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

The Joint Commission (2005) suggested several environmental strategies related to bed height, mattresses, and support devices, including: (1) the use of adjustable-height, high-low beds or fixed low-deck-height beds where applicable; (2) when feasible, keeping beds in their lowest position and providing mattresses firm enough to support safe bed transfers; and (3) providing a bed footboard to help patients as they transfer in and out of bed. Rather than using bedrails, JCAHO recommends that hospitals use adjustable beds that can be raised and lowered to enable patients to easily get in and out of beds and for staff to assist in this process. Regarding the styles of patient beds selected, the control panel for adjusting the overall height of the bed frame should be reachable by a patient who is lying on the bed. Build and maintain a facility and institute policies to provide care under safe conditions. Use low beds (about six inches from the floor to the mattress surface) with patients who are at high risk for falls, particularly geriatric patients in areas such as transitional care units. Consider specifying hospital beds that go into a “chair” position are available, allowing patients to be passively moved into a sitting position. To prevent fall-related injuries effectively, the bed height (frame and mattress) should be no higher than the average knee height for a female (19.5 inches).