FON -IX - Bedmaking.ppt

At the end of the session students will be able to
describe the hygienic care that nurses provide to clients.
identify the factors influencing hygienic practice
identify normal and abnormal assessment findings while providing hygienic care to the clients.
provide hygienic care of the skin - bath and pressure points, feet and nail, oral cavity, hair care, eyes, ear and nose.
assess the hygienic environment.
explain the various types of beds.

1. B.Sc NURSING 1
st
YEAR
FUNDAMENTALS OF NURSING
UNIT IX –MEETING NEEDS OF PATIENT
TOPIC: BEDMAKING

2. OBJECTIVES
Attheendofthesessionstudentswillbeableto
describethehygieniccarethatnursesprovidetoclients.
identifythefactorsinfluencinghygienicpractice
identifynormalandabnormalassessmentfindingswhileproviding
hygieniccaretotheclients.
providehygieniccareoftheskin-bathandpressurepoints,feetand
nail,oralcavity,haircare,eyes,earandnose.
assessthehygienicenvironment.
explainthevarioustypesofbeds.

3. OVERVIEW
DefineHygiene.
TheFactorsinfluencingHygienicpractice
Thenormalandabnormalassessmentfindingswhile
providingHygieniccaretotheclients.
ProvidingHygieniccareoftheskin-bathandpressure
points,feetandnail,oralcavity,haircare,eyes,ear
andnose.
Supportingahygienicenvironment.
Thevarioustypesofbeds.

4. INTRODUCTION
•Bed making is an essential procedure in nursing in
whichnurses prepare and arrangedifferent types of
beds for the client's comfort in the hospital or other
health care institutions
•. Bed making procedureensures the patient's
comfortaccording to the situation. It may vary on the
client's conditions, purposes and procedures such
asopen bed, closed bed, occupied bed, cardiac
bed, fracture bed, blanket bed etc.

5. •Nurses have a major role in bed making procedure
in hospital. So, a nurse should learn and follow the
proper and standard techniques ofbed making
procedure.
•

6. BED MAKING
Itisthetechniquesofpreparingdifferenttypesofbed
inmakingaclientscomfortableorhis/herposition
suitableforaparticularcondition.

7. Purpose of Bed making
To provide the client with a safe & comfortable bed to
take rest & sleep.
To keep the ward neat and tidy.
To adapt to the needs of the client and to be ready for
any emergency or critical condition of illness.
To economize time, material & effort.
To prevent bedsores.
To observe the client.
For patients comfort.
To prevent cross infection.

8. PRINCIPLES OF BED MAKING

9. PRINCIPLE -1
1.Micro-organismsare present everywhere on the used
articles, skin, clothing and environment.Preventthe
spreading of micro-organisms from the contaminated
source to the new host by taking precautions and
preventing the multiplication of the micro-organisms.
Action -
The nurse shouldwash her/his handsbefore and after the bed making
procedure to preventcross-infection.

10. •Bed linen and clothes must be changed frequently to ensure cleanliness.
• Do not drop the removed bed linen on the floor.
• Gently shake the linen to remove dust. Do not flap the bed clothing because
it transfers dust and bacteria easily.
• Linen should be folded and held away from the nurses to prevent direct
contact with dust and micro-organisms.

11. •Daily cleaning and dusting of beds and units will keep them free from dust
and micro-organisms. Soap, water, air and sunshine will help them to be
clean.
• Damp dusting is recommended because dry dusting raises dust.
• Nurse should maintain a necessary distance from patients to prevent droplet
infection.

12. •Clean the less contaminated area first and then the clean high contaminated
area to minimize the spreading of micro-organisms to the clean area.
• Linens should be disinfected before sending them to the laundry.
• Nurses who having respiratory infections should not attend to the clients.

13. PRINICIPLE -2
2.Aprotectedand comfortable bedwill provide rest,
sleep and avoid many complications of bedridden
clients e.g. bedsore, foot drop etc.
Action -
•Nurse should make a smooth and unwrinkled bed because a wrinkled bed
exerts pressure on bony prominence and lumps. The wrinkles cause
bedsores due to friction between skin and wrinkled sheets.
• Pull the bottom sheet tightly to avoid wrinkles.
• Tuck the linen far enough and tightly to keep it fixed.

