Safe use of bed rails or grab bed handles

Every patient must be risk assessed by a healthcare professional before using bed rails, bed grab handles or alternative equipment.

Bed rails

Bed rails attach to both sides of the bed to help people to stay safe while in bed.

This equipment reduces the risk of people accidentally slipping, sliding, falling or rolling out of bed.

Bed rails are widely used for this purpose, but they are not suitable for everyone, and can introduce other risks.

Bed grab handles

Grab handles are designed to help people into or out of bed and move or change position in bed.

Bed grab handles come in a variety of shapes and sizes. Depending on the grab handle selected, they can be used to fit a range of domestic divan or metal framed beds.

They will not protect people from falling from the bed.

Risks of using bed rails

• a patient may fall trying to climb over rails
• a patient may injure their legs on standard bedrails
• poorly fitted bed rails can be dangerous.

Risks of using bed grab handles

• risk of injury or being trapped if the person is restless or distressed
• increased risk of falling.

Prescribing bed rails and bed grab handles safely

To help lower the risks, a healthcare professional will carry out a risk assessment to establish if bedrails or a bed grab handle are suitable for people’s needs.  Where possible, people will have the risk assessment completed during a consultation with their health professional.

The findings will be discussed with the individual, including the person’s family or carer if appropriate.

Bed rails or bed grab handles will be prescribed and requested if the risk assessment indicates it is safe to do so.

This risk assessment must be reviewed:

• after any significant change in the person’s condition
• if the person has any changes or additions to the equipment that is used in or around the bed, for example if a pressure relieving mattress is introduced
• if the person has any concerns about using the equipment or if they are finding it more difficult to use
• if the person has any accidents or ‘near misses’ when using the equipment.

It is important that people inform their health professional if their needs have changed or they have any concerns about using the bed rail or bed grab handles safely. 

Alternatives to bed rails

Where a risk assessment, or a review suggests that bed rails are not suitable, the healthcare professional will consult with the individual, and their family or carer if appropriate, to discuss the options.

Some examples are:

• electric ultra-low beds that lower to a couple of inches from the floor to minimise the risk of fall injuries
• fall mats that can be placed beside the bed to reduce the severity of the impact if the bed occupant does fall
• alarm systems, to alert carers that a person has moved from their normal position or wants to get out of bed.

Using your equipment safely

All medical equipment that is provided to people during their stay in hospital, or issued to them at home, has been checked by specialist technicians to ensure that it is safe and suitable for use.

Bed rails and bed grab handles are selected to make sure that they are compatible with individual’s bed. They are carefully fitted to the bed to reduce any risks of entrapment.

It is very important that:

• bed rails or grab handle are used as advised by healthcare professional and the manufacturers’ guidelines should always be followed
• the position of the bed rails or grab handles should not be removed or altered, other than by a specialist technician
• bed rails should not be used as an aid to help people to move in bed (e.g. the person should not pull on the bed rails in order to sit up in bed)
• bed rails should not be used to restrain people from intentionally getting out of bed
• both bed rails should be in a raised position when people are in bed.

Checking and maintaining the equipment

The equipment provider employs technicians to check and maintain the bed rails. They will arrange to check the equipment each year to ensure that it remains in good condition and undertake any necessary maintenance.

However, there may be signs of wear and tear in between the maintenance visits. It is important that any possible fault with the equipment is reported to the equipment provider.

Users should have access to a manufacturer’s user guide when the equipment is installed for information.

User checks

We have listed below some simple ‘user checks’ that people and their family or carers, if applicable, can do to identify any problems:

• Are there any signs of damage, faults or cracks on the bed rail or bed grab handle?
• Are there any sharp edges that might cause me to injure myself?
• Does the bed rail or bed grab handle feel as if it is loose or not secure?
• Has the bed rail or bed grab handle moved since it was fitted?
• Are there any concerns about any gaps in the equipment, where part of the body could get trapped?
• Is there any excessive movement, when bed rails are raised?

If the answer to any of these questions is ‘yes’ then it is essential that contact is made with the equipment provider so that the equipment can be checked, repaired or replaced.