hOSPITAL BED MAKING PROCEDURE GUIDELINE

The presentations explains the types of beds and how they are made and purpose

1. BED MAKING

2. LEARNING OUTCOME Describe bed making Explain the importance of bed making Describe types of beds. Describe precautions for bed making Describe how each type of bed is made?

3. Definition of terms Bed Making : The technique of preparing different types of beds, making patients / clients comfortable in his/ her suitable position for a particular condition. Fanfold : Specifically folding the edge of the sheet used in the bed 6-8 inches outward. Mitered corner : a means of anchoring sheet on mattresses.

4. Definitions Toe pleat : a fold made in the top bed clothes to provide additional space for patients toes to prevent pressure ulcers from developing on patients' heels and  toes . Bed cradle : is a curved, semi- circular made of metal that can be placed over a portion of the patient‘s body.

5. DESCRIPTION Is a process of making a bed to provide clean and comfortable sleeping and resting environment for the patient. The bed is particularly important to people who are ill. It is essential for the nurse to keep the bed as clean and comfortable as possible always.

6. When to make patient’s bed Every morning Usually after client’s bath Client is sitting in chair Out of room for tests Check throughout day and straighten linen prn After meals, if eating in bed, check for food particles Change linen that is soiled or wet

7. Description Linen Is Changed Daily In A Hospital The Bed Is Usually Made In The Morning Linens Are Straightened During The Day If They Become Loose Or Wrinkled Change The Linens Whenever They Become Wet Or Soiled Check Linen For Dentures Or Other Items

8. Why is it so important? Provides physical Comfort Provide clean and comfortable bed for the patient Reduce the risk of infection by maintaining a clean environment Prevent bed sores by ensuring there are no wrinkles to cause pressure sores Psychological comfort

9. THE PATIENT'S UNIT SHOULD BE : SAFE COMFORTABLE PRIVATE

10. Under no circumstances do you place dirty linen on floor, footstool, another patient’s bed or on over the bed tables. NOTE:

11. PATIENT UNIT

12. Types of Bed 1. Unoccupied, Open, Admission - Surgical/Post-op bed/theatre bed 2. Occupied 3. Amputation bed 4. Closed bed 5. Fracture bed 6. Cardiac bed 7. Therapeutic bed/ Blanket bed

13. ELECTRIC BED MANUAL BED 1. Un occupied bed

14. Make sure the wheels on the bed are locked before you begin to make the bed.

15. CLOSED BED A Closed Bed Is Not Being Used. Top Linens Are Not Folded Back , And The Bed Is Ready For A New Person.

16. OPEN BED Fanfold top sheets to foot of bed to convert closed bed to open bed Fanfold means to fold sheets like accordion pleat. Done to welcome a new patient or for patients who are ambulatory or out-of-bed

17. OPEN BED An Open Bed Is A Bed That Is Being Used. Top Linens Are Folded Back So The Person Can Get Into Bed .

18. A SURGICAL BED PURPOSE : To receive the post-operative client from surgery and transfer him/her from a stretcher to a bed

19. Amputation bed

20. Fracture bed

21. Therapeutic bed Used to treat  clients with severe joint contractures, prolonged immobility, or skin wounds such as pressure ulcers or severe burns. These beds reduce or relieve the effects of pressure against the skins. These beds are more comfortable for clients who have severe contractures because their bodies float as if suspended in midair. Severe skin wounds are more likely to heal when the effects of pressure are reduced.

22. Therapeutic bed

23. OVERVIEW

24. 2. OCCUPIED BED Bed is made while patient is in it Usually done after the morning bath. Explain each procedure to the person before it is done. Keep the person in good alignment. Keep the far rails up.

25. NOTE: RULES FOR BED MAKING Inform patient about bed making Have everything ready before starting to make the bed If necessary, close windows Always work from the head of the bed except when putting on the counter pane/bed cover

26. Rules for Bed making Use good body mechanics at all times Follow standard precautions Always wash your hands before handling clean linen and after handling dirty linen Bring enough linen into the person’s room Always keep linen clean.

27. Rules for Bed making Never shake linens. Do not take linen from one person’s room to use on another person. Hold linens away from your uniform Never put dirty linens on the floor or on top of clean linen!!! Roll dirty linen away from your body when removing it from the bed.

