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Bincy Mathew, profile picture
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Bed making

The document discusses guidelines for making hospital beds. It explains that beds need to be prepared for different purposes like after hygiene care, for occupied patients, or for surgery. Proper practices include washing hands, avoiding shaking soiled linen, and not placing soiled linen on the floor or another patient's bed. Different types of beds are described like admission, postoperative, and fracture beds. Principles of asepsis, patient comfort and safety, and efficient techniques are outlined.

Healthcare◦
Prepared by:- BINCY MATHEW
 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.
■ 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.
 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.
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.
 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.
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.
 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.
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.
 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.
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.
 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.
 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.
 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
 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)
 It is a bed, made when it is about to be occupied by either a new patient or an ambulatory patient.
 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
 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.
 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
 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
 A bed prepared for patients with cardiac diseases.  PURPOSES:-  To prepare the bed for the cardiac patients  To relieve dyspnea
 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
 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
 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
 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
 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
 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.
 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.
 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.
Bed making
Bed making
Bed making