Other Things to Consider

Entrapment in bed and side rails is a well-known hazard for patients in an institutional setting. There is much that can be done to reduce the risk of this hazard, however, even though changes are not widely made by suppliers, facilities, and manufacturers. Other products at use in the nursing home also present problems, including enclosed beds, assistive devices, and other devices intended to protect patients.

The risk of entrapments involving bed and side rails is a well-known hazard in the nursing home, hospital, and institutional setting. Not only have the Food and Drug Administration and Centers for Medicare and Medicaid services published information on this danger, but also so have non-governmental organizations and health care organizations. Yet, for some reason, entrapments continue to happen in nursing homes across the country.

There are solutions to help reduce hazards, but they may not be widely used by suppliers, manufacturers, and the facilities. These solutions can include low cost gap fillers (when used appropriately and affixed properly), design changes to eliminate the hazard completely, and the use of better designs that exist but are not widely implemented.

Side and bed rails aren't the only products used in nursing homes that can be problematic and dangerous for patients and residents. Other risk hazards come from assistive devices, wheelchair accessories, and products used to help prevent bedsores. Ironically, the devices used to help protect patients from themselves and from injury can be the products that cause serious injuries and bed rail death. Bed exit alarms can fail, allowing patients to wander off, and bed sore prevention products can be used inadequately and allow the sores to develop.

Vail beds have received attention for posing possible entrapment hazards to residents. A Vail bed is a completely enclosed bed. These beds have rails, but also are enclosed completely in nylon netting. Just as with side rails, patients can suffocate in these beds. Unlike side rails, however, Vail beds have gone through recalls. The Food and Drug Administration issued a public health advisory in 2005 recalling all enclosed beds made by Vail Products. Likewise, the FDA also recommended that all facilities using these beds should move patients to an "alternative" bed immediately. Prior to the recall, there had been at least 30 reports to the FDA of deaths caused by these beds. The FDA stated that the beds also were misbranded, as they caused serious bed rail injury despite being used per instructions from the company.

A variety of other assistive devices also create hazards, although they may not be of the same nature and may not receive as wide recognition as bed rail entrapments. Tub grabs and raised toilet seats - two assistive devices that make it easier for people to perform personal hygiene - can pose fall hazards and lead to serious bed rail injury. There is a known history of safety hazards during personal hygiene transfers, and these also can be seen with various wheelchair accessories and other transfer devices.

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