An Analysis of Falls in the Hospital: Can We Do Without Bedrails?

OBJECTIVES: To determine the effects of introduction of a bedrail policy, and an educational program, on patient falls and fall-related injuries. DESIGN: A prospective "Before and After" design. PARTICIPANTS AND SETTING: All patients admitted during 1 calendar year in an assessment, treatment, and rehabilitation unit for older people. INTERVENTION: A policy change for the use of bedrails (restricting their use) and an educational program about their effects. MEASUREMENTS: 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.