NCM 103A Bed Making Procedure PDF

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NCM 103A FUNDAMENTALS OF NURSING Bed Making BED MAKING Bed making is a procedure, which enables the nurse to make the bed. Bed making procedure in nursing is a fundamental of nursing work. The systematic procedures followed in bed-making are as follows : • The uniform of nursing staff should not touch the bed while making a bed. • Soiled linens should not be thrown on floor. • First lift the mattress while loosening the bed-linen or removing the sheets. The sheets should not be pulled forcefully. • The bed linens should be folded from top to bottom or side to side. This applies to fold the mattress also while making one unoccupied bed. • As self precaution while tucking bedding under mattress, the palm of the hand should face downwards to prevent injury of nails. • The open end of the pillow should not face to the entrance of ward. • The beds should be in one line for better look. Bed making is one of the important nursing techniques to prepare various types of bed for patients or clients to ensure comfort and useful position for a particular condition. The bed is especially important for patients who are sick. The nurse plays inevitable role to ensure comfort and cleanliness for ill patient. It should be adaptable to various positions as per patient’s need because they spend varying amount of the day in bed. Purposes of Bed Making: Bed-making is a nursing art. The purpose of the bed-making should be patients or clients-centered. The main purposes of bed-making are to prevent complications by ensuring comfort and security to patient. 1. To provide rest and sleep. 2. To provide physical and psychological comfort and security to the patient. 3. To give the unit neat appearance and helps the bed & patient’s unit look tidy. 4. To establish an effective nurse patients relationship. 5. To provide active and passive exercise to the patient. 6. To promote fresh and cleanliness. 7. To develop skill in the posture/body alignment of the nurse in bed-making. 8. To observe, identify and prevent patient’s complications. 9. To accommodate the patient’s needs. 10. To reduce patient’s exertion by bed-making. 11. To eliminate irritants to skin from patient’s body , removes the dirt & germs from patient’s bed. 12. To dispose soiled and dirty linen properly. 13. Another purpose of bed-making is to save time, effort and material properly. 14. Enhances the esthetic looks of the patient’s unit. A. On changing an unoccupied bed – to promote the client's comfort – to provide a clean near environment for the client – to provide a smooth, wrinkle-free bed foundation, thus minimizing sources of skin irritation B. On changing an occupied bed – to conserve the client's energy and maintain current healthy status – to promote the client's comfort – to provide a clean near environment for the client – to provide a smooth, wrinkle-free bed foundation, thus minimizing sources of skin irritation IMPORTANCE OF BEDMAKING 1. It helps maintain a clean, orderly and comfortable room which contributes to the patients sense of well-being.

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NCM 103A FUNDAMENTALS OF NURSING Bed Making 2. Helps the patient secure proper rest and comfort which are essential for health and refresh him/her by providing cleanliness 3. It helps prevent or avoid microorganisms to come in contact with the patient which could cause tribulations. 4. It minimizes the sources of skin irritation by providing smooth, wrinkle-free bed foundation. Types of Beds: Nursing staff make different types of bed according to patient condition those are listed below: 1. Simple bed or unoccupied bed. • Close bed (Admission bed), • Open bed, 2. Occupied bed, 3. Cardiac bed, 4. Fowler’s bed, 5. Fracture bed, 6. Operation bed. Principles involved in Bed Making: Skillful bed making contributes patients comfort. Some basic principles of bed-making are pointed below 1. It is important to learn that how to make a bed in such a way where least amount of energy and time is required. 2. During bed-making, use good body movement and make each step purposeful. 3. Keep everything ready on bed side before starting bed-making. 4. Change bed linen frequently to assure cleanliness. 5. To ensure the patient need by providing a safe and comfortable bed. 6. It should have a finished appearance. 7. To make bed tight and free from wrinkles, place all linen straight line on the bed. 8. Prevent complications of prolonged bed ridden patient such as pressure sore. 9. Soiled linen or linen whether clean or dirty should not be thrown on the floor, but it is should be kept in a dirty linen box. 10. After cleaning bed, dump soap water and disinfectant properly. 11. Try to prevent cross infection of microorganism during bed-making. 12. Ensure all bed-making in a nursing unit alike for uniformity of appearance. Clean to unclean Simple to complex Principles of body mechanics Principles of anatomy & physiology Principles of microbiology PRECAUTIONS TO BE TAKEN DURING BED MAKING: 1. The uniform of the nurse should not touch the bed while making a bed. 2. Soiled linen should not be thrown on floor. 3. First lift the mattress while loosening the bed linen or removing the sheets. The sheets should not be pulled forcefully. 4. The bed linen should be folded from top to bottom or side-to-side. This applies to fold the mattress also while making one unoccupied bed. 5. As self-precaution while tucking bedding under mattress, the palm of the hand should face downwards to prevent injury of nails. 6. The open end of the pillow should not face to the entrance of ward. 7. The beds should be in one line for better look.

