BED MAKING INTRODUCTION: The Clients Bed The bed is an important part of the clients environment.

Aside from being a defining factor in establishing territory, the bed represents a supportive place to rest and recuperate. It is also the place where, much nursing care is given. Making and maintaining the clients bed effectively is an important nursing responsibility. Several Rules about Beds and Siderails must be observed. 1. Indicated for clients 7 years old and below, 60 years old, and above, critically ill and unconscious patients. General principles of bedmaking 1) Preventing infection from cross-contamination. 2) Preventing pressures on or irritation of the clients skin from wrinkles or other objects. 3) Providing adequate toe room to help prevent foot drop. 4) Completing the bed neatly for aesthetic purposes. 5) Using correct body mechanics when making the bed (Body mechanics refers to the manner in which one uses the body during exercise and work). Closed Bed Definition: A closed bed is one which is covered entirely by the top sheet and bedspread

Purposes: 1. To provide a bed that will readily meet the needs of newly admitted client. 2. To provide a bed which is comfortable, neat and clean. Special Considerations: 1. Before starting the procedure see to it that all the pieces of linen are on hand and are arranged according to use. 2. If the bed is of the hi-low type, adjust the height accordingly. 3. Finish one side of the bed at a time.

4. Remember that placement of the rubber sheet will depend upon the clients need. 5. Leave the clients unit in order. 6. Apply the principles of body mechanics while you are making the bed. Preparation: A. Equipment: Assemble at the bedside and arrange according to use the Following: 1 bedsheet 1 rubber sheet 1 draw sheet 1 bedspread (optional) 1 pillowcase or more as needed 1 inner pillow case (ponda) 1 mattress cover (if necessary) Unit Bed: 1. Place the bed in a position which will allow adequate work space. 2. Lower the back and knee rests, and lock casters. 3. Turn the mattress stretch or change the mattress cover if necessary. Suggested Action 1. Stand on the right side and face the bed in order to avoid overreaching and twisting of the body. Suggested Action 2. Holding it at its centerfold, place the bottom sheet at the foot part of the bed, keeping the wider hem in line with the edge of the mattress. headpart, keeping the centerfold along the center of the bed. : : : : : : : : : : : : : : : : Principles of Rationale Facing the direction of activity keeps the muscle groups in proper position for function efficiently without strain. Principle or Rationale Opening large pieces of linen on a surface, instead of holding them up at shoulder level, prevents hyperextension of the back. Lifting involves overcoming the pull of gravity against the object. Using the centerfold as a guide ensures equal length of the sheet on both side of the bed.

3. Tuck the excess length of the bottom : sheet under the headpart of the : mattres, and make a half mitered : corner. : : 4. Place one foot forward, flex the knees, and while rocking backward, tuck the sheet along the side of the bed. : : : : : : : :

Tucking the sheet under the secures it in place and prevents wrikles. A mitered corner presents a neat appearance. Flexing the knees shifts the work to the longest and strongest ,muscles and keeps the back in good alignment. Rocking backward or forward utilizes the weight of the body as a force and reduces the effort extended by the muscles. The rubber sheet serves as an excellent protector to prevent the soiling of the beddings. The draw sheet will prevent skin irritation which may be caused by a direct contact with the rubber. Tucking the sheet under the mattress secures it in place and prevents wrinkles. A mitered corner presents a neat appearance. finishing one side of the bed at a time saves time and energy. Principle or Rationale Tucking the sheet under the mattress secures it in place and prevents wrinkles. A Mitered corner presents a neat appearance.

5. If needed, place the rubber sheet followed and covered by the draw sheet. Tuck them together under the mattress.

: : : : : : ; 6. Unfold the top sheet, wrong side : up at the headpart of the mattress, : with the centerfold at the center of : the bed. : Tuck it at the foot part and make : a half mitered corner. : 7. Go to the otherside to finish the bed. : : Suggested Action :

8. Make the half-mitered corner of the : bottom sheet at the head part. : : : :

9. Pull the bottom sheet tightly grasping the sheet with the palms downward so that the action is produced by the arm and the shoulders. Tuck it along the side of the bed with palm upward and the knees flexed as mentioned. 10. Do the same with the rubber and draw sheets.

: : : : : : : : : : : : : :

The longest and strongest muscles of the body produce the most efficient action. A firm and neat bed is conducive to rest. Lumps and creases in the bed produce uneven pressure and may predispose to impair-skin circulation. The rubber sheet serves as an excellent protector to prevent the the soiling of the beddings. The draw sheet will prevent skin irritation which may be caused by a direct contact with the rubber. Tucking the sheet under the mattress secures it in place and prevents wrinkles. A mitered corner presents a neat appearance. Fluffing distribute evenly the the contents of the pillow, and an even pillow promotes comfort.

