Heights of occupied patient beds: a possible risk factor for inpatient falls

J Clin Nurs. 2008 Jun;17(11):1503-9. doi: 10.1111/j.1365-2702.2007.02086.x.

Abstract

Aims: The aim of this study was to ascertain the average height of occupied patient beds in a general medical ward and to investigate the relationship between staff working-height for patient beds, time and whether the patient was on fall precaution.

Background: The height of occupied patient beds can be an overlooked contributor to inpatient falls. Better physical design of hospital equipment such as patient beds may reduce patient falls and injuries.

Methods: This study took place in an acute medical ward of a Michigan medical center. One researcher collected all the data and used the same metric for all the measurements. Univariate analyses were performed.

Results: The average staff working-height measurement taken at the weekend was significantly higher than that taken on weekdays. The average height of patient beds on fall precaution was significantly higher than of those not on fall precaution.

Conclusions: A higher patient/nurse ratio at weekends than on weekdays may result in fewer bedside nursing hours and nurses being less conscientious about keeping beds in the low position after treatments. In an effort to prevent high-fall-risk patients from falling, nurses may have consciously or unconsciously kept their beds in higher positions. Relevance to clinical practice. If the patient bed can be manually or automatically adjusted, nurses must lower the height of the bed to the lowest position after completing treatments or tasks. This after-procedure activity should be enforced and monitored regularly as part of a hospital's patient fall prevention programme. Low beds should be used for patients at high risk of falling. Future research should investigate patients' and staff's views on hospital equipment to provide evidence-based information for policy-makers determining the design-regulation standard for hospital bedframes.

MeSH terms

  • Accidental Falls* / prevention & control
  • Accidental Falls* / statistics & numerical data
  • Analysis of Variance
  • Beds / adverse effects*
  • Body Height
  • Clinical Nursing Research
  • Electricity
  • Equipment Design
  • Equipment and Supplies, Hospital / adverse effects*
  • Female
  • Health Services Needs and Demand
  • Humans
  • Inpatients* / statistics & numerical data
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Nursing Staff, Hospital / organization & administration
  • Personnel Staffing and Scheduling / organization & administration
  • Restraint, Physical / statistics & numerical data
  • Risk Assessment
  • Risk Factors
  • Safety Management
  • Time Factors
  • Total Quality Management