Bed making fundamental procedure by Anshu

Bed making (open bed,closed bed,cardiac bed) basic procedure from nursing foundation

1. WELCOME

2. INDIRA GANDHI COLLEGE OF NURSING BED MAKING (OPEN, CLOSED, CARDIAC BED) Presented by Ms. Anshu Yadav

3. CONTENT Today we will discuss about the – Terminology Introduction Definition Purposes General instructions Types of bed Principles of bed making Articles

4. CONT…. Preliminary assessment Open bed and procedure Closed bed Cardiac bed Role of nurse after bed making Summary Conclusion Bibliography

5. TERMINOLOGY Amputation – removal of limb or part of limb Draught – current of air in the room Stripping – removing of the clothes Unwrinkled – without wrinkles Dyspnea – difficulty in breathing Hamper / linen trolley – holds dirty clothes Counter pane / bedspread – it is a decorative cover on a bed

6. CONT…. Damp duster – it is the removal of dust or dirt Mitred corner – when two edges meet at 45 degree creating a 90 degree corner Bed sore / pressure ulcer /decubitus ulcer – ulceration of tissue due to long time bed ridden Air cushion – it is comfort device Foot rest – support the foot

7. INTRODUCTION Bed making is the technique of preparing different type of bed in making comfortable or his position suitable for a particular condition. Making a comfortable bed is the responsibility of nurse. Nurse should provide clean, dry, wrinkle-free and comfortable beds to clients.

8. DEFINITION “Preparing a bed that is comfortable and suitable for a hospitalized client.” “Bed making is a type of procedure in which a bed prepared to receive a new client is an unoccupied bed.”

9. PURPOSES To provide a clean and comfortable bed for the client. To keep it ready for any emergency. To prevent bedsores. To reduce the risk of infection by maintaining a clean environment. To promote cleanliness of the client. To economize the time , material and energy. To provide an effective nurse - client relationship.

10. GENERAL INSTRUCTIONS Wash hand before and after procedure. Do not expose the client unnecessarily. Protect the client from draught. Do not mix clean linen with soiled linen. Maintain good body mechanism. Periodical sunning and airing of mattress to be done. Avoid placing dirty linen on the floor. Make the bed smooth , firm and unwrinkled.

11. TYPES OF BED Open bed / unoccupied 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)

12. PRINCIPLES Micro – organism are found everywhere on the skin , articles by used the client and in the environment. A safe and comfortable bed will ensure rest , sleep and prevent several complications. Good body mechanisms maintain the body alignment and prevents fatigue. Systematic ways of functioning saves time , energy and material.

13. ARTICLES A tray containing – -Duster – 02 - gloves - 02 -Bowel with disinfectant solution -Kidney tray / paper bag Chair stool to keep clean linen Hamper / linen trolley Counter pane (optional)

14. CONT.… Mattress with cover Bed sheets – 02(top and bottom) Draw sheet – 01 Draw mackintosh – 01 Pillow with cover – 01 Blankets

15. PRELIMINARY ASSESSMENT Check the doctor’s order for specific Precautions regarding movements. Assess the client ability for self care. Assess the number of clean linen needed. Assess the articles needed for the comfort of the clients. Preparation of the articles. Preparing of the client and the units.

16. CLOSED BED It is an unoccupied bed / empty bed made to receive the client and is fully covered with counter pane to protect it from dust and dirt. On admission of the client , the closed bed is converted into an open bed. PURPOSE – 1) to keep the bed ready for occupancy. 2) to provide a neat and tidy appearance to the unit.

17. OPEN BED Open bed - Preparing a bed that is comfortable and suitable for a client . Purpose – * to provide comfortable environment to the client.

18. STRIPPING AND BED MAKING PROCEDURE Nursing Action Rationale *Wash hands *preparation of self To prevent cross infection 2) Arrange all articles , don gloves Save time and energy 3) Remove the pillow and place it on the seat of the chair with the open end and away from the entrance. 4) Remove the top linen – - Loosen the top linen starting from the head end and proceed to the feet end. Allows easy removal of linen and prevent tearing of sheet.

19. CONT…. Remove the sheets one by one , by folding them into six. Bring the lower third over the middle third and fold the upper third over the lower third . Fold at the centre towards you, so that it falls in six. Shake gently , and place it over the back of the chair if it is to be reused or put it in the laundry bag. Remove the bedspread, blanket and top sheet separately, holding the open end towards the floor. Saves the many steps. Folding into six prevents the sheets from dragging on the floor when placed on the chair stool. Hospitals equipments sent to the laundry. 4) Fold the draw sheet. Bring opposite end to the middle of the bed and the near end over it and thus fold them into three. Place it over chair.

20. CONT.. 5) Roll the mackintosh and place it over the chair. Rubber sheets are not folded. 6) Remove the bottom sheet folding it into six. 7) Remove the mattress if soiled. 8) Turn the mattress if cotton. 9) Dust the mattress with a dry duster. 10) Clean all the surface of the furniture using a damp duster dipped in antiseptic solution. Damp dusting prevents the spread the dust. 11) Dust the higher cleaner areas first and then the less area.

