Rest and sleep are important for healing and optimal health. When making a patient's bed, it is essential for nurses to keep the bed as clean and comfortable as possible to promote both physical and psychological comfort. The nursing process involves assessing the patient's usual sleep patterns, developing a nursing diagnosis if needed, planning interventions like sleep aids, implementing a regular routine to aid sleep, and evaluating the effectiveness of interventions through monitoring nighttime sleep. Proper bed making requires attention to infection control, body mechanics, and patient safety and comfort.

1. Rest and SleepRest and Sleep
Bed MakingBed Making
Skill and RationalSkill and Rational

2. Why is it so important?Why is it so important?
The bed is particularly important to people who are ill.The bed is particularly important to people who are ill.
It is essential the nurse keep the bed as clean andIt is essential the nurse keep the bed as clean and
comfortable as possible.comfortable as possible.
Physical ComfortPhysical Comfort
Psychological comfortPsychological comfort

3. Rest and SleepRest and Sleep
• Healing and Optimal HealthHealing and Optimal Health
• Promoting SleepPromoting Sleep

4. Nursing ProcessNursing Process
• AssessmentAssessment
– Usual pattern of rest/sleepUsual pattern of rest/sleep
– bed routinesbed routines
• Nursing diagnosisNursing diagnosis
– Sleep pattern disturbanceSleep pattern disturbance
• PlanPlan
– Sleep aidsSleep aids

5. Nursing processNursing process
• ImplementaionImplementaion
– Regular habitsRegular habits
– Nutrition/exerciseNutrition/exercise
– Quiet time prior to sleepQuiet time prior to sleep
– Warm milkWarm milk
– Sleep/wake cycleSleep/wake cycle
– Back rubBack rub
– Comfortable bedComfortable bed

6. Nursing ProcessNursing Process
• EvaluationEvaluation
– Good night sleepGood night sleep

7. Promoting Rest and SleepPromoting Rest and Sleep
• Rest periodRest period
• Nonessential tasksNonessential tasks
• Night time/early am bathingNight time/early am bathing
• Lab workLab work
• Cluster activityCluster activity
• Visitor controlVisitor control
• Interventions prnInterventions prn

8. Comfort Measures for PromotingComfort Measures for Promoting
SleepSleep
♥Administer hygiene measures for clients onAdminister hygiene measures for clients on
bedrestbedrest
♥Loose fitting nightwearLoose fitting nightwear
♥Remove or change any irritants against theRemove or change any irritants against the
client’s skin (moist dsg., drainage tubes)client’s skin (moist dsg., drainage tubes)
♥Position and support dependent body parts toPosition and support dependent body parts to
protect pressure points and aid muscle relaxationprotect pressure points and aid muscle relaxation

9. Comfort Measures for PromotingComfort Measures for Promoting
SleepSleep
♥Provide caps and socks for older clients andProvide caps and socks for older clients and
those prone to coldthose prone to cold
♥Void before bedtimeVoid before bedtime
♥Analgesics or sedatives 30 min. prior H.S.Analgesics or sedatives 30 min. prior H.S.
♥Bedtime massage/backrubBedtime massage/backrub
♥Comfortable mattress and a clean dry bed!Comfortable mattress and a clean dry bed!

10. Noisy NightshiftNoisy Nightshift
• Close doors to clients’rooms/work areas ifClose doors to clients’rooms/work areas if
possiblepossible
• Telephone/paging equipmentTelephone/paging equipment
• Noisy footwearNoisy footwear
• EquipmentEquipment
• Bedside monitorsBedside monitors
• TV/radioTV/radio
• ConversationsConversations

11. Client’s EnvironmentClient’s Environment
• ChairsChairs
– Straight back post surgeryStraight back post surgery
– Lounge chairLounge chair
• LightingLighting
– OverbedOverbed
– Night lightNight light
– Call lightCall light
• Overbed tableOverbed table
• Bedside tableBedside table

