Use of Restraints and Bedrails in a British Hospital

OBJECTIVE: To determine the prevalence of restraint and bedrail use in a British hospital. DESIGN: Cross-sectional observational study. SUBJECTS: Six hundred sixty-eight patients in the acute medical, surgical, and geriatric beds of a large British teaching hospital on a single night. MEASUREMENTS: Observed use of restraints and bedrails. Reasons for restraint use were determined by interviews with nursing staff and examination of the case notes. RESULTS: Fifty-six (8.4%) patients had bedrails raised. No other restraints were in use. Reported indications for bedrail use were: prevention of falls (52 patients), prevention of wandering (1), and patient request (3). In stepwise logistic regression analysis, bedrail use was associated significantly with agitated confusion, age 70 years or more, and stroke, while patients on the acute geriatric wards were significantly less likely to have bedrails raised. CONCLUSIONS: Restraint use is relatively uncommon in Britain. Nevertheless, inappropriate use of bedrails is a reason for concern.