Validating an assessment tool
The MHRA (2006) suggested that most of the risks associated with the use of bedrails can be avoided if thorough risk assessments are carried out.Nevertheless, guidance as to what should be included in such an assessment tends to be broad and appears to be largely dependent on professional judgement and experience.It also led to a noticeable decrease in the use of bedrails and number of incidents resulting from their inappropriate use.
In our trust, an incident on a rehabilitation ward, when an 80-year-old woman got her knee stuck in a metal bedrail, distressed the patient and the staff involved.
This prompted a consideration of the policy for bedrail use.
The policy directed staff to carry out an assessment before using bedrails, but gave no specific guidance on how to undertake such an assessment.
None of the tools found met these criteria, nor have been validated for use.
The lack of effective and easy-to-use risk assessment tools for bedrail use means that nurses' professional judgement tends to be the only justification given for their use.
Ten years ago bedrail use in the acute care sector was around 8% and 4% in geriatric settings (O'Keeffe et al, 1996).