High frequency of potential entrapment gaps in beds in an acute hospital

Abstract

Objective: dimensional guidelines for bedrails have been developed to minimise the risk of patient entrapment within the bed. We examined whether bedrails in a large Irish teaching hospital complied with these standards. Design and setting: survey of 60 accessible beds in six hospital wards. Methods: a specialised cone and cylinder tool that mimics the size and weight of a small adult neck and head was used to determine gaps in the four zones most associated with entrapment. Results: the number of failures for each zone was 15 beds for zone 1 (any space between the perimeters of the rail); 42 beds for zone 2 (the space under the rail); 41 beds for zone 3 (the space between the inside surface of the bedrail and the mattress) and 13 beds for zone 4 (the space between the mattress and rail at the end of the rail). Failures were more common with hydraulic adjusted than with electric profiling beds. Mattresses that were the wrong size (usually too narrow) or too soft and bedrails that were loose or were poorly maintained accounted for many failures. Conclusion: many beds used in our hospital did not comply with dimensional standards to minimise entrapment risks. This emphasises the need for careful selection of patients for whom bedrails are to be used as well as the need for monitoring and maintenance of bed systems.