OpiniOns in the literature

Bedrails Bedrails used on the beds of adult hospital patients or care home residents are also called side rails, cotsides or safety rails. This article uses the word ‘bedrails’ as it is the clearest term and because patients prefer it (NPSA, 2007c). Bedrail use is common in health and social care settings, with reported prevalence in UK hospitals of 8%–39%, and in nursing homes internationally of 9%–71% (Healey et al, 2008). The most common reason given by staff for bedrail use is falls prevention (NPSA, 2007c). Some papers have automatically categorised them as a form of physical restraint, describing their use as ‘unethical’ and so making any discussion of their effectiveness immaterial. However, there is a difference between a safety measure and physical restraint or deprivation of liberty. In the UK, RCN (2007) guidance suggested an ethics-based definition of restraint: ‘the intentional restriction of a person’s voluntary movement or behaviour’ or ‘stopping them doing something they appear to want to do’. Bedrails used to prevent an accidental fall from bed would be unlikely to be considered as restraint using these definitions, while using bedrails to keep a patient in bed against their will would be restraint.