12. Special MattressesSpecial Mattresses
TypesTypes
Regular firm, plastic coveredRegular firm, plastic covered
Mattresses used to prevent & treat decubitusMattresses used to prevent & treat decubitus
ulcersulcers
KCI bedsKCI beds
EggcrateEggcrate
SheepskinSheepskin

13. Special mattresses are not a substitute forSpecial mattresses are not a substitute for
nursing carenursing care
• Turn patients Q2hTurn patients Q2h
• Skin careSkin care
• positioningpositioning

14. ConsiderationsConsiderations
• Bed positionBed position
– SafetySafety
– Body mechanicsBody mechanics
– GatchsGatchs
• Infection controlInfection control
• Skin breakdownSkin breakdown
–

15. The bed changing processThe bed changing process
• Every health care agency wants the end productEvery health care agency wants the end product
to be neat, clean, comfortable and durable.to be neat, clean, comfortable and durable.
• EconomicalEconomical
– TimeTime
– EquipmentEquipment
– Energy, patients and nursesEnergy, patients and nurses

16. Assembling EquipmentAssembling Equipment
• 2 sheets2 sheets
– Fitted/flat for bottomFitted/flat for bottom
– Flat for topFlat for top
• PillowcasesPillowcases
• Cotton/rubber drawsheet as neededCotton/rubber drawsheet as needed
• SoakerSoaker
• BedspreadBedspread
• BlanketBlanket

17. Linen OverloadLinen Overload
• Just what you needJust what you need
• Cost controlCost control
Once linen brought into a client’s room, if unused,Once linen brought into a client’s room, if unused,
must be discarded for launderingmust be discarded for laundering
Excess linen causes clutter and obstacles in aExcess linen causes clutter and obstacles in a
cramped spacecramped space

18. Rubber drawsheetRubber drawsheet
• Save on linenSave on linen
• TimeTime
• Turning and positioningTurning and positioning
• Placed under cotton drawsheetPlaced under cotton drawsheet
Drawsheet extends from above waist to midthigh.Drawsheet extends from above waist to midthigh.
Absorbs secretions due to urinary/fecalAbsorbs secretions due to urinary/fecal
incontinenceincontinence

19. Linen ChangeLinen Change
• As per hospital protocolAs per hospital protocol
– CostCost
– Pillow cases/drawsheet ODPillow cases/drawsheet OD
– Soiled or bath daySoiled or bath day
– Laundry shute/hamperLaundry shute/hamper
– If soiled with feces/bloodIf soiled with feces/blood
– Use of glovesUse of gloves

20. SkillSkill
Under no circumstances do you place dirtyUnder no circumstances do you place dirty
linen on floor, footstool, another patient’slinen on floor, footstool, another patient’s
bed or on over the bed tables.bed or on over the bed tables.
AssessmentAssessment
What needs to be changedWhat needs to be changed
Client’s conditionClient’s condition

21. When does the bed get changed?When does the bed get changed?
• Usually after client’s bathUsually after client’s bath
• Client is sitting in chairClient is sitting in chair
• Out of room for testsOut of room for tests
Check throughout day and straighten linen prnCheck throughout day and straighten linen prn
After meals, if eating in bed, check for foodAfter meals, if eating in bed, check for food
particlesparticles
Change linen that is soiled or wetChange linen that is soiled or wet

22. Effective Body Mechanics andEffective Body Mechanics and
Bed MakingBed Making
1.1. Maintain good body alignmentMaintain good body alignment
2.2. Use the large muscles of the bodyUse the large muscles of the body
3.3. Work smoothly and rhythmicallyWork smoothly and rhythmically
4.4. Push or pull rather than liftPush or pull rather than lift
5.5. Use your own weight to counteract the weightUse your own weight to counteract the weight
of an object.of an object.

