MHRA consultation on guidance on the safe use of bed rails

Care providers, care home managers, carers and staff with responsibility for the provision, maintenance and fitting of bed rails will be interested in the Medicines and Healthcare products Regulatory Agency’s latest consultation published earlier this month.

This consultation has been launched in response to the ongoing reporting of adverse incidents involving bed rails where users have been seriously injured or have died as a result of the improper use of bed rails.

Bed rails are used extensively in acute and community care environments to reduce the risk of bed occupants falling out of bed and injuring themselves. The most serious of these have led to injury and death by asphyxiation after entrapment of the head or neck.

Most reported incidents occurred in community care settings, particularly in residential and nursing homes. The MHRA say these could have been prevented if adequate risk assessments and appropriate risk management had been carried out.

NHS ‘Never events’ are defined as “serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented by healthcare providers.” NHS ‘Never events’ number 11 (1) covers chest or neck entrapment in bed rails.

A summary of the relevant legislation is set out at chapter eight.

Guidance on safe use of bed rails

The MHRA has updated its guidance document to reflect changes in devices and practices, as well as information gained from the investigation of adverse incidents. It also now includes information on a standard for medical beds for children published since the previous guidance.

The guidance identifies areas for safe practices, so that policies and procedures can be reviewed and put in place.

Areas covered include:

  • risk management
  • management responsibilities  
  • meeting legal requirements  
  • training  
  • planned preventative maintenance

Good practice guidance is also set out in the document, covering areas, such as:

  • checking and ensuring that a bed rail is necessary
  • the need for good communication between bed occupant and carers or staff  
  • compatibility of the bed rail and bed, mattress and occupant combination  
  • taking into account the use environment and possible interaction with any other equipment or
  • devices present in that environment  
  • correct fitting and positioning of the bed rails initially and after each period of use  
  • re-assessing for changing needs of the bed occupant  
  • the need for risk assessment before the provision and use of bed grab handles

Share your views

The MHRA are keen to hear your comments on the draft guidance – you have until 5pm on Friday 13 September to send them your responses. You can complete the response form or e-mail your responses to dts@mhra.gov.uk.

A final version of the guidance document will be published later this year.

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