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Reducing the use of full-length bed rails doesn't increase falls among older patients, new research suggests. In fact, removing rails may help prevent falls that occur when patients try to climb over them.


In the study, an advanced practice nurse helped four nursing homes find alternatives to the routine use of restrictive bed rails to see if they could reduce falls. The study included 700 nursing home residents who were part of the intervention group and 251 residents (the control group) for whom no changes were made. The residents were evaluated 1 month and 1 year after initiation of interventions, which included using shorter side rails that could function as handholds, lowering beds, improving residents' strength and balance through physical therapy and rehabilitation, and providing bedside commodes and well-placed light switches.


Only one of the four nursing homes continued to follow the interventions during the study period. That facility significantly reduced the incidence of falls. In the three facilities that didn't follow through with the interventions, the fall rate didn't change.


Lead researcher Elizabeth Capezuti, RN, PhD, notes that bed rails can provoke, rather than prevent, falls in confused patients who see them as obstacles to overcome. She advises family members to question nursing home staff about the routine use of restrictive side rails and ask if their bed rail policy conforms to Food and Drug Administration (FDA) guidelines.




Capezuti E, et al., Consequences of an intervention to reduce restrictive side rail use in nursing homes, Journal of the American Geriatrics Society, March 2007.