King Saud University College of Nursing Medical surgical Nursing

Module 2 -122

:Prepared By
Lecturer Magda Bayou!i

.HOSPITAL BEDS BED MAKING .PRACTICE GUIDELINES FOR BEDMAKING TYPES OF BED-MAKING IMPLEMENTATION FOR BED-MAKING .PROCEDURES

Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577

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Bed Making

Hospital Be s

Hospital beds are designed to easily change the body position of the user. They are electric so the user can ad their own comfort. Hospital beds are usually 66 cm. high and 0.9 m wide, narrower than the usual bed, so tha nurse can reach the client from either side of the bed without undue stretching. The length is usually 1.9 m. S .beds can be e tended in length to accommodate !ery tall clients

" trape#e $ar attac%es to t%e %ead$oard of a %ospital $ed and is %elpful in c%anging positions& for
instance pulling patient up in t%e $ed or sitting up'

."n o!er bed table rolls under the bed and pro!ides a nice table top for eating, reading, or writing They are adjustable in height

Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577

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" patient lift is used to !ove a person fro! t%eir $ed to a (%eelc%air& etc' )%is (ould $e a person (%o is una$le to stand or transfer' " sling is used under t%e patient and is attac%ed to t%e lift'

Matt!esses

" !attress is a piece of bedding on which to sleep or lie. *ospital !attress protectors are suita$le for aut (as%ing and provide opti!u! sterili#ation against !icroorganis!s' #any special mattresses are also use hospitals to relie!e pressure on the body$s bony prominences, such as the heels. They are particularly helpful clients confined to bed for a long time. for e ample% air mattress designed for use by indi!iduals at ris& for pr .sores ' decubitis ulcers

Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577

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Commonly Used Bed Positions

,+lat: mattress is completely hori)ontal, *lient sleeping in a !ariety of bed +ositions, Such as bac&,lying Side,lying ( .and prone position

-owler$s position% Semi,sitting position in which con!enient for eating, reading, !isiting, .atching T/, head (
of bed is raised to angle of at least 01. 2nee may be fle ed or hori)ontal relief from lying positions, to promote lung . e pansion for client 3espiratory problem

Semi,-owler% head of bed is raised only to 40 angle, relief from lying position, to promote lung e pansion (

Trandelengurg$s position% head of bed is lowered and the foot raised in a straight incline, used (
.to promote !enous circulation in and certain clients to pro!ide postural drainage of basal lung lobes

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Bed Making

3e!erse Trndelenburg$s% head of bed raised and the foot lowered. Straight tilt in direction opposite to (
trendelenburg$s position. 5sed to promote stomach emptying and pre!ent esophageal refle in client with hiatal .hearia

Si e Rails Foot"oa! o! Foot"oot

Safety sides are used on both hospital beds and stretchers. They are of !arious shapes and si)es and are usuall .made of metal

These are used to support the immobili)ed client$s foot is a normal right angle to the legs to pre!ent planne .fle ion contracture

Be C!a les

" bed cradle is a de!ice designed to &eep the top bedclothes off the feet, legs, and e!en abdomen of a client. The bedclothes are arranged o!er the de!ice and may be pinned in place. 6esigned to fit under the mattress to Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577
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.form a support to &eep bedclothes clear of the feet and legs

I#t!a$e#o%s Ro s

7ntra!enous rods 8poles, stands, standards9, usually made of metal, support intra!enous 87/9 infusion containe .while fluid is being administered to a client. Some hospital units ha!e o!erhead hanging rods on a trac& for 7

MAKING BEDS

:urses need to be able to prepare hospital beds in different ways for specific purposes. The be is occupied or unoccupied, or the purpose for which the bed is being prepared, *ertain practic .guidelines pertain to all bed,ma&ing

P!a&ti&e G%i eli#es 'o! Be

-Ma(i#)

..ash hands thoroughly after handling a client$s bed linen ;inens and e<uipment that ha!e been soiled with secretions and e cretions harbor .microorganisms that can be transmitted to others directly or by the nurse$s hands or uniform .Hold soiled linen away from uniform .;inen for one client is ne!er 8e!en momentarily9 placed on another client$s bed +lace soiled linen directly in a portable linen hamper or tuc&ed into a pillow case at the .end of the bed before it is gathered up for disposal 6o not sha&e soiled linen in the air because sha&ing can disseminate secretions and .e cretions and the microorganisms they contain .hen stripping and ma&ing a bed, conser!e time and energy by stripping and ma&ing .up one side as much as possible before wor&ing on the other side To a!oid unnecessary trips to the linen supply area, gather all linen before starting to .strip a bed

,T*pes o' "e +a(i#) p!o&e %!es

U#o&&%pie "e - used when the client is able to get out of bed, is left open with the top ,1
Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577
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sheets folded down Postope!ati$e /post op0 o! s%!)i&al "e , used when clients ha!e left for the operating room -. or procedural area, is left with the top sheets fanfolded lengthwise and not tuc&ed in to .facilitate the client$s return to bed .O&&%pie "e - used when the client is not allowed out of bed,4

