Bed Rail Safety

Since 1990, the FDA has received 102 reports of head and body entrapments involving hospital bed rails, including 68 deaths. Patients can be caught, trapped, entangled or strangled, with deaths caused by entrapment of the head, neck or thorax.

You can protect frail, elderly or confused patients from bed rail injuries by following these guidelines:* Evaluate bed rails to insure the dividers are not large enough for a patient to insert his head or thorax.

* Split or quarter side rails can be risky for individuals because they can get caught in the space between the top and bottom rails. Nurses must determine the need for upper and lower rails in the context of resident assessment.
* Any time a new mattress is purchased for an old bed there should be no more than a 2-inch clearance between the rails and mattress. If the distance is greater, the mattress should not be used.
* Bed rails should not be used as a substitute for patient protective restraints.

Treating wounds

Approximately five million patients a year suffer from chronic wounds and the number will increase as our population ages. But if basic procedures are followed, many wounds can be prevented.

It is vital to understand the cause of the wound and the patient’s overall status before treating the wound. Here are some questions to help in assessment:

* What caused the wound?* What is the location of the wound?
* What kind of tissue is in the wound bed?* Is the wound draining?
* Is the patient incontinent?
* Is pain a factor?

After a patient is assessed and the above questions are answered, appropriate treatment will include:

* Wound dressings – occlusive, non-occlusive, absorbtive, debriding, etc.
* Sharp debridement – performed by a physical therapist or physician
* Nutritional support – vitamin, mineral or protein supplements may be needed to support wound healing
* Incontinence care – frequent and generous applications of barrier creams can prevent breakdown from incontinence
* Electrical stimulation – radio frequency, ultrasound, whirlpool and hyperbaric oxygen therapy