14. • Smooth the mattress, if there is a collection of cotton in one place before
making a bed.
• Do not keep any wet linen on the bed.
•Daily dusting should be done to remove any peeling or seeds that are
adhered to the bed linen of a bedridden client.
• A bed should have enough space to move from side to side. The
movements prevent bedsore, stimulate blood circulation and maintain muscle
tone.
• Use comfort devices to provide additional comfort to the client.

15. PRINICIPLE -3
3.Goodbody mechanismsmaintain body alignment
and prevents fatigue.
Action -
• The stability of the body is assured by keeping the centre of gravity over its base. In the standing
position, the nurse can have a wide base by separating his/her feet.
• The nearer to the centre of gravity a weight is held, the less is strain produced. E.g. it is more
suitable to place the linen on the edge of the bed instead of holding it above shoulder level.
• Flex the knees and hips when tucking the sheet under the mattress. This position shifts the
work to the long and strong muscle of the thigh and keeps the back in good alignment.
• When placing and tucking the linen, face the direction of the work and move with the work
rather than twisting the body and overreaching.
•

16. PRINICIPLE -4
4.Planned and organizedways of working saves
energy, time and equipment.
Action -
• Collect and arrange all the articles before starting the bed making procedure.
• At thefirstfinish on one side of the bed making and then go to the opposite
side.
• Remove the bed linen one by one holding the open end towards the floor
when stripping the bed so that the client's possessions and the hospital
articles are not sent to the laundry.
• The bed sheets are folded in such a way that they can be replaced easily.

17. BED MAKING
UniversalPrecautions
Observeuniversalprecautioniflinenis
contaminatedbybloodorbodyfluids
Washhandsfrequentlyandwear
gloveswhilehandlinglinen
Followagencypolicyforproper
disposaloflinen
BodyMechanics
Maintaingoodbodyalignment.
Worksmoothlyandrhythmically
Pushorpullratherthanlift
becauseitrequireslesseffort.
Usingyourownweightto
counteracttheweightofanobject
decreasestheeffortandstrain.

18. Guidelines for Bed Making
Washhandthoroughlybeforeandafterhandlingclientsbedlinenwhich
helpstocontrolnosocomialinfection.
•Gatheralltherequiredlinenandaccessoriesbeforemakingthebed.
•Avoidshakingthelinentopreventthespreadofmicroorganismsanddust
particles.
•Avoidplacinglinenscleanordirtyonanotherpatient’sbed.
•Don’tplacedirtylinenonfloorinsteadputinlinenbag.
•Alwaysusegoodbodymechanics.
•Stayononesideofthebeduntilitiscompletelymade.
•Observethepatientanddocumentanynursingobservationsmade.

19. Kinds of Linens
A-Blanket:alargepieceofclothoftensoft,woolenandis
usedforwarmthasabedcover.
B-Topsheet:usedtocoverthepatienttoprovidewarmth,
madeofthickcotton,thermalmaterial.
C-Cottondrawsheet:apieceofclothspreadoverthe
rubbersheetandisusedtoabsorbandmoisture.
D-Bottomsheet:usedtocoverthebedaftermattress
cover.
E-Rubbersheet/Mackintosh:usedtoprotectthebottom
sheetfromsoilingduetopatientsecretionsandpreventthe
patientsfromgettingbedsore.

20. Types of Bed Making
A -Occupied Bed: Is made when the patient is not
able or not permitted to get out of the bed. Or when
patient is already occupied in the bed.
B -Unoccupied Bed: Is made when there is no patient
confined in bed.

21. 1-Openbed:thetopcoversarefoldedbacksothe
patientcaneasilygetbackintobedandispreparedfor
ambulatorypatients.
2-Closedbed:thetopsheetblanketsandbedspreads
aredrawnuptotheheadofthemattress.
3-Post-operativebed:knownasrecoverybedor
anaestheticorsurgicalbed.
4-AmputationorDividedbed:Thisisabedthatis
preparedforapatienthavingamputatedlimb.
Types of Bed Making Contd..

22. 5-Fracturebed:Thisisahardfirmbeddesignedforthe
patientwithfractureparticularlyofspine,pelvisorfemur.
6-Cardiacbed:thisispreparedforpatientwithbreathing
difficultandmakeuseofcardiactabletorelievetheir
dyspnoea.
7-Therapeuticbed:areusedtotreatclientswithsevere
jointcontractures,prolongedimmobility,orskinwounds
suchaspressureulcersorsevereburns.Thesebeds
reduceorrelievetheeffectsofpressureagainsttheskin
throughvariousmechanisms.
Types of Bed Making Contd..