23. Nursing DiagnosisNursing Diagnosis
• Activity intoleranceActivity intolerance
• Impaired physical conditionImpaired physical condition

24. Types of BedTypes of Bed
• OccupiedOccupied
• UnoccupiedUnoccupied
• Surgical/post-op bedsSurgical/post-op beds

25. Occupied BedOccupied Bed
• Gloves if drainageGloves if drainage
• Check chart/kardex for client’s activityCheck chart/kardex for client’s activity
• Talk to the client, explain procedureTalk to the client, explain procedure
• PrivacyPrivacy
• Assemble all equipment, incontinent pads prnAssemble all equipment, incontinent pads prn
• Safety with side rails/call bellSafety with side rails/call bell
• Wash hands before and afterWash hands before and after

26. PlanningPlanning
• Expected outcomesExpected outcomes
• Best time to change linenBest time to change linen
• Equipment neededEquipment needed

27. ImplementationImplementation
• Wash handsWash hands
• Gloves prnGloves prn
• EquipmentEquipment
• Adjust bed height-HOB downAdjust bed height-HOB down
• Lower side rail- remove call bellLower side rail- remove call bell
• Loosen linenLoosen linen
• Keep soiled linen away from uniformKeep soiled linen away from uniform

28. Infection Control andInfection Control and
Bed MakingBed Making
1.1. Microorganisms are present on the skin and inMicroorganisms are present on the skin and in
the general environment.the general environment.
2.2. Some microorganisms are opportunists; that is,Some microorganisms are opportunists; that is,
they can cause infections when conditions arethey can cause infections when conditions are
favorable ( break in skin, mucous membranes)favorable ( break in skin, mucous membranes)
3.3. Clients are often less resistant to infectionsClients are often less resistant to infections
because of the stress resulting from an existingbecause of the stress resulting from an existing
disease process.disease process.

29. Infection Control andInfection Control and
Bed MakingBed Making
4.4. Microorganisms may be transferred from oneMicroorganisms may be transferred from one
person to another or from one place toperson to another or from one place to
another by air, by inanimate objects or byanother by air, by inanimate objects or by
direct contact among people. Therefore:direct contact among people. Therefore:
 Avoid holding soiled linen against uniformAvoid holding soiled linen against uniform
 Never shake linenNever shake linen
 Always wash hands before going to anotherAlways wash hands before going to another
patient.patient.

30. Avoid shaking linen for infectionAvoid shaking linen for infection
control purposescontrol purposes
• Linen to be reusedLinen to be reused
– fold and place on chairfold and place on chair
• Soak and rinse linen soiled with feces or bloodSoak and rinse linen soiled with feces or blood
before placing in hamperbefore placing in hamper
• Make sure no tripads, personal articles orMake sure no tripads, personal articles or
anything besides linen is placed in hamperanything besides linen is placed in hamper

31. EvaluationEvaluation
• Inspect bedInspect bed
– CleanClean
– NeatNeat
– Wrinkle freeWrinkle free

32. Always be alert to client comfort andAlways be alert to client comfort and
safety during bedmaking.safety during bedmaking.
• When finished evaluateWhen finished evaluate
– Safety re bed positionSafety re bed position
– Call lightCall light
– Side railsSide rails
– Unit tidyUnit tidy
– Personal belongings are within reachPersonal belongings are within reach

33. AccessoriesAccessories
• Bed cradle/foot cradleBed cradle/foot cradle
• Fracture boardFracture board
• Foot boardFoot board
• Toe pleatToe pleat
Therapeutic Frames allow movement forTherapeutic Frames allow movement for
immobilized patients & help preventimmobilized patients & help prevent
complications R/T immobilitycomplications R/T immobility

34. RememberRemember
• To make bed, position is elevatedTo make bed, position is elevated
• When completed, bed is loweredWhen completed, bed is lowered
• If occupied, patient comfort & safetyIf occupied, patient comfort & safety
• Soiled linen away from uniformSoiled linen away from uniform
• Gloves prnGloves prn
• Bath before making bed if occupiedBath before making bed if occupied