Validating an assessment tool
The absence of a simple and effective means of assessing patients at risk - and suitability for bedrail use - led us to devise our own tool.
This tool was piloted on the rehabilitation ward and appeared to help the bedrail use decision-making process.
It also led to a noticeable decrease in the use of bedrails and number of incidents resulting from their inappropriate use.
After numerous modifications, the assessment tool became the Coventry Bed Rails Use (CBRU) tool, and this article describes the validation study.
The latest MHRA bulletin (MHRA 2006) reported that there have been serious incidents and deaths associated with the use of bedrails, and suggested that these could have been prevented by an adequate assessment of the risks involved.
Raising the rail on a bed increases the height from which a patient can fall by a minimum of 18 inches.
The MHRA (2006) suggested that most of the risks associated with the use of bedrails can be avoided if thorough risk assessments are carried out.
Nevertheless, guidance as to what should be included in such an assessment tends to be broad and appears to be largely dependent on professional judgement and experience.
Further research on its use in other clinical areas should be carried out.
The use of bedrails as a way of preventing patients falling from their beds and sustaining injuries is now common practice in many healthcare settings (MHRA, 2006; Jehan, 1999).
Bedrails can be used as physical restraints or as a safety device.
This prompted a consideration of the policy for bedrail use.
The policy directed staff to carry out an assessment before using bedrails, but gave no specific guidance on how to undertake such an assessment.