Inpatient falls are the most commonly reported incidents in hospitals, yet they are largely avoidable and, therefore, an unsolved issue in patient care. It comes as no surprise that patient falls tend to occur most frequently in patient rooms, patient bathrooms, and hallways—the places in which patients spend the majority of their time during their hospital stay. Falls are attributed to breakdowns in communication between patients and caregivers, inadequate assistance, and also the design of the physical environment. In this article, the authors hone in on the potential benefits of changing handrail and grab-bar design guidelines to help reduce patient falls. They assert that current guidelines are not necessarily based in empirical research, and that research is needed to determine precise recommendations for optimal handrail and grab-bar configurations.
The goal of this article was to discuss current handrail and grab-bar guidelines in acute care settings and propose that changes be made to the guidelines to better suit the diverse needs of hospital inpatients as well as community-living people.
The authors propose that changes be made to handrail and grab-bar guidelines in hospital settings, with considerations for nonhealthcare settings as well. They mention that their recommendations in this article are based on previous observations, some preliminary studies involving patient surveys, and interviews of nursing staff, and also by referencing building codes in the Americans With Disabilities Act: Accessibility Guidelines for Buildings and Facilities. In particular, they suggest installing high-low horizontal grab bars or handrails on every part of patient room walls, walls of bathrooms located in patient rooms, and in hallways typically used by patients. High-low horizontal grab bars include two bars at two horizontal heights to accommodate patients with different body dimensions. Horizontal bars are recommended to help patients grasp the bar and push themselves up if needed. The authors stress that having these bars all along the walls will enable patients to travel autonomously from their bed to the bathroom or hallway with continuous assistance.
While the authors propose specific revisions to current handrail and grab-bar guidelines, asserting that current guidelines are not backed by empirical research, the recommendations in this article are also not based on a particular empirical research study. More research is needed to define specific requirements for handrails and grab bars in healthcare and nonhealthcare settings.