Failure to Use Siderails: When is it Negligence?

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Abstract
Nurses frequently wonder about the legal aspects of using siderails to prevent patient falls from bed. Questions arise as to when siderails are clinically indicated; whether a patient may refuse the use of siderails; whether, when a patient does fall from bed, the fall resulted from negligent failure to use siderails; and whether a decision to use siderails is a medical or nursing judgment. This article examines the legal issues involved in the use of siderails and provides some recommendations for the use of siderails and other restraints. Liability for a patient's fall from bed is imposed according to the general principles of the law of negligence—when the patient-plaintiff can demonstrate that a particular act or omission on the part of the defendant (usually the hospital, through its nursing staff) did not conform to the accepted standard of care, and that this deviation resulted in harm to the patient.

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