Bed making-principles,purposes, articles, procedure & nurses responsibilities.

1. Prepared by:-
BINCY MATHEW

2.  Nurses need to be able to prepare hospital
beds in different ways for specific purposes.
In most instances, beds are made after the
client receives hygienic care and when beds
are unoccupied. At times, however, nurses
need to make an occupied bed or prepare a
bed for a client who is having surgery (an
anesthetic, postoperative, or surgical bed).
Regardless of what type of bed equipment is
available, whether the bed is occupied or
unoccupied, or the purpose for which the
bed is being prepared, certain practice
guidelines pertain to all bed-making.

3. ■ Wash hands thoroughly after handling a client’s bed linen. Linens
and equipment that have been soiled with secretions and
excretions harbor microorganisms that can be transmitted to
others directly or by the nurse’s hands or uniform.
■ Hold soiled linen away from uniform.
■ Linen for one client is never (even momentarily) placed on
another client’s bed.
■ Place soiled linen 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.
■ Do not shake soiled linen in the air because shaking can
disseminate secretions and excretions and the microorganisms
they contain.
■ When stripping and making a bed, conserve time and energy by
stripping and making up one side as much as possible before
working on the other side.
■ To avoid unnecessary trips to the linen supply area, gather all
linen before starting to strip a bed.

4.  Beds are often changed after bed baths. The
linen can be collected before the bath. The
linen is not usually changed unless it is
soiled. Check the policy at each clinical
agency. Unfitted sheets, blankets, and
bedspreads are mitered at the corners of the
bed. The purpose of mitering is to secure the
bedclothes while the bed is occupied.

5. PRINCIPLE 1 :- Micro organisms are found everywhere on the
skin, on the articles used by the client and in the
environment. The nurse takes care to prevent the
transference of micro organisms from the source to the
new host by direct or indirect contact or prevent the
prevent the multiplication of the microorganisms.
 The nurse washes her hands before and after bed making
to protect the client and herself from cross infection.
 When changing bed linen, follow principles of medical
asepsis by keeping soiled linen away from the uniform.
 Place soiled linen in special linen bags before placing in a
hamper.
 To avoid air currents that spread microorganisms, never
shake the linen.
 To avoid transmitting infection, do not place soiled linen
on the floor. If clean linen touches the floor or any unclean
surface, immediately place it in the dirty linen container.
 Dry dusting raises dust. Damp dusting is recommended.

6.  The nurse keeps a reasonable distance from
the client’s face to prevent droplet
infection.
 Cleaning an area where there are less
number of organisms before cleaning an area
where there are numerous organisms
minimizes the spread of organism to the
clean area. Eg. Clean the bed first before
cleaning the bedside locker.
 The linen removed from the isolation unit is
disinfected first before they are sent to
laundry.

7. PRINCIPLE 2:-A safe and comfortable bed will
ensure rest, sleep and prevent several
complications in bedridden patients. E.g.
bedsore, foot drop etc.
 The body exerts uneven pressure against the
mattress, the pressure is greatest over the
bony prominences. Lumps and creases in the
bed can cause bedsores due to friction
between the bed and mattress or wrinkled
sheets. Therefore the nurses should take
care to make the bed smooth and
unwrinkled.
 Pull the bottom sheet tightly so that there is
no wrinkles.
 Keep the linen tucked far enough under the
mattress, keep it fixed, tight and smooth.

8.  While tightening the sheets, do not alter the
shape of the mattress.
 No wet linen should remain on the bed.
 A bed made for a client should allow enough
freedom for moving from side to side. The
movement of the client stimulates circulation,
prevent bed sores and maintains muscle tone.
Comfort devices are used to provide additional
comfort to the client.
 If the client is in bed for longer time , tight
upper bedding may cause foot drop.
 It can be prevented by making a pleat in the top
sheet and blanket across the foot of the bed.
 While tucking the upper bedding, ask the client to
flex his knees.
 Place a pillow, foot board or cradle at the foot of the
bed to take the weight of the upper bedding.

9. PRINCIPLE 3 :- Good body mechanisms maintain the
body alignment and prevents fatigue.
 During bed making use safe patient handling
procedures and proper body mechanics .
 The stability of the body is assured by keeping its
centre of gravity over its base. When the base is wide
it ensures that the center of gravity will fall through
its base. In standing position the nurse can have a
wide base by separating her feet.
 The nearer to centre of gravity a weight is held, the
less is the strain produced. Eg. When opening the
linen it should be placed on the edge of the bed
rather than holding it above the shoulder level.
 Always raise the bed to the appropriate height before
changing linen so you do not have to bend or stretch
over the mattress. You move back and forth to
opposite sides of the bed while applying new linen.
 Body mechanics and safe handling are important
when turning or repositioning the patient in bed.

10.  When tucking the sheets under the mattress,
flexing is done by knees and hips. This
position shifts the work to the long and
strong muscles of the thighs and keep the
back in good alignment. This reduces strain
on the back.
 When placing the linen on the bed and
tucking them under the mattress face the
direction of work and move with the work
rather than twisting the body and over
reaching.

11. PRINCIPLE 4:- Systematic ways of functioning saves
time, energy and materials.
 When patients are confined to bed, organize
bed-making activities to conserve time and
energy.
 Assemble all articles and arrange them
conveniently before starting the bed making.
 Arrange the linen in the reverse order of use.
 Finish on one side of the bed before going to the
opposite side
 When stripping the bed, remove the bed linen
one by one holding the open end towards the
floor, so that the client’s possessions and the
hospital articles are not send to the laundry.
 The bed sheets are folded in such a way that it
can be replaced easily.

