Falls Risk and Side Rails Policy

A side rail is not automatically a falls-prevention intervention. For this policy decision, treat a side rail as a physical restraint because it can limit a patient's ability to leave the bed and can change how the patient falls. The indication is narrow: a documented, individualized assessment must show that the patient is at imminent risk of falling out of bed, and less-restrictive measures have been considered. A general history of falls, an elevated fall-risk score, or staff convenience does not by itself justify raising the rails. The type of risk matters. A patient who is likely to stand and fall while walking to the bathroom may climb over a rail and sustain a more serious injury. A patient who is repeatedly rolling or sliding toward the edge despite repositioning may have a genuine risk of falling out of bed. Those situations call for different assessments and different interventions. Rails can also create entrapment between the mattress, rail, and bed frame. The safest plan therefore addresses the patient's movement, cognition, environment, and reason for trying to leave the bed—not merely...