Bed Rails in Nursing Homes

This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Terry Crouppen who has more than 40 years of legal experience as a personal injury attorney. Our last modified date shows when this page was last reviewed.

This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Terry Crouppen who has more than 40 years of legal experience as a personal injury attorney. Our last modified date shows when this page was last reviewed.

Bed rails are so common in nursing homes that many people don’t realize they pose hazards. They’re standard on most nursing home beds, which are essentially hospital beds modified for nursing home use. 

Dozens of nursing home residents suffer bed rail-related injuries yearly. Sometimes, the injuries are fatal. Unfortunately, limited guidance exists to protect patients from bed rail dangers in nursing homes.

Are Bed Rails Allowed in Nursing Homes?

Most nursing home facilities allow bed rails because they benefit both patients and staff. 

Made from metal or plastic, bed rails surround a patient’s bed, just like a hospital bed. They’re useful for several purposes, including fall prevention and support.

Nursing home bed rails can prevent patients who move around in their sleep from inadvertently rolling off the bed. They also prevent mobility-impaired patients from trying to get out of bed. 

Patients may rely on their bed rails for support when adjusting their bodies in bed. Staff also use them as a brace when shifting a patient’s position.

If patients are mindful of their surroundings and possess the physical strength to get in and out of bed, then bed rails are relatively harmless. They can improve the patient’s well-being and motility while in the facility.

Problems with bed rails arise among particularly frail or confused patients. According to the Food and Drug Administration, more than 800 patients suffered bed rail-related injuries—over half of which were fatal—between 1985 and 2008. Most injuries occurred when patients became accidentally caught or strangled by bed rails. 

Understanding the Risks of Bed Rails

Usually, injuries from bed rails in nursing homes occur among elderly patients when they become entrapped beneath them. The patient may accidentally roll under the rail and then struggle to remove themselves because they lack strength or are disoriented. The pressure from the bed rail can cause suffocation or chest injuries if the patient’s neck or chest area becomes stuck.

Occasionally, patients may try climbing over the rails to get out of bed. However, this approach can cause patients to trip or fall and suffer broken bones or fractures. A fall can be catastrophic because many nursing home patients lack the strength or mobility to catch themselves.

Other risks of bed rails include scrapes and bruising. While not as serious an injury, a scrape or bruise can be quite painful and may take extensive time to heal.

Sometimes, facility staff use bed rails to restrain patients from getting out of bed as a safety precaution. However, being confined to the bed can be emotionally trying for patients and cause them to feel lonely and isolated.

How Bed Rail Entrapment Injuries Happen

Bed rail entrapment is a severe injury that occurs when an elderly patient’s upper body—including their head, neck, or chest—becomes caught underneath a bed rail. This injury is possible when staff fail to install bed rails properly and leave too large of a gap between the patient’s bed and the rail. 

Bed rail entrapment can occur in other ways, too. For instance, the patient may become stuck between two siderails or a rail’s head and footboard. Occasionally, staff may install bed rails with the wrong type of mattress, increasing the risk of injury. 

Patients who experience bed rail entrapment are at high risk for severe injury. They may exhibit certain behaviors or symptoms, including the following:

  • Agitation or delirium
  • Uncontrolled body movements
  • Loss of bladder or bowel control
  • Acute pain

If the staff fails to act swiftly, a bed entrapment injury can be fatal.

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Bed Rail Entrapment Injuries Are Preventable

There are a few ways that nursing home staff and patients’ loved ones can prevent bed rail entrapment injuries.

Evaluate the Patient's Condition Regularly

First, regularly monitor changes in the patient’s strength, mobility, and awareness. If a patient exhibits signs of disorientation or reduced stability, they’re at a higher risk of bed rail entrapment injuries. Staff should note their condition and monitor them frequently. Take note of their bathroom and feeding habits, and regularly provide the patient with opportunities to get out of bed or obtain desired items with staff’s assistance.

Install Bed Rails According to the Manufacturer's Specifications

It’s critical to install bed rails correctly on a new patient’s bed. Ensure that the mattress size aligns with the bed rail’s manufacturer guidelines and check for gaps between the rails and the bed. Remember that the patient’s weight can increase the gap size depending on their position, so you want to minimize gaps as much as possible.

Frequently Check for Bed Rail Gaps

If you’re a nursing home patient’s loved one, check for gaps between bed rails and the mattress whenever you visit. If you notice any openings that may pose a hazard, notify staff immediately and stay with the patient until the issue is addressed. 

There is an easy test you can use to appraise bed rail safety. Simply insert your fingers between the mattress and the rails. If you can fit four fingers or more into the gap, it’s unsafe. 

Other Options Besides Bed Rails

The industry standard for protecting bedridden nursing home patients is usually bed rails. However, some alternatives may be safer. 

Sometimes, patients don’t require nursing home bed rails—even if they’re frail or disoriented. Instead, loved ones can request that the facility not provide bed rails and instead take specific precautions to prevent unnecessary falls or injuries.

Some facilities provide beds that extend relatively low to the ground, so a patient who accidentally rolls off the mattress won’t fall more than a few inches. Less impact means a reduced risk of injury. You can make a low bed even safer by padding the floor around the mattress.

Beds also come equipped with locking mechanisms to prevent the bed from shifting when the patient moves. Locking mechanisms prevent rolling when the patient tries to get in or out of bed. 

Mobility aids can help patients and caregivers when transferring from the bed. However, both parties must understand how to use them to reduce fall risk.

Get Assistance From an Attorney if Your Loved One Suffers a Bed Rail Injury

If your loved one experiences a bed rail entrapment injury, it’s imperative to seek legal assistance. Doing so can highlight the nursing home’s shortcomings and prevent others from experiencing similar injuries.

Brown & Crouppen represents clients in nursing home abuse cases throughout Missouri, including Kansas City and St. Louis. Our award-winning attorneys have over 40 years of experience holding negligent parties accountable in nursing home abuse lawsuits. We’ve helped thousands of accident victims and their families recover over $1 billion in personal injury lawsuits. 

To learn about your legal options in a bed rail entrapment case, contact us for a free consultation at 800-536-4357 or by completing our online form. We do not charge a fee unless we win your claim.


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