12.  The patient’s privacy, comfort, and safety
are all important when making a bed.
 Using side rails to aid positioning and
turning, keeping call lights within the
patient’s reach and maintaining the proper
bed position help promote comfort and
safety.
 After making a bed, return it to the lowest
horizontal position and verify that the wheels
are locked to prevent accidental falls when
the patient gets in and out alone.

13.  When possible, make the bed while it is
unoccupied . Use judgment to determine the
best time for the patient to sit up in a chair
so you can make the bed. When making an
unoccupied bed, follow the same basic
principles as for occupied bed making.

14.  To provide a clean and comfortable bed for the
patient
 To give a neat and tidy appearance to the unit
 To keep it ready for any emergencies
 To receive the patient comfortably
 To provide active and passive exercise to the
patient
 To establish interpersonal relationship
 To economize the time, material and energy
 To teach relatives how to take care of the
patient at home
 To prevent bed sores

15.  Open bed
 Closed bed
 Occupied bed
 Admission bed
 Post operative bed
 Cardiac bed
 Amputation bed/divided bed
 Fracture bed
 Therapeutic bed (renal bed, rheumatism
bed, blanket bed)

16.  It is a bed, made when it is about to be
occupied by either a new patient or an
ambulatory patient.

17.  It is an unoccupied or empty bed made to
receive the patient and is fully covered with
counter pane to protect it from dust and
dirt. On admission of the patient, the closed
bed is converted in to an open bed.
 PURPOSES:-
 To keep the bed ready for occupancy.
 To provide a neat and tidy appearance to the
unit

19.  This bed is made with the patient in it.
 PURPOSES:-
 To make a bed with least possible discomfort to
the patient.
 To handle the bed clothes skillfully while the
patient is on bed, giving least disturbance to the
occupant.
 To provide a neat, clean and tidy appearance.

21.  This is the bed prepared to receive a newly
admitted patient.
 PURPOSES:-
 To welcome the patient
 To provide immediate care, safety and comfort
 To protect the bed linen while giving bath on
admission

22.  It is a bed prepared for a patient who is
recovering from the effects of anesthesia
following surgery.
 PURPOSES:-
 To receive the patient conveniently
 To provide warmth and comfort
 To prevent shock
 To prevent injury
 To prevent soiling of the bed
 To meet any emergency

24.  A bed prepared for patients with cardiac
diseases.
 PURPOSES:-
 To prepare the bed for the cardiac patients
 To relieve dyspnea

25.  It is a bed in which top linen is divided into
two parts to visualize the amputed part of
the lower limbs without disturbing the
patient.
 PURPOSES:-
 To watch the stump for hemorrhage and apply
tourniquet instantly
 To take the weight of the bed clothes off the
patient.
 To keep the stump in position

27.  It is a bed which is prepared for patients
with fracture, bone diseases and deformity.
 PURPOSES:-
 To prevent undue sagging of mattress
 To immobilize the fractured part
 To restrict sudden jerky movements
 To keep the traction in position

28.  Renal/ Rheumatism/Blanket bed:-
 it is a bed made for patients suffering from
rheumatism or renal disease.
 PURPOSES:-
 To carry the weight of the bed clothes off the
painful joints
 To keep the patient warm
 To induce sweating

29.  PRELIMINARY ASSESSMENT:-
 Check the doctor’s order for specific precautions
regarding the movement and positioning of the
client.
 Assess the client’s ability for self care
 Check the furniture and linen available in the
client’s unit.
 Assess the number of clean linen needed.
 Assess the articles needed for the comfort of the
client. Eg.:-blankets, backrests

30.  Bottom sheet
 Mackintosh
 Draw sheet
 Top sheet
 Blanket
 Pillow cover (pillow case)
 Additional articles :_
 Laundry bag
 Dusters
 A bowl with antiseptic solution (savlon 1:40)
 A kidney tray

34.  Explain the procedure to the client to win
the co operation and confidence of the
client.
 Explain how the client can assist.
 Screen the client to provide privacy if
needed.
 move furniture away from the bed and move
the bed away from the wall.
 Lower the back rest if any.
 Place the laundry bag within the reach.

36.  Keep the articles near to the unit.
 Explain the procedure. Make the patient to sit in a chair
comfortably.
 hand washing
 Remove the pillow and place it in a side.
 Remove the old linens, if there(blanket,top sheet, draw sheet,
mackintosh, bottom sheet)
 Dust the mattress and the cot and the furnitures.
 Spread the bottom sheet, mackintosh and draw sheet.
 Tuck the near side first from top to bottom. Make metre corner.
 Go to opposite side. Tuck that side.
 Spread the top sheet ( and blanket if needed).
 Make a knee pleat. Tuck near side bottom and then the opposite
side. allow the sides to hang freely.
 Fanfold the top sheets to the bottom.
 Put the pillow cover on pillow. Place it with open end away from
the door side.

39.  Help the client to get in to the bed.
 Replace the comfort devises used.
 See that the whole unit is clean and tidy before
you leave the unit.
 Send the laundry bag with soiled linen to
laundry. If stains are present on the linen ,
remove them with appropriate methods before
sending them for laundry.
 Soak the duster in antiseptic solution to disinfect
it. Rinse it with clean water and put to dry.
 Hand washing
 Record the procedure.