Healey Frances, Oliver David, Milne Alisoun, Connelly James B
National Patient Safety Agency, 4-8 Maple Street, London W1 T 5HD, UK.
Age Ageing. 2008 Jul;37(4):368-78. doi: 10.1093/ageing/afn112. Epub 2008 May 20.
around one-fourth of all falls in healthcare settings are falls from bed. The role of bedrails in falls prevention is controversial, with a prevailing orthodoxy that bedrails are harmful and ineffective.
to summarise and critically evaluate evidence on the effect of bedrails on falls and injury
systematic literature review using the principles of QuoRoM guidance.
adult healthcare settings
using the keyword, bedrail, and synonyms, databases were searched from 1980 to June 2007 for direct injury from bedrails or where falls, injury from falls, or any other effects were related to bedrail use.
472 papers were located; 24 met the criteria. Three bedrail reduction studies identified significant increases in falls or multiple falls, and one found that despite a significant decrease in falls in the discontinue-bedrails group, this group remained significantly more likely to fall than the continue-bedrails group; one case-control study found patients who had their bedrails raised significantly less likely to fall; one retrospective survey identified a significantly lower rate of injury and head injury in falls with bedrails up. Twelve papers described direct injury from bedrails.
it is difficult to perform conventional clinical trials of an intervention already embedded in practice, and all included studies had methodological limitations. However, this review concludes that serious direct injury from bedrails is usually related to use of outmoded designs and incorrect assembly rather than being inherent, and bedrails do not appear to increase the risk of falls or injury from falls.
在医疗机构发生的所有跌倒事件中，约四分之一是从床上跌落。床栏在预防跌倒方面的作用存在争议，目前普遍的正统观念认为床栏有害且无效。
总结并批判性评价有关床栏对跌倒和伤害影响的证据。
采用QuoRoM指南原则进行系统的文献综述。
成人医疗环境。
使用关键词“床栏”及其同义词，检索1980年至2007年6月的数据库，以查找床栏导致的直接伤害，或跌倒、跌倒伤害或任何其他与使用床栏相关的影响。
共找到472篇论文；24篇符合标准。三项减少使用床栏的研究发现跌倒或多次跌倒显著增加，一项研究发现，尽管停用床栏组的跌倒次数显著减少，但该组跌倒的可能性仍显著高于继续使用床栏组；一项病例对照研究发现，将床栏升高的患者跌倒的可能性显著降低；一项回顾性调查发现，床栏竖起时跌倒导致的受伤和头部受伤发生率显著较低。十二篇论文描述了床栏造成的直接伤害。
对一种已在实践中应用的干预措施进行传统的临床试验很困难，且所有纳入研究都存在方法学上的局限性。然而，本综述得出结论，床栏造成的严重直接伤害通常与过时的设计和不正确的组装有关，而非其固有特性，而且床栏似乎不会增加跌倒或跌倒伤害的风险。