ASSESSMENT
.*hec& the acti!ity order, and assess the client$s ability to get out of bed,1 .Rationale: This determines whether an unoccupied or occupied bed should be made ."ssess the client$s self,toileting ability> note the presence of any wounds, drainage tubes,= .Rationale: This determines if placement of waterproof pads should be on the bed

PLANNING
.? pected outcomes focus on the client$s safety and comfort ,-pected .utco!es .*lient has a clean, safe en!ironment throughout hospitali)ation,1 .*lient !erbali)es a sense of comfort while in bed,= .*lient$s s&in remains free of irritation throughout hospitali)ation ,4

.1

Unoccupied Bed !a/ing ,1

E1%ip+e#t

;inen bag, matters 8change only when soiled 9,bottom sheet 8flat or fitted9, drawsheet 8optional9, top sheet, blan&et, bedspread, waterproof pads 8optional9, pillowcases, bedside chair or table, disposable glo!es 8if linen i .soiled9, washcloth, and antiseptic cleanser

:S),PS
.6etermine if client has been incontinent or if e cess drainage is on linen. @lo!es will be necessary "ssess acti!ity orders or restrictions in mobility in planning if client can get out of bed for procedure. ."ssist to bedside chair or recliner .;ower side rails on both sides of bed, and raise bed to comfortable wor&ing position .3emo!e solid linen, and place in laundry bag. "!oid sha&ing or fanning linen .thoroughly ."pply all bottom linen on one side of bed before mo!ing to opposite side .6 Ae sure fitted sheet is placed smoothly o!er mattress. To apply a flat unfitted sheet, allow about =1 cm .0 .4

3eposition mattress, and wipe off any moisture using a washcloth moistened in antiseptic solution. 6ry

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810 inches9 to hang o!er mattress edge. ;ower hem of sheet should lie seam down, e!en with bottom edge of .mattress. +ull remaining top portion of sheet o!er top edge of mattress ..hile standing at head of bed, miter top corner of bottom sheet .Tuc& remaining portion of unfitted sheet under mattress .9 .B

Cptional% "pply drawsheet, laying center fold along middle of bed lengthwise. Smooth drawsheet o!er .mattress, and tuc& e cess edge under mattress, &eeping palms down #o!e to opposite side of bed, and spread bottom sheet smoothly o!er edge of mattress from head to foot .of bed ."pply fitted sheet smoothly o!er each mattress corner .1= .-or an unfitted sheet, miter top corner of bottom sheet 8see Step B9, ma&ing sure corner is taut @rasp remaining edge of unfitted bottom sheet, and tuc& tightly under mattress while mo!ing from head .and then at bottom .7f needed, apply waterproof pad o!er bottom sheet or draw sheet .head to foot, being sure top edge of sheet is e!en with top edge of mattress ma&e hori)ontal toe pleat> stand at foot of bed and fan fold in sheet 1 to 10cm 8= to 0 inches9 across bed. +ull .sheet up. -rom bottom to ma&e fold "ppro imately 11 cm 86 inches9 from bottom edge of mattress .10 +lace top sheet o!er bed with !ertical center fold lengthwise down middle of bed. Cpen sheet out from

to foot of bed. Smooth folded drawsheet o!er bottom sheet, and tuc& under mattress, first at middle, then at top

Tuc& in remaining portion of sheet under foot of mattress. Then place blan&et o!er bed with top edge parallel to .top edge of sheet and 11 to =0 cm 86 to B inches9 down from edge of sheet .#a&e cuff by turning edge of top sheet down o!er top edge of blan&et and spread .1B .sheet, blan&et, and spread under mattress. Ae sure toe pleats are not pulled out .8tip of triangle 8see illustration

Standing on one side at foot of bed, lift mattress corner slightly with one hand, and with other hand tuc& top .1

#a&e modified mitered corner with top sheet, blan&et, and spread. "fter triangular fold is made, do not tuc& .=

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@o to other side of bed. Spread sheet, blan&et, and spread o!er e!enly. #a&e cuff with top sheet and blan&et. .= .#a&e modified corner at foot of bed ."pply clean pillowcase .== +lace call light within client$s reach on bed rail or pillow, and return bed to height allowing for client transfer. ."ssist client to bed ."rrange client$s room. 3emo!e and discard supplies. +erform hand hygiene .=0

COMMUNICATION TIP
Use an organized approach and reassuring tone of voice so the client feels safe and .comfortable during bedma ing !ncourage the client to report any discomfort or special re"uests while the bed is .being made #hen ma ing an occupied bed$ as the client to assist as able and to report any .discomfort or the need to rest .%nteract throughout the entire procedure$ even if client is not responsive

.SURGICAL BED BEDMAKING -.