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NCM 103A FUNDAMENTALS OF NURSING Bed Making REMEMBER DURING BED MAKING IN HOSPITAL: During bed-making we should remember some knowledge those are useful for us and also to patient. 1. During bed-making, bed position keep elevated and ensures nursing staff’s good body alignments 2. During the procedure, the nurse should study her movements so as to avoid waste of time and energy. 3. After completing, bed should be lower position. 4. During occupied bed making, confirm patient safety and comfort. 5. Wash hands before and after bed making and use gloves during bed-making. 6. Maintain privacy while making bed. 7. Keep soiled linen away from uniform which may have germs. 8. Do not shake dirty linen to prevent germs spread around room. 9. Do not mix soiled and clean linen during bed-making. 10. For bed ridden patient, mattress must be turned air and ensure free of lumps and fold. DEFINITION OF TERMS 1.1 Bed making – the ability of the nurse to keep the bed clean and comfortable – the technique of preparing different types of bed in making patients/clients comfortable in his/her suitable position for a particular condition – it requires keen inspection to be sure that the linens are clean, dry and wrinkle-free 1.2 Fanfold – is done by grasping the upper edge of the linen with both hands – specifically folding the edge of the sheet used in the bed 6-8 inches outward 1.3 Mitered corner – a means of anchoring sheets on mattresses – method of folding the bed clothes at the corners to secure them in place while the bed is occupied – it is accomplished on the bottom sheet by placing the end of the sheet evenly under the mattress – folding the bedding at the corners when making a bed so that the sheet is tightly stretched with no wrinkles. 1.4 Toe pleat – a fold made in the top bed clothes to provide additional space for patient’s toes 1.5 Foot drop – dropping of the foot from paralysis of the anterior muscle of the leg – plantar flexion of the foot with permanent contracture of the gastrocnemius (calf) muscle and tendon 1.6 Bed cradle – is a curved, semi-circular device made of metal that can be placed over a portion of the patient’s body – is sometimes called an Anderson frame, is a device designed to keep the top bedclothes off the feet, legs, and even abdomen of a client 1.7 Magic corner – corners of a folded linen when upon opening it automatically positions the sheets the way it is placed on the bed RELATED TERMINOLOGIES “Top of the bed” – refers to the top sheet, the blanket & the bedspread. “Bottom of the bed” – refers to the mattress pad, if used; the bottom sheet & the draw sheets. Draw sheet – small sheet made of plastic, rubber, or cotton placed across the middle of the bed to cover & protect the bottom sheet & assist in moving the client. Decubitus ulcer (bedsore) – open wound which occurs from lack of blood supply to an area usually located on a bony prominence. Seam – a line where 2 pieces of cloth have been sewn together. 3

