Southampton Care Centre

(519) 797-3220 - 140 Grey Street South Southampton, Ontario

QI - Innovation of the Year Award 2016

Reducing Risk and Injury Caused by Side Rail Entrapment 

Southampton Care Centre - Long Term Care, Grey-Bruce

On November 24th, 2016, Southampton Care Centre received the 2016 Quality Improvement – Innovation of the Year Award from the Ontario Long-Term Care Association for their work to drastically reduce side rail use in the home.

Bed entrapment is a risk that many people don’t consider in healthcare. Although rare, a resident can get trapped between the mattress, bed components and side rails with alarming results. A resident’s neck, arm, head or chest can be lodged between the bed and the rails leading to asphyxiation, injury or even death. Bed rails are could also considered to be a type of environmental restraint, restricting a resident’s mobility, increasing their risk of injury or even receive care from nursing or personal support workers.

Starting in December 2014, conversations were revolving around bed entrapment and the use of side rails in resident beds in both Quality Council Meetings and Risk Management. Because those living with dementia have a decreased ability to process and navigate their environment, it is compromising to their safety. The team at Southampton initiated a review of their side rail use with every resident to identify if they are used as a personal assistive service device (PASD), or if they were being used out of habit.

By partnering with a pharmacist, medical director, attending physicians, the fall prevention committee, restorative care team and back care committee, an audit was conducted to assess all residents using a side rail. Communication started as early on as admission tours about the safety of bed side rails and the risks involved in having them in place. Further consultation and education with the Resident and Family Councils allowed for open discussions about bed side rail use. If the side rails were to stay in place as a PASD, there was to be a doctor’s order and care planning in place.

The results of all of this hard work has been recognized by the Ontario Long-Term Care Association (OLTCA) in this year’s Quality Awards for Innovation. Side rails and the risks associated with their use decreased from 100% in January 2015 to 24% in July 2016. Residents currently using side rails are for PASD only. There were no increases in falls from the bedside, residents were free to enter and exit from either side of their beds and enjoy a freedom of movement with no interference from side rails which also allows for a better quality of sleep. Unexpectedly, some residents were able to make their own beds, contributing to their sense of independence and normalcy.

Bed side care is improved which has promoted proper body mechanics for staff. A measurement of staff Muscular Skeletal Disorders decreased from 26.5% in 2014 to 21% in 2015.

Through the adoption of this best practice, the team was able to dispel the misguided belief that side rails are a safety device. It is the intention of the home to help promote the results and wide-spread adoption of this best practice to allow patients, in hospital or at home as well as residents in long-term care, to move and live free from unnecessary physical restraints.

Southampton Care Centre a Jarlette Health Services home is a CARF Accredited 88 bed long term care facility providing quality care to residents in Grey and Bruce Counties. We are located on the shore of Lake Huron in the retirement/tourist town of Southampton. We offer two short stay beds serving as respite and care giver relief. We also have four interim beds which alleviates hospital case loads and offers a more suitable placement for those waiting for long term care.

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