Steps

.See standard protocol .1 .Postoperative 0post op1 or surgical $ed' Aegin with clean unoccupied bed .= .Rational: &acilitates transfer of postoperative client from stretcher to bed a,-old all top linen from foot of bed toward center of mattress. ;inen fold should be flush with bottom edge o .mattress b. -old top linen that is hanging down o!er sides of bed toward center of mattress. -ace one side of bed and f nearest bottom corner bac& and o!er toward opposite side of bed, forming a triangle. 3epeat for top corner 8s .8illustration .c. @rasp ape of triangle and fanfold top linen o!er to far side of bed .d. ;ea!e bed in high position with side rails down .R.d.'atches height of stretcher and facilitates client transfer

Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577

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Bed Making

-2 ,O&&%pie Be Ma(i#)
.nurse$s side> lea!e far side rail up .R. a. %t is easier to apply wrin le(free$ tight linens if bed is in the flat position

a,3aise entire bed to comfortable wor&ing height. ;ower head of bed, if tolerated by client. ;ower side rail o

b. ;oosen all top linens. 3emo!e spread and blan&et, lea!ing client co!ered with top sheet or bath blan&et. -o spread and blan&et in <uarters, and place o!er bottom of bed or on bac& of chair if they are clean and are to be .reused .3.b. @lo!es are worn to remo!e linen only if it is soiled with body secretions c. "ssist client to a side,lying position on far side of bed. Slide pillow o!er so it remains under client$s head. .*hec& that any tubing is not being pulled .3. c. +ro!ides pri!acy and warmth d. 3oll bottom sheet, drawsheet, and any pads as far as possible toward client. *lean and dry mattress if .necessary .R. d. Reduces transmission of organisms and eeps new linen dry .e. +lace clean bottom sheet on bed with seam side down .Aottom sheets may be fitted 819 .7f flat, center sheet on bed and pull bottom hem to foot end of mattress. Cpen sheet toward client 8=9 .5nfold flat bottom sheet lengthwise to co!er mattress. Tuc& top of sheet under head end of mattress .g.#iter top corner of a flat bottom sheet, and tuc& in side of sheet under mattress .3. g. 3educes transmission of organisms and &eeps new linen dry

h, +lace folded drawsheet and'or waterproof pads center of bed with seam side down. -anfold towar client. R.h. Provides additional protection to bed .linen

i,*o!er unoccupied portion of bed with half the material, tuc&ing drawsheet under mattress. +lace remaining materials as close to client as possible. .2eep clean linen and soiled linen separate

j. +lace waterproof pads with absorbent side up and plastic side down. Some pad under cloth drawsheet. :ewer, larger absorbent pads go on top of drawsheet or

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.8replace it 8chec& agency policy .R.). #aterproof absorbent pads protect bedding and eep moisture away from client*s s in

"ssist client with logrolling o!er all linen and facing you. 2eep client co!ered with top sheet or bath .blan&et. 3aise side rail on the side client is facing. @o to other side of bed, and lower side rail

3emo!e soiled linens. Hold them away from uniform. +lace on chair seat or in disposable bag or . hamper if it is close by. 6o not lea!e client alone with side rail down, e!en for a moment. 3emo!e glo!es if .worn, and dispose of them properly .R.l. Reduces transmission of microorganisms .@ently slide clean linen toward you, and straighten the clean linen out .m .3.m. "!oids friction of linen being pulled across s&in. n.#iter the top corner of bottom sheet as before .n. #iter the top corner of bottom sheet as before .o. @rasp side of flat bottom sheet tightly. 2eeping it taut, tuc& it under mattress. +roceed from head to foot .p.3epeat by tuc&ing drawsheet, proceeding from middle to top to bottom .<.Straighten out waterproof pads that are on top of drawsheet

r."ssist client into a supine position> place a clean top sheet, blan&et, and spread o!er client, lea!ing se!era .inches of sheet at top to be folded down

s. with client grasping clean top linens, slide out used top sheet or bath blan&et. *uff top sheet o!er blan&et and .spread R.s. prevent e+posure of client. ,ive a neat appearance t .bed and eeps client*s face off blan et

t. #a&e a modified mitter corner with linens at foot of be #iter the corner as before, but donot tuc& in lower edge .tringle u,;oosen linen at client$s feet to client$s comfort

Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577

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R.u. -llows for movement of client*s feet$ prevents top linen from forcing feet into plantar fle+ion$ and preven pressure ulcers from developing !. Supporting client$s head remo!e pillow and change pillowcase

Slide out used top sheet while &eeping client co!ered

E3ALUATION
.Cbser!e client$s linens for cleanliness and tightness ."s& if client is comfortable after bed is made .= .Cbser!e client$s s&in for signs of irritation .4 .1

U#e4pe&te O%t&o+es a# Relate I#te!$e#tio#s

.*lient is not comfortable in bed .1 .*hec& that linens are clean and dry. Tighten them ."ssist client with changing position in bed .b .*lient$s s&in appears red and irritated .= .a

t f r e < u e n

epo ition clie

. *onsider use of pressure,relie!ing mattress .2eep client$s bedding clean and dry .b Lecturer/ Magda Bayoumi http://faculty.ksu.edu.sa/73577
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Bed Making

Re&o! i#) a# Repo!ti#)

Aed ma&ing is usually not documented. Some agencies re<uire the nurse to chec& off this acti!ity on a flo .sheet

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