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Recently informed side rails are considered a restraint - I would think they are considered a safety item to prevent falls for clients who are not alert and oriented.

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Get clarification from your state what the regulation says about
" restraints"; your perception of side rails is one many have; but in many places bed rails are included in the definition of " restraints". A Licensed Social Worker or administrative staff at facility should be able to direct you to document that explains this.
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ahcentrainj0312: They are typically not allowed due to strong possibility that the patient may attempt to climb over the rails, causing injury to the person.
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I'm in MA, but in my mother's facility, they use mattresses with raised perimeters which makes it difficult to get out of bed. Like this one: https://store.directsupply.com/Product/panacea-prime-plus-foam-mattress-raised-perimeters-6-h-width-35-length-76-4813631?quantity=1&

My mother's roommate is a major fall and wander risk so they use that kind of mattress but she's also lowered all the way to the ground when she goes to bed.
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I live in NJ and they are not allowed. My DD works in Del and they are not allowed.
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I found this:
copy and paste into your search engine:

N.J.A.C. 10:42 Title 10, Chapter 42 - NJ.gov
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In my state (MN) they are not allowed. If there is concern for someone falling out of bed, have the facility put the mattress on the floor, or provide a concave mattress (which is much harder to get up and out of).
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People have been known to try to climb over the rails.
Legs and or arms can become trapped.
There are other ways to keep a person in bed safe.
Lowering the bed as low as possible and placing a pad next to the bed makes it safer if the person does try to get out of bed. With the mattress as low as possible it makes it more difficult to get out of bed.
Placing wedges or bolsters at the edge of the bed can help prevent someone from getting out of bed.
Pool noodles can be used under the sheet to create an edge that might prevent someone from rolling out of bed. It also makes it a bit more difficult to get out if you have to scoot over the lump.
If possible placing one side of the bed against a wall cuts down the number of "exits" off the bed.
Bed alarms are also used in some cases but they can go off easily so they often get ignored and that defeats the purpose.

I have to add this...
Falls WILL happen. It is not a matter of IF but WHEN
They can happen with a caregiver right at the side or the person.
The easiest thing to do is to learn how to help a person "fall" safely to the floor.
Gait belts also help and make it safer for the caregiver.
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