Fundamentals of Nursing Q 68
Studies have shown that about 40% of patients fall out of bed despite the use of side rails; this has led to which of the following conclusions?
A. Side rails are ineffective.
B. Side rails should not be used.
C. Side rails are a deterrent that prevent a patient from falling out of bed.
D. Side rails are a reminder to a patient not to get out of bed.
Correct Answer: D. Side rails are a reminder to a patient not to get out of bed.
Since about 40% of patients fall out of bed despite the use of side rails, side rails cannot be said to prevent falls; however, they do serve as a reminder that the patient should not get out of bed. A process that requires ongoing patient evaluation and monitoring will result in optimizing bed safety. Many patients go through a period of adjustment to become comfortable with new options. Patients and their families should talk to their health care planning team to find out which options are best for them.
Option A: Patients who have problems with memory, sleeping, incontinence, pain, uncontrolled body movement, or who get out of bed and walk unsafely without assistance, must be carefully assessed for the best ways to keep them from harm, such as falling. Assessment by the patient’s health care team will help to determine how best to keep the patient safe.
Option B: Historically, physical restraints (such as vests, ankle or wrist restraints) were used to try to keep patients safe in health care facilities. In recent years, the health care community has recognized that physically restraining patients can be dangerous. Although not indicated for this use, bed rails are sometimes used as restraints. Regulatory agencies, health care organizations, product manufacturers, and advocacy groups encourage hospitals, nursing homes, and home care providers to assess patients’ needs and to provide safe care without restraints.
Option C: Anticipate the reasons patients get out of bed such as hunger, thirst, going to the bathroom, restlessness, and pain; meet these needs by offering food and fluids, scheduling ample toileting, and providing calming interventions and pain relief. When bed rails are used, perform an on-going assessment of the patient’s physical and mental status; closely monitor high-risk patients.