21. CONT…. 12) Make the base of bed (bottom linen) on one side of the bed – When placing the linen on the bed and when tucking them under the mattress, face in the direction of the work and move with the work rather than twisting the body and overreaching. When tucking the linen under the bed, separate the feet slightly apart and flex the knees instead of back. when placing the bottom sheet on the bed begin at the foot end, tuck the head under the mattress, Mitre the corner and tuck under the sides as you return to the foot of the bed. Facing the direction of the activity keeps the muscles group in proper position and the function efficiently.

22. CONT.… Place the bottom sheet on the middle of the mattress. Making sure that the central longitudinal crease in the longitudinal axis of the bed. Unfold it and spread it straight allowing 30 to 37 cm to tuck under the top of the mattress and leaving just enough at the foot end to tuck in. Tuck it securely the top in the near side make a mitred corner. Tuck at the foot end, secure the corner as before, tuck the sheet along the sides. Place the mackintosh approximately 37 cm from the head and tuck it along the sides. Tucking at the head end and sides of the bed prevents slipping of the sheets and keeps the bed firm. Keeping the mackintosh at the middle of the bed.

23. CONT…. Place the draw sheet over the mackintosh, keeping it about 25 cm from the top of the mattress. Go to the opposite side and tuck the sheets in the same manner . Draw sheet above the mackintosh. Contact with rubber sheet produces discomfort in the client. 13) Return to the side of the bed first made. Place the top sheet with the wrong side out. Unfold it with the top edge even with the top of the mattress. 14) Place the blanket over the top sheet 15 to 20 cm below from the top of the mattress.

24. CONT…. 15) If the bedspread is used, place it over with the outer side out. 16) Make the head end of the linen. Cuff the bedspread under the blanket and then bring the top sheet over the spread as second cuff. Make sure that it will reach upto client. Gives a neat appearance to the bed. Prevents scattering of the linen when the client move on to the bed. To convert it to a closed bed, the top linen will be long enough to cover the whole bed. 17) Tuck at the foot end all together or separately any make mitre corners allowing the sides to hand free or tucked according to the hospital routine.

25. CONT…. 18) Put the pillow case on the pillow and place the pillow at the head end, the open end away from the entrance. While putting on the pillow case the pillow should not touch the nurses uniform. Prevents from cross-infections. 20) Replace all articles. 21) Wash hands. 22) Documentation of the procedure. Helps in communicating between staff members.

26. CARDIAC BED INTRODUCTION - A cardiac bed is used to help the client to assume a sitting position which can afford him greatest amount of comfort with least strain. DEFINITION – “A bed is prepared for patient with cardiac diseases.”

27. CONT….

28. PURPOSES To relieve dyspnea. To provide comfort with least strain. To reduce load of heart in cardiac diseases. To prepare for cardiac clients.

29. ARTICLES Articles for an open bed Additional pillows Back rest Cardiac table Air cushion Foot rest Knee pillow

30. PROCEDURE * Make the bed as an open bed. Provide privacy , if needed. * place back rest at client back and arrange pillows Supports the client back. * Keep the client in bed and cover him properly. * Place a pillow under the knees. Prevents slipping of the client. * Arrange the pillows on either side of the client below both the arms.

31. CONT…. * Place cardiac table in front of the client and adjust with pillow. Helps client to lean forward * ensure the client sitting comfortably in the new position. * wash hands and replace articles Prevents from cross infection. * record the procedure and observation made on the client in the nurses notes. Promotes communication among staff.

32. ROLE OF NURSE AFTER BED MAKING Nurse should check the bed is wrinkle free and suitable for client. Nurse should assess the client feel comfortable or not. Nurse should replace all articles. Wash hands. Nurse should documentation of the procedure in nurses records.

33. SUMMARY In today class we discussed about - Terminology Introduction Definition Purposes General instructions Types of bed principles of bed making Preliminary assessment Articles Procedure Role of nurse after bed making

34. CONCLUSION The class is able to understand about topic - bed making (open, closed, cardiac bed making) and able to follow the procedure as demonstrated for bed making.

35. BIBLIOGRAPHY Jacob annamma . Etc . clinical nursing procedure – the art of nursing practice. 3 rd ed ;Jaypee brothers publication. Pp – 65, 76. Nancy sr. principles and practice of nursing – nursing art procedure. 4 th ed. Vol 1: indore road; NR publishing house. Pp – 149 to 155. Chawla satish. Fundamentals of nursing- A procedure manual published by TNAI: pp – 149 to 152. Kurian Saumya. A textbook of nursing foundations. 1 st ed. 2019: medical book publisher. Pp – 248. DEBR. Textbook of nursing foundation. 1 st ed. Bangalore ; EMMESS medical publisher. Pp – 162.

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