23. 8.Blanket Bed -
•The blanket bed is made for a client who is suffering
from renal disease to promote elimination through the
skin.
Purpose of blanket bed:
•To lift the weight of the bedclothes away from the
painful joints.
•To maintain the client's warmth.
•To encourage elimination via the skin.

25. •Preparation of the articles for bed making
procedure -
1. Cot
2. Mattress and pillow
3. Chair or stool
4. Bedside table
5. Mackintosh
6. Blanket
7. Mattress cover
8. Top sheet and bottom sheet
9. Draw sheet
10. Pillowcase
11. Counterpane
12. Laundry bag
13. Dusters

26. Closed Bed-Articles
1. Two large sheets.
2. Draw sheet.
3. Blankets.
4. Bed spread.
5. Pillow cases.
6. Rubber Mackintosh.
7. Linen Hamper.
8. Bedside Table.
9. Disposable Gloves.

27. Closed Bed -Procedure
1. Wash hands and wear disposable gloves.
2. Assemble and arrange equipment on bed side table.
3. Fold and keep reversible linens such as blanket or bedspread
on bedside table.
4. Bundle all soiled linen in bottom sheet and directly place into
the laundry bag.
5. Place the bottom sheet with its center fold in the center of bed
and towards the top to have sufficient sheet to tuck under the
head of the mattress.
6. Unfold the bottom sheet, spread it over the mattress and tuck in
with mitten corner.

28. 7.Spreadthemackintoshatthecenterofthebedandtuckitalongthe
side.
8.Placethedrawsheetsoverthemackintoshandtuckitalongthe
side.
9.Movetheoppositesideandtuckthesheets.
10.Placetheblanketoverthetopsheetabout6inchesbelowthetopof
thesheet.
11.Ifthebedspreadisusedplaceitovertheblanket.
12.Tuckthetopsheet,blanketandbedspreadunderthefootofthe
bedonthesideclosetoyouandmiterthecorners.
Closed Bed –Procedure Contd..

29. 13.Foldtheupper6inchesofthetopsheetdownover
thespreadandmakeacuff.
14. Move to other side and follow the same procedure for
screening top sheets.
15. Put the pillow case and place the pillow at the head
end.
16. Fanfold or pie fold top linens.
17. Dispose off soiled linen and wash hands.
Closed Bed –Procedure Contd..

30. Open Bed-Articles
1. Bottom Sheet.
2. 36 inch Mackintosh.
3. 36 inch Draw sheet.
4. Top Sheet.
5. Blanket.
6. Bed Spread.
7. Pillow case.
8. Duster -2.

31. Open Bed -Procedures
1.washhandsandcollectrequiredlinen.
2.Arrangelinenonchairinmannerinwhichitisgoingtobeused.
3.Explainproceduretothepatientandrelatives.
4.Screenpatient,ifnecessaryandloosentopbedding.
5.Liftpatientsheadandremoveextrapillow.
6.Loosenbottombeddingandremovetopsheetbypullingitdown
fromundercover.
7.Brushoffthemackintoshandrollitbacklooselyoverpatient.

32. 8.Roll bottom sheet as far under patients back as possible.
9. Place the clean sheet on the mattress with length wise fold at centre of
the bed.
10. Adjust sheet and tuck in at the top making a square corner. Then tuck
in at the side.
11. Bring back mackintosh lying over the patient.
12. Place clean draw sheet at the centre of the bed.
13. Pull and tighten bottom sheet and tuck in at top making a square
corner.
Open Bed –Procedures Contd..

33. 14. Pull and tighten mackintosh and draw sheet and tuck in well.
15. Turn the top of the counter pan and top sheet back over the blanket.
16. Return to the other side, fold and tuck in top bedding as on the first
side.
17. Change the pillow case and put it under patient’s head and
shoulders.
18. Discard soiled linen in dirty box.
19. Make the patient comfortable and Wash hands.
Open Bed –Procedures Contd..

34. Occupied Bed -Articles
1. Top Sheet.
2. Blanket.
3. Pillow Case.
4. Bottom Sheet.
5. 36 inch Mackintosh.
6. 36 inch Draw sheet.
7. counter pane.
8. Duster -2.

