Hospital bed safety

Learn about the risks of bedrails in hospitals, nursing homes and home healthcare. Find out how you can prevent bed entrapment by following useful safety tips.

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Bed entrapment

The use of bedrails in hospitals, nursing homes and home healthcare can help keep patients safe. However, in some situations, bedrails may also pose risks. One risk is bed entrapment. This means a patient could get trapped in areas around or between the bedrails, mattress and bedframe.

Bed entrapment does not happen often, but when it does, it can result in serious injuries. In some instances, someone's head, neck or chest can get trapped. This can lead to trouble breathing and may even cause death.

The 7 potential entrapment zones

This image shows the 7 zones where patients could get trapped in a hospital bed.

  • Zone 1 - within the rail
  • Zone 2 - under the rail, between the rail supports or next to a single rail support
  • Zone 3 - between the rail and the mattress
  • Zone 4 - under the rail or at the ends of the rail
  • Zone 5 - between split bedrails
  • Zone 6 - between the end of the rail and the side edge of the head or footboard
  • Zone 7 - between the head or footboard and the end of the mattress

A summary of entrapment zones, as defined in the Hospital Bed Safety Workgroup (HBSW) guidance document, is also found in Health Canada's guidance document.

Facts about bed entrapment in Canada

Learn facts about bed entrapment and risk factors in Canada:

Bed entrapment can happen to anyone in any healthcare setting. The risk is greater for seniors, especially if they are frail, confused, restless or unable to control their body movements. The risk is also greater if the mattress does not fit the bedframe.

Other risks of bedrails

The use of bedrails may pose other risks like:

  • injuries from a fall if a patient tries to climb over the bedrail,
  • cuts, scrapes, bruises and other injuries from moving or damaging the bedrail, or
  • injuries if a bedrail falls suddenly because the latch failed or was not fastened securely.

Benefits of bedrails

Although bedrails may pose risks, they also provide benefits:

  • They prevent patients from falling out of bed.
  • They help caregivers turn or reposition a patient in the bed.
  • They also give patients:
    • a handhold for getting into or out of the bed,
    • a way to support themselves to reach bed controls or personal care items and
    • a feeling of comfort and security.

The benefits and risks of using bedrails are different from patient to patient. Your healthcare provider can help you decide whether the benefits outweigh the risks for you or a family member.

Reduce your risk

Reduce your risk of bed entrapment by learning some tips on bedrail safety.

Before using bedrails:

  • Assess whether a patient would benefit from the use of bedrails.
  • Study the potential zones of entrapment and get rid of gaps that could trap someone.
  • Make sure the mattress is the right size and type for the bedframe.
  • Use a mattress with raised foam edges to prevent the patient from getting trapped between the mattress and bedrail.
  • Contact the manufacturer for the most recent safety information about the product you are using. This is especially important for beds from the year 2000 or earlier. Some manufacturers have produced covers or upgrade kits for bedrails to reduce the risk of bed entrapment.
  • Evaluate the reliability of the bedrail latching system.
  • Perform preventive maintenance procedures, which are set out in the manufacturer's manual.

When using bedrails:

  • Lower one or more sections of the bedrail if possible.
  • Make sure all latches are fastened securely before leaving the patient.
  • Check the patient frequently.

If concerned about the use of bedrails for a family member in a healthcare facility, talk to the healthcare team. Ask what steps they are taking to reduce risks, including the risk of bed entrapment. Health Canada recommends that high-risk patients be closely monitored when hospital beds or bedrails are used.

The Government of Canada's role

Health Canada regulates the safety, effectiveness and quality of medical devices imported into and sold in Canada. This includes hospital beds with bedrails. As part of this work, Health Canada:

  • sends safety information to manufacturers, healthcare professionals and consumers to help reduce risks,
  • encourages healthcare professionals and consumers to report problems involving bed-related entrapment and falls, and
  • monitors problems with these products and works with manufacturers to correct them when problems are identified.
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