Validating an assessment tool
VOL: 103, ISSUE: 20, PAGE NO: 30-31 Margaret Goodman, MSc, MA, BA, Dip N, FETCert, RGN; Judith Smith, BSc, Dip Specialist Practice, RGN, ONC; Mollie Gilchrist, MSc, MA, PGCE, BA; Leanne Buck, RGN Margaret Goodman is senior lecturer and research facilitator in practice; Judith Smith is practice facilitator; both at Coventry University and University Hospitals Coventry and Warwickshire NHS Trust; Mollie Gilchrist is principal lecturer, Coventry University; Leanne Buck is ward manager, Rugby St Cross Hospital, University Hospitals Coventry and Warwickshire NHS Trust. et al (2007) Developing and validating a risk assessment tool for using bedrails.
The study consisted of three stages: training in the use of the tool and applying it to patient scenarios; three separate patient assessments using professional judgement, an experienced CBRU tool user and a novice one; and assessment using the modified tool by an experienced and novice CBRU user.
The MHRA (2006) suggested that most of the risks associated with the use of bedrails can be avoided if thorough risk assessments are carried out.
Nevertheless, guidance as to what should be included in such an assessment tends to be broad and appears to be largely dependent on professional judgement and experience.
Conclusion: The tool should be implemented in adult inpatient areas with an education programme about the risks of inappropriate bedrail use, followed by an audit.
Further research on its use in other clinical areas should be carried out.
Audit evidence suggests that nurses and other healthcare practitioners pull up bedrails when they are fitted to a bed without really considering whether or not they are needed (Govier and Kingdom, 2000).
Research evidence, however, indicates that instead of preventing injuries to patients, bedrails are actually responsible for causing injury and even death (Parker and Miles, 1997; Gray and Gaskell, 1990).
Raising the rail on a bed increases the height from which a patient can fall by a minimum of 18 inches.In assessing the risk associated with the use of bedrails, the primary aim is to decide whether they are actually required.Such decisions will include an assessment of the likelihood of a patient falling from his/her bed; a determination of whether using bedrails is the most appropriate solution to prevent a fall from bed; and suitability of bedrail use in relation to risk of injury from either falling or the rails themselves.It also led to a noticeable decrease in the use of bedrails and number of incidents resulting from their inappropriate use.After numerous modifications, the assessment tool became the Coventry Bed Rails Use (CBRU) tool, and this article describes the validation study.