We have all different kinds of bedrails at my nh. Most of them are illegal. That is true that some of the res could fall out of bed and hurt themselves but probably what will happen is all of the beds will have to be low to the ground beds. Also the res/pts will have to be checked on more frequently. There are a couple of beds at my facility that are so shotty that the beds won't go up or down. They're in a position that really kills your back when I change the res, I have to bend over the bed. You think the facility would give them a new bed? Hell no! It's all about money. Facilities don't want to be sued for restraining a res/pt just like they won't replace a crappy bed if they know that the pt's family won't complain.

Actually I had a friend who works in a hospital that had a pt fall out of bed. The side rails were down and the bed was at a normal position but the pt requested that the light be turned off and the door shut. He got out of bed ( I guess he was slightly confused ), fell and smacked his head right open. My friend felt so bad but she did follow the law....

When I worked in a convalescent home. We had a couple patients that we had to put the siderails up on. One patient we had to put the 2 side rails up, because she sundown's at night, and she broke her hip, and leg at home, even with both side rails up. I still had to watch her, because she would try to climb over the side rails with her bad leg, she always call out that she want to get out of here and go home. I always reassure her that her niece is taking care of her home. I have to keep reorientating her.

First there needs to be a siderail assessment done. There are ways to write M.D. orders that allow for siderails. I work in LTC. Alot of residents did fine with half side rails. " up prn per resident request" Write the order : "per patient request "if they are alert. "needed for repositioning". You can also discuss the issue with the families and have them sign a waiver. When our facility first started implementing the no siderail rule, we all freaked out. It really wasn't so bad. We had a few that fell, but they would have fell with or without rails. Bed alarms work wonders if staff responds in a timely manner. The resident doesnt like the noise either, so for the most part they lay back down to turn it off.The really confused folks have low beds, about 4 inches off the floor with mats. If sundowners wanted to walk at h.s. we let them walk.

If the facility will pay for them, there are electric beds that go all the way to the floor.

bedrails has been used by a lot of my residents in turning and repositioning themselves but last night i was really horrified when an order from the state demanded the policy "NO BEDRAIL FACILITY." i know the consequences that no bedrails, the residents had been denied the opportunity to be independent in simple turning or repostioning, there will be more falls inspite of the precautions. families are upset because residents feels they are deprived. staff will have back injuries, more staff needs to be hired because they need to reposition heavy residents, nurse have to monitor residents every hour. i am aware that some residents are so confused and can get hurt with siderails but what we must assess individual residents' need. not all in the facility are confused but all of them have this to help them get up. in doing nursing care we assess, then look for options. i am aware that the states are doing their jobs making sure that health care facilities are all safe but it the staff of the facility who are dealing with them everyday.

Thankfully we have not gone to the no side rail policy in my facility and I don't think we ever will. We complete a side rail assessment on every resident then get a doctors order for the side rail if it will be used as a restraint, however if the resident can roll from side to side using the side rail it is not a restraint but an enabler and the order is written as so