An analysis of falls in the hospital: can we do without bedrails?
OBJECTIVE
To determine the effects of introduction of a bedrail policy, and an educational program, on patient falls and fall-related injuries.


METHODS
A prospective "Before and After" design.


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


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


METHODS
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.
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D001513:Beds / Q000592:standards; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D009520:New Zealand; D016134:Organizational Policy; D011446:Prospective Studies; D011482:Protective Devices; D012149:Restraint, Physical; D012449:Safety