DOH Issues Guidance on Entrapment

DOH has issued DAL NH 15-05 Entrapment Risk with Bed Systems and Components, warning of the need to evaluate the risk of entrapment with bed rails and enabler bars on all beds in your nursing home. The issuance of the guidance coincides with the citing of a facility at the Immediate Jeoapardy (IJ) level when it was discovered  that the facility's new replacement beds had gaps that were larger than what is recommended in the Federal Drug Administration (FDA) document "Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment" issued on March 10, 2006. These gaps created a distinct possibility of entrapment.

The DAL advises that while new bed systems need to be assessed for safety to assure components are compatible and installed correctly, it is equally important to assess bed systems already in use. Wear and tear can compromise the integrity and function of bed components, rendering them potentially unsafe. Over time, mattresses become soft and compressed and side rails and enablers can become loose, wobbly, and improperly positioned.

The DAL emphasizes that the facility remains attentive to prevent negative resident outcomes associated with entrapment and that ALL staff should be aware of the facility's systems, policies and procedures for identifying, managing, preventing, and responding to entrapment risk. It recommends posting the DAL at all nursing stations and staff rooms.

Contact:  Elliott Frost, efrost@leadingageny.org, 518-867-8832