. Bedrails are not intended to prevent a client from leaving their bed and falling elsewhere.

Seven Steps Support Ltd has a procedure in place to ensure that bedrails are used safely, through thorough risk assessment, correct fitting, and regular maintenance.

Seven Steps Support Ltd does not advocate the use of telescopic or extended height bedrails at any time.

Bedrails will only be used in exceptional circumstances and after all other methods to prevent falls from bed have been explored and documented in the Bed Rails Risk Assessment.

The fact that a client has used bedrails in a previous establishment does not automatically justify their use in at Seven Steps Support Ltd.

Procedure for the Use of Bed Rails

Before using bed rails on a Client’s bed, the following procedure must be followed:

The Bed Rails Risk Assessment Form must be completed as soon as it is considered that bed rails may be required, which may also be part of the pre-admission process if bed rails are already in use in the client’s home.
The Bed Rails Risk Assessment Form must be completed in full before installing or using the bed rails.
Bed rails will only be used on profiling beds purchased from the approved supplier of beds/bed rails.
A full explanation of the risks associated with the use of bed rails must be provided to the client and/or their relative (where appropriate). Written consent, where appropriate, will be obtained from the client or a ‘Best Interest’ decision may be taken by a Next of Kin, Power of Attorney (health) relative or advocate, and recorded on the Bed Rails Consent Form.
The decision to install or remove bed rails will be based on the professional judgment of the person conducting the assessment, and consultation with other health/social care professionals will take place if necessary.
The client’s Care Plan must reflect the requirement for bed rails and clearly state that they are to be used at all times when the client is in bed.
If the client requires an overlay mattress, the height from the top of the mattress to the top of the bed rail mattress must be 220mm or more to reduce the risk of the client rolling over the bed rail and getting injured. If this height requirement cannot be achieved, a low bed with a ‘crash mat’ should be provided instead.
The Senior Carer must visually inspect and sign the Bed Rail Risk Assessment form when the bed rails are initially fitted to ensure they are correctly secured, intact, and in good working order.
The bed rails must be fitted by a competent person and in accordance with the relevant manufacturer’s instructions.
The padded bumper must be fitted correctly, according to the manufacturer’s guidance, to ensure the full length of the bed rail is covered.

Maintenance & Procurement

Pending changes:

Manufacturer’s maintenance
Inspecting bedrails, wearable parts
Lifespan of the product
Manufacturing traceability (serial numbers)
Measurements