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. Five such studies were identified; [ 7 , 45—48 ] all succeeded in reducing bedrail use. It also offers direction for future research. Research and reducing inequity in healthcare. The methods employed conformed to the principles set out in Quality of Reporting of Meta-analyses guidance . You must accept the terms and conditions.
The methods employed conformed to the principles set out in Quality of Reporting of Meta-analyses guidance .
Whilst such emotive presentation renders objective analysis of the evidence difficult, it is precisely this challenge that this paper seeks to address. CPSI offers patients and families, patient advisors, healthcare providers, leaders, litwrature organizations a place to connect in real time so they can share, learn and help others.
This complicates the existing clinical challenge staff face in balancing patient safety with the promotion of independence and rehabilitation [5, 1329, 37, 38]. Additionally, npssa studies were based on reports from frontline staff, a method limited by incomplete data and under-reporting [ 1419—21].
Bedrail reduction achieved but specific level not stated.
Given the emotive nature of the bedrail debate, qualitative exploration of the views of patients and staff may also be helpful. We want to help all users of NRLS data to understand and use it appropriately. Injury and death associated with hospital bed side-rails: Concurrent use of body restraints. The design of retrospective surveys, case series, and case studies means they inherently fail to meet quality criteria, but may still provide useful circumstantial information.
However, if the text of the paper is read the apparent change in serious injury occurred in an extra category not included in the results tables but defined within the text as minor head injuries where neurological observations were taken.
The design of retrospective surveys, case series, and case studies means they inherently fail to meet quality criteria, but literatuure still provide useful circumstantial information.
Sixteen such studies [ 1451—65 ] were included. The best evidence we located were four of the five before-and-after studies of bedrail reduction which met seven to eight quality criteria [ 746—48 ], whilst one before-and-after study was of lower quality [ 45 ].
We intended the review to provide a resource to inform clinical practice and to identify gaps for future research. The full list can be found in the supplementary data online, on the journal website http: Large urban academic hospital in the USA, including general and psychiatric patients no other overall demographics given.
Related articles in Web of Science Google Scholar. You have entered an invalid code. Continue group pre 2, post 1. Education of staff, selection non-randomised 2 by advanced practice nurse of patients to continue or discontinue bedrails, literaturre alarms, floor mats, low beds.
Addition of bed alarms, non-slip floors and shoes, transfer rails, exercise.
One study described a non-significant decrease in falls [ 7 ], two described a significant increase in falls [ 4547 ], one described a significant increase in multiple fallers [ 48 ] and one described a significant decrease in falls rates in the patients who had bilateral bedrails removed, although falls remained significantly less likely to occur in the patients who continued to use bilateral bedrails [ 46 ].
National Forum on Simulation for Quality and Safety. Because a perceived risk of falls is the nurses’ main rationale for providing bedrails [1, 4, 5], it is unsurprising to find that patients provided with bedrails are older, less mobile, more cognitively impaired and more likely to be incontinent than patients who are not provided nlsa bedrails [1, 2, 1367—69].
In addition to effects on falls and injury, any other potential harms or benefits of bedrail use merit investigation, as does the effect of different bedrail designs, partial npsw to full bedrails, alternatives to bedrails, and the role of policy or decision tools to support staff in assessing the risks and benefits of bedrail use for individual patients.
This review suggests that healthcare organisations should not aim for the universal reduction of bedrail use, but focus on eliminating outdated equipment and reducing inappropriate bedrail use on a case-by-case basis. This review suggests that healthcare organisations should not aim for the universal reduction of bedrail use, but focus on eliminating outdated equipment and reducing inappropriate bedrail use on a case-by-case basis.
Mean length of stay Even the eight better-designed studies [ 71345—50 ] met only between four and eight quality criteria out of a maximum of ten.
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 from 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 http: