Instruction on Bedside Rails

Hospital beds shall be maintained in a safe and operational status

Safety Rails – are designed to help prevent people rolling out of bed accidentally. They usually have bars which run across and between the bed and the mattress for greater security. Also included are alternatives to conventional rigid rail systems

  1. It is essential that bed rails are suitable for the patient who is using them and compatible with the particular beds being used. Bed rails should never be used to restrain the user.
  2. If the user is likely to attempt to climb over the rails and thus fall from an even greater height, it may be worth considering placing a suitable mattress directly onto the floor to care for the patient at this level. Caring for someone at floor level can be problematic, but in certain cases it provides a safer and more dignified solution.
  3. Side rails can pose a risk of serious injury, for example if part of the body gets trapped between them. Thus it is essential that care is taken when selecting, positioning and adjusting the rails and also when choosing or changing the type of mattress to be used in a bed with rails so as not to put the user at risk.


  1. Beds
    1. Electric beds shall be maintained and tested by the Engineering & Maintenance Department for proper ground and defects.
    2. All patient beds are provided with side rails.
    3. Electrically operated beds should not have excessively long cords, which create tripping hazards and are subject to pinching by the bed mechanism.
  2. Side rails shall routinely be up for the following:
    1. At night when patient is settled for sleep.
    2. For post operative patients, until patient is completely reactive and responsible
    3. After administration of analgesic or hypnotic drugs.
    4. Any disoriented or restless patient
  3. The maximum or equivalent allowed gap between the side rails for adults and children’s must be addressed.
  4. Care should be taken that people do not injure themselves on hard metal frames and that heads or limbs do no become trapped by them. Limbs, for example, can be trapped in large spaces between bars, in the gap between the end of rail and headboard, between the mattress and lowest rail of the device or in the gap as a result of the weight of a patient compressing the mattress. Profiling beds need checking for dangerous gaps in all positions.
  5. Some bed rails are provided with net sides to reduce the risk of impact injury. Some companies supply padding to go over rails. Do not assume the netting or padding will reduce the risk of being trapped. Also, some covers are not air-permeable and may present a risk of suffocation.