siderails

[Slowone]

I'm sure this is a topic that has been brought up before however, I was just curious how different facilities around the country are dealing with the changing regulations on siderail usage.

Here in Washington we have had two deaths in the past year due to siderails and it has become a very hot topic for surveyors. Siderails are no longer viewed as a "restraint" issue. It is now a safety issue.

What is the policy and procedure in your facility for siderails? What kind of beds or adaptive eqiptment are you using in lieu of siderails?

Just curious. thanks in advance for your responses.

SLOW:)

[aimeee, BSN, RN]

We have lots of low beds around here for patients who are high risk for falls. The CNA's really dislike them when they aren't electric (and who can blame them!) But they really really work. Mats by the bed are helpful, but they are also an unstable surface for the resident to stand on if they do manage to get up. Personal alarms are of limited value. Half the time the resident is on the floor by the time you get to them!

I once had a resident who was post total hip replacement get caught between split siderails. These were the ones that are sort of diamond shaped. He got his hips wedged into the gap between the two rails with his legs hanging out. I couldn't lower the siderails because his hips were in the way, and couldn't lift him up because the siderails were in the way. It took 4 or us to extricate him. Had to lift him up while supporting his body and turning at the same time to maneuver him out. I was so thankful there was no hip injury.

[km rn]

We utilize the following:

a) bed alarms; b) gerihips - special undergarment with padding that covers the trochanter area; c) low beds; d) we use antifatigue mats for bed side mats - they are sold for nurses station to help prevent fatique but I use them at the bedside for residents. They provide cushioning, have beveled edges and also help prevent residents from sliding with their nylon feet. e) DPM mattress - mattress with 20% incline on sides to slow resident's exodus from bed; f) sometimes we use fun noodles or ""water noodles" as single use items for residents who want/need reminder on where the edge of the bed is; g) we use some bed canes for residents who need something to grab onto as they transfer to/from bed - chair OR need to grab something to assist with turns; h) trapezes also work as assist devices instead of side rails for turning/repositioning.

[Fran-RN]

1:1 care is not possible. we have several residents that attempt to rise on their on but are not safe alone. but we have only 6 staff members, (RNs, LPNs, CNAs) to care for 70 residents. We use pressure sensitive bed alarms and they are hooked into the call light system. We also use low beds with mats. We still have some falls but injuries are minimal. like the poor, the fallen will always be with us.

[night owl]

At this time, we use 1:1 on one resident. We have 60 residents on our unit, 3 CNA's, 1 CNA for the 1:1, 1 RN and 1 LPN on nights. When we have only 3 CNA's and ask for help for the 1:1, they always seem to find that one person. Before we had the 1:1 and had only 3 CNA's if we asked for the fourth CNA, the super would say, "Sorry, but we can't spare anyone for you." Hmmmmmm!

We utilize all of those little gagets like you, but to no avail, some one will always fall anyway...the fallen will always be with us no matter what.

Had a CNA float to another unit for a 1:1. She fell asleep, the resident climbed OOB and fell. No serious injuries, but she was suspended for two weeks without pay.