Do you have policy regarding usage of side rails on med-surg units?

[Sassy1]

I am still gathering information related to the use of side rails. I think most of the people that have replied may have worked in long term care/ Nursing home units etc. What about hospitals? How are you using side rails in med surg units? Do you use the hi-low beds that can be lowered to about 12 inches off the floor and does anyone use fall pads in the Med surg area? What is going on in the private sector? I have worked for 17 years for the VA. I am working with a committee that deals with patient safety issues. Side rails is one on the main concerns. Please let me know what kind of unit you work on and what you are doing with side rails and why. Many thanks!

[meownsmile, BSN, RN]

No we dont use Hi-lo beds in my med/surg. We use split side rails, the top(head) rails stay up due to bed controls/tv controls and bottom rails stay down unless specifically written for or RN determines patient needs protection until drugs/anesthesia wears off. Or possibly to keep an extremity from flopping over the bedside.

In most hospitals siderails are considered restraints so an order needs to be written within 1 hour of putting up rails if they are to stay up. Rational being that having side rails up is a greater risk for patient injury from climbing over rails than having a confused patient get out of bed.

[Rose B]

I work on a Med/Surg floor. We have 4 siderails on the beds now. In our state if you keep all 4 rails up it is considered a form of restraint and you have to document the reason. We don't use the floor pads but all of the local nursing homes do. We do use the personal alarms for those at risk for falling, man, are those things noisy!!! One just went off right now, LOL!

[VivaLasViejas, ASN, RN]

We don't consider the use of side rails or gerichairs as a restraint at my hospital (at least, not yet, but give it time ). These are part of our fall prevention protocol, which also calls for close observation (q 15 min. checks) and bed alarms, as well as 1:1 or 1:2 when necessary. This has been very effective at preventing falls, and we rarely use actual physical restraints on M/S anymore except with out-of-control detox pts. and those who present a danger to the staff and themselves (combative, throwing things etc.).