title: Prevalence and predictors of bedrail use in an acute hospital.
abstract: OBJECTIVE
  to determine the prevalence and predictors of bedrail use in an acute hospital.
  
  
  METHODS
  overnight survey in a University teaching hospital.
  
  
  METHODS
  Three-hundred and twenty-seven beds and patients in 14 wards.
  
  
  METHODS
  data were collected on bedrail use and on the bed system, ward and patient characteristics. Medical, nursing and physical therapy notes were examined and the night and day nurses and, if necessary, the doctors and therapists caring for the patient interviewed to determine patients' diagnoses, functional and cognitive status.
  
  
  RESULTS
  there were 133 (40.7%) beds with one or more raised rails. Independent predictors of bedrail use were use of electric profiling beds, confusion, reduced alertness and any difficulty with transferring from bed. The most common reported indication for bedrail use was 'to prevent rolling out of bed' (59%); 'to prevent getting out of bed' was recorded in 11% of cases. Use of bedrails was judged inappropriate in 27/133 (20.3%) patients and in 14/43 (32.6%) patients with abnormal mental status; misuse was particularly common in those with confusion or agitation [13/34 (38.2%)]. Failure to use bedrails was potentially inappropriate in 32/194 (16.5%) of those without bedrails.
  
  
  CONCLUSIONS
  this study using individual patient data shows that the use of electric profiling beds, abnormal mental states and difficulty transferring from bed are the main predictors of bedrail use in acute hospitals. Inappropriate use of bedrails is common in those with cognitive impairment or with agitation.
authors.affiliation: Geriatric Medicine, Galway University Hospitals, Galway, Ireland.
authors.forename: Tomás
authors.initials: T
authors.lastname: O Flatharta
authors.affiliation: Geriatric Medicine, Galway University Hospitals, Galway, Ireland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Haugh
authors.affiliation: Geriatric Medicine, Merlin Park University Hospital, Galway, Ireland.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Robinson
authors.affiliation: Geriatric Medicine, Galway University Hospitals, Galway, Ireland.
authors.forename: Shaun T
authors.initials: ST
authors.lastname: O'Keeffe
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001513:Beds; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D004867:Equipment Design; D005260:Female; D019538:Health Care Surveys; D006742:Hospital Bed Capacity; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D061214:Patient Safety; D011482:Protective Devices; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000523:psychology; D012149:Restraint, Physical / Q000295:instrumentation*; D019564:Unnecessary Procedures; D055815:Young Adult
keywords: bedrails; delirium; dementia; older people; restraints