NCM 103A FUNDAMENTALS OF NURSING Bed Making Seamless – done or made so that you do not notice where part ends & another part begins. TYPES OF BED Bed - is primarily divided into 3 sections - length: 1.9m (6.5ft). - weight: 0.9m (3ft.) - high: 66cm (26in.) - but sometimes varies depending on circumstances A. Common Types of Bed 1. Occupied bed the occupied bed is made when the patient is not able or not permitted to get out of the bed the important part of making an occupied bed is to get the sheets smooth and tight under the patient so that there will be no wrinkles to rub against the patient’s skin the client’s privacy, comfort and safety is also important when making the bed 2. Unoccupied bed • the unoccupied bed is made when there is no patient confined in bed • A unoccupied bed may be: A. Open bed – the top covers are generally folded back so that a client can easily get into bed – surgical, recovery and postoperative bed is a modified version of the open bed; the top bed line is arranged for easy transfer of the client from a stretcher to the bed – the top sheets are folded to one side or fanfolded to the bottom third of the bed B. Close bed – the top sheet blankets and bedspreads are drawn up to the head of the mattress and under the pillows, this is prepared in a hospital room before a new client is admitted to that room C. Cradle Bed – Contains cradle, a device for holding the top covers off. – The outer cradle is made of wood, metal or at home for a brief period, a cardboard art to shape. D. Postoperative Bed – Also known as recovery bed or anesthetic bed. – Used not only for clients who have undergone surgical procedures but also for clients who have given anesthetics for a certain examination. – Used for a patient with a large cast or other circumstance that would make it difficult for him to transfer easily into bed. B. Special Types of Beds 1. Water bed Special mattress filled with water. It controls temperature of water reducing pressure on body parts. Indications: Patients confined to bed for long periods 2. Turning Frames (Stryker Wedge) – It allows repeated changes between the supine and prone positions without disturbing spinal alignment. – Indications: complication of immobility such as atelectasis, pneumonia, decubitus ulcer and renal calculi. 3. Rotation Bed – promote postural drainage, peristalsis and helps prevent the complications of mobility – Indication: patients with spinal cord injury, severe burns 4

NCM 103A FUNDAMENTALS OF NURSING Bed Making 4. Circolectric Bed – Permits frequent turning of several injured or immobilized patient with minimal trauma or extraneous movement. – Helps prevent and treat pressure ulcers, respiratory and circulatory complications – Indications: Patients confined to bed for long periods of time 5. Clinton Therapy Bed – Also called the air-fluidized bed – Designed for managing burns and patients with various disabilities. – Indications: Patients with managing burns and patients with various disabilities. 6. Air Therapy Bed – For patients who have risk skin breakdown – Provide different levels of support to different body parts. – Indications Patients who are at risk to skin breakdown • COMMON BED POSITIONS ➢ Contour Head section is elevated; the knee and foot section are elevated. ➢ Indications: used for certain injuries or disease of the lower extremities. PRINCIPLES IN BEDMAKING • BODY MECHANICS it is important to the nurse to observe the correct body mechanics in order to prevent quick tiring, back problems and muscle pain. • ANATOMY & PHYSIOLOGY the conscious knowledge of the normal state and condition of certain parts of the body wherein one would be able to tell any abnormality. the body exerts uneven points of pressure against different areas of the mattress. The sacrum may become the site for pre-assure sore because of the weight of the patient’s body and a reduced blood supply to the tissues over bony prominence. • CHEMISTRY woolen blanket fibers may cause irritation to the patient’s skin; there must always be a sheet to separate the blanket from the patient strong detergent, soap and bleaches used in commercial laundries may cause skin irritation if bed linens are not thoroughly rinsed • MICROBIOLOGY pathogenic microorganism may be transferred from the source to a new host directly by contaminated linen. Hands should be washed before and after making bed. bed linen should be folded away from the body to minimize the transfer microorganism to the clothing fanning bed clothing stirs up bacteria in the air, and air motion is a method of transfer. • PHYSICS friction can irritate the skin and cause rashes. It is therefore appropriate to keep the lines smooth and wrinkle-free. stability of body (center of gravity over its base) • PSYCHOLOGY use skill and efficiency in making the bed to minimize undue exertion and fatigue for the patient. If the procedure brings comfort and relaxation, his attitude will improve. • SOCIOLOGY the nurse should know how to talk to patients. The nurse should also know the subject of conversation which interests the patient including his condition, family, and work. KINDS OF LINENS 1. Blanket 5

NCM 103A FUNDAMENTALS OF NURSING Bed Making a large piece of cloth often soft, woolen and is used for warmth as a bed cover 2. Top sheet used to cover the patient to provide warmth, made of thick cotton, thermal material 3. Cotton drawn sheet a piece of cloth that covers the rubber sheet and is used to absorb and protect moisture 4. Bottom sheet used to cover the bed after mattress cover 5. Rubber sheet • used to protect the bottom sheet from soothing due to patient secretions and prevent the patients from getting bedsore. It is usually placed over the center of the bottom sheet 6. Mattress cover • a piece of cloth to cover the mattress 7. Woolen blanket • a large rectangle piece of cloth of soft fabric often either bound edges used especially for warmth as a bed covering. It should be light, warm and large enough to cover the shoulder and to tuck in well at the foot and to extend over sides. GUIDELINES IN BEDMAKING 1. Wash hands thoroughly after handling client’s bed linen. 2. Hold soiled linens away from the body. 3. Linen for one client is never placed on another client’s bed. 4. Soiled linen is placed directly in a portable linen hamper or tucked into a pillow case at the end of the bed before it is gathered up for disposal in the linen hamper or in linen chute. Pillowcase is then tied and labeled with: name, room number, communicable/noncommunicable 5. Soiled linen is never shaken in air. 6. When stripping and making a bed, conserve time and energy by stripping and making up one side as completely as possible before working on the other side. 7. Gather all needed linen before starting to strip the bed. 8. Keep the patient’s environment as clean and as neat as possible. BEGINNING SKILLS IN BEDMAKING A. STRIPPING THE BED Removal of used linen and the airing of the mattress. Procedure: 1. Place chair at the foot of the bed. 2. Remove pillow case from pillow. Place pillow on chair. Place soiled pillow case on lower bar of the bed. 3. Loosen all bed linens starting at center of head of bed, raising the mattress with one hand and drawing out bed clothes with other. 4. Remove sheets separately. Fold each linen with soiled part inside. Wrap them all in a sheet and place on lower bar of the bed. 5. Roll rubber sheet and place on chair. 6. Remove mattress cover. 7. Arranging clean bed linens on patient’s bed ready for admission. Equipment: a. mattress cover e. top sheet b. bottom sheet f. pillow cases - 2 c. rubber sheet g. blanket d. cotton draw sheet Procedure: 1. Refold each sheet according to its system of use. 2. Place clean linens on chair in order of use. See to it that the bed is flat. 3. Cover mattress. 4. Place bottom sheet with center fold in center in line with rim of mattress at foot part. Spread across bed. Make mitered corner of head part. Tuck extra sheet at side from head to foot. 6

NCM 103A FUNDAMENTALS OF NURSING Bed Making 5. Put rubber sheet 12-15 inches from the head of mattress. Cover with drawsheet. Spread across bed. Tuck together extra length. 6. Place topsheet in line with mattress at head part and spread across bed. Tuck extra length of sheet at foot part. Miter corners. Allow to hang free at sides. 7. Go to opposite side and repeat same procedure. 8. Put pillow case on pillow. To put on, grasp middle of slip’s bottom. Flip open and grasp short side of pillow. Pull pillow slip over body of pillow. 9. Spread top sheet over pillow. 10. Pull folds of clean sheets into place. Tuck bottom sheet at head part and miter at the side. 11. Tighten rubber sheet and draw sheet. Tuck together with bottom sheet. 12. Help patient to roll on his back at center of bed. 13. Place clean fanfolded sheet over patient. Cover shoulders. Draw fanfolded sheet together with used top sheet at foot part. 14. Tuck clean top sheet at foot part. Miter corner. 15. Fit pillow into pillow case. 16. Fold dirty linens separately. Wrap in one sheet. 17. Carry soiled linens to laundry. Making an Unoccupied Bed Safety • Follow infection control guidelines, because bed making increases the risk of exposure to— and transmission of—microorganisms. Be sure to wear clean gloves to remove soiled linen. Hold soiled linen away from your uniform, and avoid shaking or fanning it. • Use proper body mechanics when making a bed. • Assess the environment for safety; check the room for spills, make sure equipment is working properly, and ensure that the bed is in the locked, low position. • Remember to lower the side rails when preparing to make the bed. • Check the position of the chair for transfer. Equipment List for Making an Unoccupied Bed • Linen bag or hamper • Mattress pad (optional, change only when soiled) • Bottom sheet (flat or fitted) • Top sheet • Drawsheet (optional) • Large, quilted waterproof pads • Bath blanket • Bedspread • Pillowcases • Bedside chair or table • Clean gloves • Washcloth • Towel • Antiseptic cleanser Delegation The skill of making an unoccupied bed can be delegated to nursing assistive personnel (NAP). Before delegating, be sure to inform the NAP of the following: • Any position or activity restrictions that affect the patient’s ability to get out of bed. • Any special linen instructions if the patient is on an airflow mattress. • Specify that Standard Precautions are to be used when making an unoccupied bed. Preparation • Gather all needed equipment and supplies • Wear gloves when removing soiled linen. 7...