Court Case: North West NHS Foundation Trust
In April this year, a North West NHS Foundation Trust was fined £100,000 for failing to properly manage the use of bed side rails at its hospitals. The court who issued the fine were told by the Health and Safety Executive (HSE) that, 'University Hospitals of Morecambe Bay NHS Foundation Trust failed to ensure that they managed the risk of bed rails, a fundamental element of patient safety for which extensive and comprehensive guidance on risk, management and policies existed.'
Bed rail management is a fundamental element of patient safety for which extensive and comprehensive guidance on risk, management and policies exist.
A visit to the Trust in early 2012 by the HSE resulted in the issuing of an Improvement Notice on bed rail management, and a letter recommending possible solutions to the failings. The Trust identified actions that needed to be taken to improve bed rail management, but on inspection a year later, it was clear that they had failed to implement these actions.
The result of failing to address the mismanagement of bed rails and non-compliance with bed rail regulations? A £100,000 fine and additional costs of £18,465.
Bed Rail Guidance and Regulation
The BS EN 60601-2-52:2010 medical beds standard outlines the dimensional requirements of bed rails, and has been introduced to prevent entrapment and bed falls occurring as a result of unsafe bed rails.
Guidance on the safe use of bed rails was updated by the Medicines and Healthcare Products Regulatory Agency (MHRA) in 2013. The guidance covers five main issues relating to bed rails:
- Risk management
- Adverse incidents
The MHRA guidance is aimed at care home managers and staff, hospital and community nurses such as those working in the North West Foundation Trust (see above), occupational therapists, and any other professional who works with, purchases or manages bed rails.
Managing Bed Rail Safety Effectively
First and foremost, the bed and mattress combination must be fully compliant with the BS EN 60601-2-52:2010 medical beds standard. View on the HSE website.
Secondly, where bed rails are not suitable for the bed user, look for alternative solutions. Low beds have been developed to minimise fall injury, reducing the need for protective side rails. Finally, ensure the mattress depth is suitable for the bed and does not infringe on the regulation that states there should be a minimum of 220mm from the top of the mattress to the top of the bed side rails. When using a deep airflow pressure mattress, extension side rails are often required. Alternatively, invest in a bed such as the Opera Signature which is able to accommodate deep airflow mattresses and remain compliant without the need of a bed rail extension kit.
With proper equipment and the vigilance to ensure the equipment is being used correctly, managing the safety of bed rails can be done easily and effectively with minimal cost. The risk of failing to manage the safety of bed rails effectively is surely not worth the consequences.
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