11. Tuck the top sheet at the foot part : of the bed and make the half-mitered : corner. : : : 12. Get the pillow and fluff its contents. : : : 13. Put on the pillow case this way: : a) If both ends of the pillow case : are open insert one arm through the: pillow case. Pull in the pillow by : grasping it at one end while the other : hand adjusts the pillow case. : b) If only one end is open insert : the pillow case and hold one corner : from the inside. With the same hand, : grasph one corner of the pillow while: the other hand adjusts pillow case on : the pillow. : 14. Place the covered pillows on the headpart of the bed and under the top sheet : : :

Placing pillows under the top sheet protects them from dust and lint.

: The bedspread protects the : beddings from dust and gives the : the bed an attractive appearance. _______________________________________________________________________ _ Open Bed Definition: It is a bed with the top sheet folded back, ready for clients occupancy. Suggested Action 1. Fold the bedspread and set it aside : : : : : : : : : : : : : Principle or Rationale Setting the bedspread aside removes hindrance to clients movements, and prevents its being soiled. Principle or Rationale Folding back the top sheet affords easy transfer of the client to the bed and provides adequate covering up to the clients chest.

15. Cover with the bedspread and tuck it at the foot part.

Suggest Action 2. Fold back the top sheet 12-18 inches from the headpart and either, footpart or a) fanfold it towards the foot part or b) fold one side obliguely across the bed.

3. Arrange the pillows such that the : seam of the pillow case is underneath: or towards the headpart of the bed. :

Seams cause pressure and discomfort.

Post-Operative Bed or (Ether, Recovery or Anesthetic bed) Definition: It is a bed which has been prepared to receive and to meet the needs of a client recovering from anesthesia, after either surgery or a diagnostic procedure. To provide a bed where the client can be transferred readily while recovering from anesthesia. 2. To provide comfort and warmth thus maintaining body heat and lessening the dangers of shock and pneumonia. 3. To protect the beddings from soiling.

Purposes: 1.

Special Considerations: 1. Make sure that all needed equipment are assembled and ready for use before the client arrives. 2. See to it that the bed protectors are placed according to clients needs. 3. Arrange the clients unit in order to provide adequate work space. Preparation: A. Equipment: Assemble at the bedside and arrange according to use the following: 2 large sheets 1 rubber sheet 1 draw sheet 1 blanket (optional) 1 bath towel Safety pins Tissue wipes Emesis basin T.V. Stand Paper bag for waste Drainage bottles (if necessary) B.P. apparatus and stethoscope Oxygen therapy equipment (if necessary) Suction apparatus (if necessary) Suggested Action 1. Place the bottom sheet as in the closed bed. 2. Place the rubber and draw a sheets according to clients need. : : : : : : Principle or Rationale Same as #2,3,4, of closed bed. Same as #5 of closed bed. The site of operation determines the placement of the rubber protector. Adequate covers ensure body warmth. Placing the blanket over the top sheet will prevent skin irritation that maybe caused by woolen fibers.

3. Spread the top sheet, if needed, : spread a blanket over the top sheet. : fold back together their excess : length at the footpart, in line with : the edge of the mattress. : Fold them back also 12-18 inches : from the headpart. :

4. Fanfold the top sheet with the blanket, if used) either towards the footpart or one side of the bed. 5. Spread a bath towel at the head part and secure it with safety pins.

: : : : : :

Same as #2 of open bed.

The bath towel provides additional protection for the bottom sheet and the mattress from soiling. A pillow placed against the bedbar will protect the head of a restless client from possible injury. Such an arrangement ensures the required flat position following most surgeries. : Principle or Rationale

6. Place the pillow leaning against the : bed-bar at the head part of the bed. : : : : : Suggested Action 7. Place an IV stand at the head or foot : part of the bed and the drainage : bottles at either side. : :

Having all equipment ready and properly arranged will ensure efficiently, safety and comfort of the anesthetized client.

Occupied Bed: Definition: It is a bed that is made with the client in it. Purposes: 1. To change wet or soiled beddings for the safety and comfort of the patient. 2. To provide a change of position and to afford an opportunity to inspect the clients body. Special Considerations: 1. Before starting the procedure, be sure all needed bed linen are assembled and Arranged according to use. 2. Observe all the principles of medical asepsis. 3. Maintain correct body alignment and minimize the clients physical exertion by: a) efficient and quick workmanship b) observing precautions in turning or lifting the client. c) being careful not to fan the bed. d) raising the mattress at minimum height to tuck in the sheets 4. If needed, secure assistance. 5. Be sure that the client remains adequately covered during the procedure. 6. Perform modifications of the basic technique in order to meet the clients need. 7. Tuck the top sheet to loose enough to prevent plantar flexion.

Preparation: A. Equipment: Arrange at the bedside and in the order to use the following: 2 bedsheets 1 draw sheet 1 rubber sheet (if it needs changing) 1 or more pillow cases