35. Occupied Bed -Procedure
1.Assembletheequipmentandarrangethelinenwithintheeasyreach.
2.Loosenthebeddingonallsidesandremovethespreadandthe
blanketleavingthetopsheetovertheclient.
3.Fanfoldthedrawsheettotheclientsandpushitasclosetotheclient
aspossible.
4.Dustthemattresswithadryduster.Thenbyraisingthemattress,
cleanthecotwithadampduster.
5.Placethecleanbottomsheetoverthemattressmakingsurethatthe
middlefoldisinthemiddleofthebed.
6.Bringingthemackintoshbackintotheplaceandtuckittightlyunder
themattress.

36. 7.Turntheclientbackoverthefoldedlinenandthentowardsyou.Go
totheoppositesideofthebed.
8.Removethesoiledlinenandputtheminthelaundrybag.
9.Turntheclientbacktothemiddleofthebed.Placeacleantop
sheetovertheclientandremovethesoiledtopsheet.
10.Replacetheblanketandspreadoverthetopsheetandmakethe
bedasinanopenbed.
11.Tuckthefootendgivingenoughfreedomformovement.
12.Placeafootboardorcradleatthefootofthebed.
13.Putthecleanpillowcasesandplacethepillowsinpositionand
leavetheclientcomfortable
Occupied Bed –Procedure Contd..

37. Post Operative Bed -Articles
1. Gauze, pieces, narrow Mackintosh and narrow sheet.
2. Artery forceps.
3. Mouth gag, air way.
4. TPR Tray B.P. apparatus.
5. Bed Blocks -2.
6. Hot water bags with cover.
7. I.V stand.
8. Kidney tray and paper tray.
9. Suction apparatus and oxygen cylinder.

38. Post Operative Bed -Procedure
1.Preparethefoundationofthebedassimplebed.
2.Putnarrowmackintoshandnarrowsheetatthehead
endtoprotectthebedfromsoilingthelinenbyvomitus.
3.Thefootendofthetoplinenareleftuntucked.
4.Theupperbeddingisfanfoldedtooneside,opposite
thestretcher.

39. Post Operative Bed –Procedure Contd..
5.Postanesthetictray,bedblocks,I.V.standetcarekept
readyathand.
6.Thepillowisusedtoprotectthepatientfrominjuryby
hittingagainstthebarsattheheadendofthebed.
7.Hotwaterbagsareusedtokeepthebedwarmandthey
areremovedbeforereceivingthepatientinthebed.

40. Fractured Bed
Articles:
1. Bed Sheet & Drawsheet.
3. Topsheet & Blanket.
5. Bed spread & Pillow case.
7. Duster.
8. Fracture board.
9. Sand bags with cover.
10. Bed cradle.
11. Extra pillows.

41. Fractured Bed -Procedure
1.Placethefractureboarddirectlyoverthebedsprings.
2.Placeathinfirmmattressorpadoverthefracture
board.
3.Thebedispreparedassimpleopenbed.

42. Amputation Bed -Articles
1. Set of top extra bedding.
2. Blankets and counter pane.
3. Bed cradle.
4. Tourniquet.
5. Pillow and plastic cover.
6. Sand bags and draw sheet.

43. Amputation Bed -Procedure
1.Preparethebedassimpleopenbed.
2.Makebottomhalfofthebed.Foldsheetcrosswiseatthecenterofthe
bedatbottomtuckinandmakecorners.Makeupperhalfofthebed.
Theothersetofthetoplinenstartsfromthestump;butoverlapping
thefirstoneandtheexcessistuckedunderthemattressatthefoot.
3.Whenthepatientisbroughtbackfromtheoperationtheatre,fanfold
thetwosetsoflinenonesideofthebedandreceivethepatienton
thebed.
4.Bedcradleisusedtotakeofftheweightofthetoplinen.

44. Amputation Bed –Procedure Contd..
5.Coverthepatientandkeephimwarmandcomfortable.
6.Amputationbedisusuallyusedforamputationoftheleg,operation
bedisusedforanamputationofthehand.
7.Thetwosectionsofthetoplinenshouldoverlapeachotheratleast
by8to10inches.Sothatitcaneasilyliftedtoobservethestump
andalsotopreventunnecessaryexposureofthepatient.

45. References
BIBLIOGRAPHY
1.Potter,A,G.Perry,P.A.Stockert&A.M.Hall,Canadian
FundamentalsofNursing(5thedition)
2.M.L.A.Kozier&Erb’sfundamentalsof
Nursing:Concepts,processandpractice.(2008)
NETREFERENCE
3.https://study.com/academy/course/nursing-hygiene-
training.html