What Are Bed Rails in Health and Social Care?

Bed rails, also known as side rails or cot sides, are attachments used on beds in hospitals, care homes, and private residences. Their primary purpose is to provide safety and support for individuals who may have limited mobility, physical frailty, or cognitive impairments. Bed rails are linked to the bed and are typically adjustable. They can lower or raise according to the user’s needs.

These rails are widely used in health and social care settings to assist people who are at risk of falling out of bed. They can also be helpful in promoting independence by giving individuals something to hold when repositioning themselves in bed. Although bed rails offer many benefits, they must be used properly to avoid any risks to the individual’s safety and comfort.

Always follow your organisations policies and procedures when using any care equipment.

Why Are Bed Rails Used?

The main purpose of bed rails is to prevent falls from the bed, especially for individuals with limited strength or poor balance. Falling out of bed can lead to serious injuries, such as fractures or head trauma. Bed rails act as a barrier to minimise these risks.

Aside from preventing falls, bed rails are also used to:

• Help individuals reposition themselves more easily
• Provide a sense of security for those who feel anxious about falling
• Support people with mobility issues during transfers to and from the bed
• Assist carers when performing tasks such as moving or turning the individual

It’s important to assess the individual’s needs before fitting bed rails, as using them without proper consideration can result in risks, such as entrapment or injury.

Types of Bed Rails

Several types of bed rails are available in health and social care settings. Each type is used depending on the specific needs of the individual and their environment. Some of the most common types include:

Full-Length Bed Rails

These span the entire length of the bed and are often used in hospital or care home beds. They provide extensive coverage to prevent individuals from rolling or falling out of bed. Full-length rails are typically adjustable and can be lowered for easier access.

Half-Length Bed Rails

As the name suggests, these rails cover only part of the bed’s length, usually from the head to the middle. They offer some fall protection but give the individual more freedom of movement. These are often chosen for people who move independently but still need partial safety support.

Split Bed Rails

Split rails are divided into two sections, usually positioned near the head and the feet. This design provides safety and support while allowing carers easier access for personal care tasks.

Portable Bed Rails

These are standalone rails that can be placed alongside a regular bed, without needing permanent fixtures. Portable options are often used in home care settings for people who may only need temporary support.

Safety Considerations

While bed rails are designed to improve safety, they can sometimes cause harm if not used correctly. The person using the bed rails should undergo a risk assessment to determine if they are suitable for them.

Here are some safety issues to address:

The Risk of Entrapment

Entrapment occurs when a part of the body, such as the head, neck, or limbs, gets caught in the gaps between the rails, mattress, or bed frame. This can lead to injury or, in severe cases, suffocation. Modern bed rails are designed to minimise these risks, but carers and staff must always check for potential hazards.

Using the Correct Size of Rails

Using rails that do not fit the bed properly can increase the risk of accidents. For example, there may be large gaps between the mattress and the rail if they are not compatible. Always ensure the rails are appropriate for the specific bed in use.

Over-Reliance on Bed Rails

Although bed rails can prevent falls, they may not always be the right solution. Some individuals may feel trapped or attempt to climb over the rails, which can result in falls from an even greater height. Alternatives, such as low-profile beds or cushion mats, may be better for them.

Who Can Benefit from Bed Rails?

Bed rails are beneficial for a range of people in various health and social care settings. They are especially helpful for individuals who experience:

• Limited mobility due to age or illness
• Risk of falling out of bed due to balance issues
• Cognitive impairments, such as dementia, where there is increased risk of accidental injury
• Recuperation following surgery or injury, when extra support is needed to stay in bed safely
• Tremors or involuntary movements while sleeping

Carers and healthcare professionals need to identify who is most likely to benefit from the use of bed rails and ensure they are used appropriately. In many cases, consulting with the individual being cared for is good practice to respect their preferences and dignity.

Alternatives to Bed Rails

In situations where bed rails are not safe or practical, other options are available to promote safety. Some alternatives include:

• Low-Profile Beds: These are designed to sit closer to the floor. If the person were to roll out of bed, the risk of serious injury is significantly reduced.
• Crash Mats: These padded mats are placed on the floor beside the bed to cushion any potential falls.
• Bed Alarms: These systems alert carers if an individual gets out of bed, reducing response times in the event they may need help.
• Bolster Cushions: Placed at the edges of the bed, these can act as a soft barrier to prevent falls without the rigidity of rails.
• Supervision: In some cases, having direct support from a carer during rest or sleep may be the best solution.

Legal and Regulatory Requirements

The use of bed rails is governed by health and safety regulations, and it must align with best practices in caring for vulnerable individuals. Organisations like the Care Quality Commission (CQC) oversee care providers in the UK, ensuring they follow these guidelines.

Some of the most relevant regulations include:

• The Health and Safety at Work Act 1974: This requires employers to ensure the safety of their staff and service users. Proper training in the safe use of bed rails forms part of this responsibility.
• The Manual Handling Operations Regulations 1992: Carers must minimise risks to themselves and their patients when adjusting or fitting bed rails.
• The Medical Devices Regulations 2002: Bed rails are considered medical devices, meaning they must meet safety standards and be regular checked for faults.
• The Mental Capacity Act 2005: If an individual lacks the capacity to consent to using bed rails, a best-interest decision is required. This involves discussing the situation with carers, healthcare professionals, and family members.

Training and Education for Staff

Carers and professionals working in health and social care settings should receive training on how to use bed rails appropriately. This training should cover:

• How to fit bed rails securely and adjust them as needed
• Identifying and minimising risks, such as potential entrapment hazards
• Monitoring individuals regularly to ensure the rail is suitable and safe to use
• Recognising when alternatives may be more suitable

Inadequate training or incorrect usage can lead to significant dangers. For this reason, organisations must invest in educating staff about the safe and effective use of bed rails.

Maintaining Bed Rails

Regular maintenance is a vital part of using bed rails safely. This involves routine checks to ensure the rails are in good condition and functioning as intended.

Things to look out for during maintenance include:

• Worn or broken parts, such as latches and hinges
• Sharp edges or protruding fixtures that could cause injury
• Proper compatibility between the bed, mattress, and rails
• Cleanliness, especially in care home settings, to prevent the spread of infection

When To Stop Using Bed Rails

It might sometimes be necessary to stop using bed rails if they are no longer beneficial or safe. Situations where stopping is advised include:

• The individual shows signs of climbing over the rails, increasing fall risks
• The rails cause distress or agitation
• Alternative measures would be more effective and safer
• The person’s health condition has improved, and they need less support

Always monitor the individual and review their care plan regularly.

Conclusion

Bed rails are an essential tool in health and social care when used correctly. They prevent falls, assist with mobility, and support dignity and independence. Careful consideration of their use, along with proper training and maintenance, ensures the safety and wellbeing of individuals. Always evaluate the risks and benefits for each person to decide whether bed rails are the right choice for their care.