Patient Mobility in Hospital Beds With and Without Side Rails

Background: The use of hospital bed side rails for increased mobility and safety for elderly and high fall risk patients has become a controversial topic. The suggested removal of side rails to prevent entrapment, as recommended by Consumer Federation of America, increases the risk that a patient may fall out of the bed. Additionally, without side rails, patients may require additional assistance from nurses to reposition patients in bed, which increases the risk of back injuries among nurses (Jang et al. 2007). Objective: To examine the biomechanics associated with a patient’s ability to move freely in bed with and without side rails. Methods: Biomechanical data for in bed movements from fifty-two older adults with a history of falls (Morse Fall Scale value>45) (mean age=68 years, SD=11.4) was analyzed. An 18-camera motion tracking system (NaturalPoint, Corvallis, OR) was used to track body biomechanics. Participants were instructed to lie down on an instrumented hospital bed. They were then instructed to turn onto their right side, then onto their left side. This was performed three times with three different side rail configurations; rail 1, rail 2 and no rails. After each turn, distance of the pelvis from the edge of the bed and maximum rotation of the pelvis were quantified. A one