Poorly fitting bed rails have caused deaths where a person’s neck, chest or limbs become trapped in gaps between the bed rails or between the bed rail and the bed, headboard, or mattress.

Other risks are:

• Rolling over the top of the rail
• Climbing over the rail
• Climbing over the foot board
• Violently shaking and dislodging rails
• Violent contact with bed rail parts

Equipment manufacturers must provide a warning about any risks and limitations on how to use the equipment with maintenance requirements. All of the people using the equipment must be aware of and comply with these.

Risk Assessments

Comprehensive risk assessments will need to be carried out for each person before a bed rail is used. The risk assessment must be recorded and regularly reviewed, especially if there are any significant changes about the individual or the equipment. 

Bed rail assessments must include:

• -Only approved bed rails or safe wedges can be used.
• -Where possible, the individual and a family member or advocate should be fully involved with the risk assessment.
• -Manufacturer’s instructions must be followed when installing and using bed rails.
• Specific bed rails are designed for use on divan beds. These are not suitable for use on profiling or metal framed beds.
• -The gap between the head board, foot board and the bed rail end should be less than 60 mm.
• -The bed rail and mattress platform must be less than 120 mm.

When using bed wedges you must ensure that they are secured, firmly strapped and buckled underneath the divan or pressure relieving mattress.

Grab rails may be fitted to beds when a person has been assessed as needing these to aid mobility.

Risk assessments need to be explicit in identifying whether bed safety rails or grab rails are required.

• -Divan beds must have mattresses of the correct size for the bed before bed rails are used.
• -Gaps between the bars of the bed rails must be less than 120 mm.
• -The responsibility lies with all employees to ensure that bed rails and equipment are visually checked every time you support an individual to use them.
• -If a bed rail is fitted to a bed, then an appropriate semi permeable full length bumper must be used.
• -When using bed rails with a 125 mm or 150 mm airflow system on a profiling, hospital style bed, there must be a high density 50 mm underlay, biscuit mattress and not a standard 125 mm or 150 mm mattress under the airflow system mattress.
• -The correct bumpers for that bed safety rail should be used.
• -Monthly maintenance checks must be carried out.
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• In a care home it is the Registered Home -Manager’s accountability to ensure the compliance of bed rails. They may ask suitable individuals in the home to assist or carry out checks on their behalf. Accountability still sits with the Registered Home Manager. If you work in an individual’s home, you will need to check the requirements with your manager.
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• You should always undertake a visual check each time bed rails are used.
• Bed rail equipment that does not comply with your organisation’s bed safety rail policy must not be used.

Some individuals have a higher risk of injury from using a bed rail. 

Higher Risk Situations

Research has identified that people with physical or clinical conditions have a greater risk of getting trapped in the rails, of suffocation or a de-gloving which is a serious injury tearing off the skin and severing the blood supply. Any injury which would induce de-gloving to the head or torso is likely to be lethal. 

People at greater risk might have: