Bed making (open bed,closed bed,cardiac bed) basic procedure from nursing foundation

2. INDIRA GANDHI COLLEGE OF
NURSING
BED MAKING (OPEN, CLOSED, CARDIAC BED)
Presented by
Ms. Anshu Yadav

3. CONTENT
Today we will discuss about the –
o Terminology
o Introduction
o Definition
o Purposes
o General instructions
o Types of bed
o Principles of bed making
o Articles

4. CONT….
o Preliminary assessment
o Open bed and procedure
o Closed bed
o Cardiac bed
o Role of nurse after bed making
o Summary
o Conclusion
o Bibliography

5. TERMINOLOGY
Amputation – removal of limb or part of limb
Draught – current of air in the room
Stripping – removing of the clothes
Unwrinkled – without wrinkles
Dyspnea – difficulty in breathing
Hamper / linen trolley – holds dirty clothes
Counter pane / bedspread – it is a decorative
cover on a bed

6. CONT….
Damp duster – it is the removal of dust or dirt
Mitred corner – when two edges meet at 45
degree creating a 90 degree corner
Bed sore / pressure ulcer /decubitus ulcer –
ulceration of tissue due to long time bed
ridden
Air cushion – it is comfort device
Foot rest – support the foot

7. INTRODUCTION
Bed making is the technique of preparing
different type of bed in making comfortable
or his position suitable for a particular
condition.
Making a comfortable bed is the responsibility
of nurse.
Nurse should provide clean, dry, wrinkle-free
and comfortable beds to clients.

8. DEFINITION
“Preparing a bed that is comfortable and
suitable for a hospitalized client.”
“Bed making is a type of procedure in which a
bed prepared to receive a new client is an
unoccupied bed.”

9. PURPOSES
 To provide a clean and comfortable bed for
the client.
 To keep it ready for any emergency.
 To prevent bedsores.
 To reduce the risk of infection by maintaining
a clean environment.
 To promote cleanliness of the client.
 To economize the time , material and energy.
 To provide an effective nurse - client
relationship.

10. GENERAL INSTRUCTIONS
o Wash hand before and after procedure.
o Do not expose the client unnecessarily.
o Protect the client from draught.
o Do not mix clean linen with soiled linen.
o Maintain good body mechanism.
o Periodical sunning and airing of mattress to be
done.
o Avoid placing dirty linen on the floor.
o Make the bed smooth , firm and unwrinkled.

11. TYPES OF BED
1. Open bed / unoccupied bed
2. Closed bed
3. Occupied bed
4. Admission bed
5. Post – operative bed
6. Cardiac bed
7. Amputation bed / divided bed
8. Fracture bed
9. Therapeutic bed (renal bed , rheumatism bed ,
blanket bed)

12. PRINCIPLES
• Micro – organism are found everywhere on
the skin , articles by used the client and in the
environment.
• A safe and comfortable bed will ensure rest ,
sleep and prevent several complications.
• Good body mechanisms maintain the body
alignment and prevents fatigue.
• Systematic ways of functioning saves time ,
energy and material.

13. ARTICLES
A tray containing –
 -Duster – 02
 - gloves - 02
 -Bowel with disinfectant solution
 -Kidney tray / paper bag
 Chair stool to keep clean linen
 Hamper / linen trolley
 Counter pane (optional)

14. CONT.…
 Mattress with cover
 Bed sheets – 02(top and bottom)
 Draw sheet – 01
 Draw mackintosh – 01
 Pillow with cover – 01
 Blankets

15. PRELIMINARY ASSESSMENT
Check the doctor’s order for specific
Precautions regarding movements.
Assess the client ability for self care.
Assess the number of clean linen needed.
Assess the articles needed for the comfort of
the clients.
Preparation of the articles.
Preparing of the client and the units.

16. CLOSED BED
• It is an unoccupied bed / empty bed made to
receive the client and is fully covered with
counter pane to protect it from dust and dirt.
• On admission of the client , the closed bed is
converted into an open bed.
PURPOSE –
1) to keep the bed ready for occupancy.
2) to provide a neat and tidy appearance to the
unit.

17. OPEN BED
Open bed - Preparing a bed that is
comfortable and suitable for a client .
Purpose –
* to provide comfortable environment to the
client.

18. STRIPPING AND BED MAKING
PROCEDURE
Nursing Action Rationale
1) *Wash hands
*preparation of self
To prevent cross infection
2) Arrange all articles , don gloves Save time and energy
3) Remove the pillow and place it
on the seat of the chair with the
open end and away from the
entrance.
4) Remove the top linen –
- Loosen the top linen starting from
the head end and proceed to the
feet end.
Allows easy removal of
linen and prevent tearing
of sheet.

19. CONT….
-Remove the sheets one by one , by
folding them into six. Bring the lower third
over the middle third and fold the upper
third over the lower third . Fold at the
centre towards you, so that it falls in six.
-Shake gently , and place it over the back
of the chair if it is to be reused or put it in
the laundry bag.
-Remove the bedspread, blanket and top
sheet separately, holding the open end
towards the floor.
Saves the many
steps. Folding into
six prevents the
sheets from
dragging on the
floor when placed
on the chair stool.
Hospitals
equipments sent to
the laundry.
4) Fold the draw sheet. Bring opposite
end to the middle of the bed and the near
end over it and thus fold them into three.
Place it over chair.

20. CONT..
5) Roll the mackintosh and place it over
the chair.
Rubber sheets are not
folded.
6) Remove the bottom sheet folding it
into six.
7) Remove the mattress if soiled.
8) Turn the mattress if cotton.
9) Dust the mattress with a dry duster.
10) Clean all the surface of the furniture
using a damp duster dipped in antiseptic
solution.
Damp dusting prevents
the spread the dust.
11) Dust the higher cleaner areas first
and then the less area.

21. CONT….
12) Make the base of bed (bottom linen) on
one side of the bed –
•When placing the linen on the bed and when
tucking them under the mattress, face in the
direction of the work and move with the work
rather than twisting the body and
overreaching.
•When tucking the linen under the bed,
separate the feet slightly apart and flex the
knees instead of back.
•when placing the bottom sheet on the bed
begin at the foot end, tuck the head under the
mattress, Mitre the corner and tuck under the
sides as you return to the foot of the bed.
Facing the
direction of the
activity keeps
the muscles
group in proper
position and
the function
efficiently.

22. CONT.…
•Place the bottom sheet on the middle of the
mattress. Making sure that the central
longitudinal crease in the longitudinal axis of
the bed.
•Unfold it and spread it straight allowing 30
to 37 cm to tuck under the top of the
mattress and leaving just enough at the foot
end to tuck in.
•Tuck it securely the top in the near side
make a mitred corner. Tuck at the foot end,
secure the corner as before, tuck the sheet
along the sides.
•Place the mackintosh approximately 37 cm
from the head and tuck it along the sides.
Tucking at the head
end and sides of the
bed prevents
slipping of the
sheets and keeps
the bed firm.
Keeping the
mackintosh at the
middle of the bed.

23. CONT….
•Place the draw sheet over the
mackintosh, keeping it about 25 cm
from the top of the mattress.
•Go to the opposite side and tuck the
sheets in the same manner.
Draw sheet above the
mackintosh. Contact
with rubber sheet
produces discomfort in
the client.
13) Return to the side of the bed first
made. Place the top sheet with the
wrong side out. Unfold it with the top
edge even with the top of the
mattress.
14) Place the blanket over the top
sheet 15 to 20 cm below from the top
of the mattress.

24. CONT….
15) If the bedspread is used, place it
over with the outer side out.
16) Make the head end of the linen.
Cuff the bedspread under the
blanket and then bring the top sheet
over the spread as second cuff.
Make sure that it will reach upto
client.
•Gives a neat appearance to the
bed. Prevents scattering of the
linen when the client move on to
the bed.
•To convert it to a closed bed, the
top linen will be long enough to
cover the whole bed.
17) Tuck at the foot end all together
or separately any make mitre
corners allowing the sides to hand
free or tucked according to the
hospital routine.

25. CONT….
18) Put the pillow case on the pillow
and place the pillow at the head end,
the open end away from the entrance.
While putting on the pillow case the
pillow should not touch the nurses
uniform.
Prevents from cross-
infections.
20) Replace all articles.
21) Wash hands.
22) Documentation of the procedure. Helps in
communicating
between staff
members.

26. CARDIAC BED
INTRODUCTION -
A cardiac bed is used to help the client to
assume a sitting position which can afford him
greatest amount of comfort with least strain.
DEFINITION – “A bed is prepared for patient
with cardiac diseases.”

27. CONT….

28. PURPOSES
To relieve dyspnea.
To provide comfort with least strain.
To reduce load of heart in cardiac diseases.
To prepare for cardiac clients.

29. ARTICLES
 Articles for an open bed
 Additional pillows
 Back rest
 Cardiac table
 Air cushion
 Foot rest
 Knee pillow

30. PROCEDURE
*Make the bed as an open bed.
Provide privacy , if needed.
*place back rest at client back and
arrange pillows
Supports the client back.
*Keep the client in bed and cover
him properly.
*Place a pillow under the knees. Prevents slipping of the client.
*Arrange the pillows on either side
of the client below both the arms.

31. CONT….
*Place cardiac table in front of the
client and adjust with pillow.
Helps client to lean
forward
*ensure the client sitting
comfortably in the new position.
*wash hands and replace articles
Prevents from cross
infection.
*record the procedure and
observation made on the client in
the nurses notes.
Promotes communication
among staff.

32. ROLE OF NURSE AFTER BED MAKING
Nurse should check the bed is wrinkle free and
suitable for client.
Nurse should assess the client feel comfortable
or not.
Nurse should replace all articles.
Wash hands.
Nurse should documentation of the procedure
in nurses records.

33. SUMMARY
In today class we discussed about -
 Terminology
 Introduction
 Definition
 Purposes
 General instructions
 Types of bed
 principles of bed making
 Preliminary assessment
 Articles
 Procedure
 Role of nurse after bed making

34. CONCLUSION
The class is able to understand about topic -
bed making (open, closed, cardiac bed
making) and able to follow the procedure as
demonstrated for bed making.

35. BIBLIOGRAPHY
1. Jacob annamma . Etc . clinical nursing procedure – the art
of nursing practice. 3rd ed ;Jaypee brothers publication. Pp –
65, 76.
2. Nancy sr. principles and practice of nursing – nursing art
procedure. 4th ed. Vol 1: indore road; NR publishing house.
Pp – 149 to 155.
3. Chawla satish. Fundamentals of nursing- A procedure
manual published by TNAI: pp – 149 to 152.
4. Kurian Saumya. A textbook of nursing foundations. 1st ed.
2019: medical book publisher. Pp – 248.
5. DEBR. Textbook of nursing foundation. 1st ed. Bangalore ;
EMMESS medical publisher. Pp – 162.