Safe use of bed rails

What is the risk?

Bed rails, also known as side rails or cot sides, are widely used to reduce the risk of falls.  Although not suitable for everyone, they can be very effective when used with the right bed, in the right way, for the right person.

However, accident data shows that bed rails sometimes don't prevent falls and can introduce other risks.

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 footboard
• violently shaking and dislodging rails
• violent contact with bedrail parts

Bed rails are 'medical devices', which fall under the authority of the Medicines and Healthcare Products Regulatory Agency (MHRA). MHRA enforces the Medical Devices Regulations and the General Product Safety Regulations to ensure medical devices are acceptably safe. MHRA guidance on the 'Safe Use of Bed Rails' (Device Bulletin DB 2006(06)) and details of when and how to contact them can be found on the MHRA website.

What do you need to do?

When bed rails are used during the course of a work activity, such as in a care home or hospital, the employer or self-employed person providing them must ensure that they are safe

Risks identified during inspection include:

• trapping between poorly fitting mattresses and bedrails
• rolling over the top of the bedrails when overlay mattresses reduce their effective height
• trapping between the bedrail and mattress, headboard or other parts because of poor bedrail positioning.

Bed rails need careful management. Users should ensure:

• they are only provided when they are the right solution to prevent falls
• a risk assessment is carried out by a competent person taking into account the bed occupant, the bed, mattresses, bed rails and all associated equipment
• the rail is suitable for the bed and mattress
• the mattress fits snugly between the rails
• the rail is correctly fitted, secure, regularly inspected and maintained
• gaps that could cause entrapment of neck, head and chest are eliminated
• staff are trained in the risks and safe use of bed rails

HSE advises users to take into account the dimensions in British standard BS EN 1970:2000 (to be withdrawn on 1st April 2013) and BS EN 60601-2-52:2010 when assessing risk and ensuring correct fitting. Manufacturers and suppliers of bedrails also have a duty to ensure that equipment is safe for use and you should refer to their instructions.