28. Rules for Bed making The bottom linens must be tightly tucked without wrinkles. A cotton drawsheet must completely cover the plastic drawsheet Straighten and tighten loose linen whenever necessary Make one side of the bed completely before going to the other side The large hem goes to the top of the bed

29. Types of Hospital Linen Bottom sheet A rectangular piece of cloth used either singly or in a pair as bedding, being placed immediately below  bed occupant

30. Types of Hospital Linen Mackintosh  - plastic that are used in many applications in the healthcare setting for waterproof bed protection.

31. Draw sheet A small bed  sheet  placed crosswise over the middle of the bottom  sheet  of a mattress to cover the area between the person's upper back and thighs. Often used by medical professionals to move patients. It can be made of plastic, rubber, or cotton, and is about half the size of a regular  sheet .

32. Draw sheet

33. Top sheet A rectangular piece of cloth used either singly or in a pair as bedding, being placed immediately after bed occupant

34. Counterpane/ Bed cover Is a decorative cover of a bed

35. BED ACCESSORIES Air rings - an inflatable rubber  ring  used as a cushion to relieve pressure on prominent bony points (as in helping to prevent bedsores)

36. BED ACCESSORIES A  bed cradle  is a frame used to keep the sheets and blankets from laying directly on patient while in  bed .

37. Bed accessories Sand bags- For rehabilitation, patient positioning and therapeutic purposes .

38. Bed accessories Back rest- a support for a person's back when they are seated.

39. Mattress Pad Bottom Sheet Drawsheet Top Sheet Blanket Bedspread Pillowcase COLLECT LINEN IN THE FOLLOWING ORDER NB. Once you have collected the linen, turn the stack over onto the other hand.

40. THINGS TO REMEMBER Raise the bed to a comfortable working height. Wash your hands before and after every patient contact Gather all the equipment needed Roll the soiled linen away from your body Place the soiled linen in the linen bag or linen hamper. And never on the floor!!!!

41. Return the bed to the lowest horizontal position when you are finished To make a closed bed into an open bed, fanfold the sheets to the foot of the bed The smooth side of the hem faces the patient

42. Bed making procedure

43. A. UNOCCUPIED/ADMISSION BED. REQUIREMENTS A trolley containing : 2 bed sheets 1 mackintosh 1 Draw sheet 1 Blanket Bed cover/counterpane Pillow and pillow case Bag/container for dirty linen

44. Explain procedure to patient Check if the bed is in good working condition

45. METHOD Wash hands Place the bottom sheet in the middle of the bed and unfold right side up Tuck in at the top bottom and sides pulling tightly to ensure there are no wrinkles. When tucking in make mitered corners.

46. Place mackintosh across middle of the bed and tuck in both sides Cover mackintosh with draw sheet and tuck in both sides Place top sheet wrong side up and spread full length on top of the mattress, fold back the top 30cm and leave enough loosely to tuck in at the bottom

47. Spread the blanket on top of the top sheet and leave it hanging loose Fanfold or pie fold top linens Tuck top linens securely at the foot of the mattress and make mitered corners Place the bed cover on top of top linen Cover the pillow with pillow case and place in position

48. NOTE Place dirty linen in linen container or bag

49. MITERED CORNER

50. CHANGING THE PILLOWCASE

51. B. THEATRE BED Requirements : Same as of admission bed with extras Post operative tray Vomitus bowl with lid Oxygen apparatus Suction machine and any other post operative apparatus as necessary

52. METHOD Make as of admission/unoccupied bed from step one to six then Remove pillows Fold the top linen in the three longitudinally then make a pack by folding in three transversely make sure the top end is uppermost when the pack is complete

53. Place the pack at the bottom of bed ready for use Have post operative tray and vomitus bowl at hand Place all other post operative apparatus at bed side

54. Post op bed

55. THINGS TO REMEMBER OCCUPIED BED explain the procedure to the patient before beginning protect the patient’s privacy Cover the patient with a bath blanket

56. make sure the siderail is up on the side you are not working on when finished make a toe pleat over the patient’s toes to prevent the weight of the linen from pressing down on the toes

57. C. OCCUPIED BED REQUIREMENTS Are as for admission bed with the following additions depending on patient’s conditions and these include Back rest Extra pillows Air ring Sand bags Dressing towels

58. 6. Dressing mackintosh 7. Bed cradle 8. Clean linen

59. METHOD CHANGING THE BOTTOM SHEET This method is used for patients who are nursed in an upright position e.g. heart position. Preparation is as of other types of bed making

60. Explain the procedure to the patient Close the windows Screen the bed Wash hands and put on clean gloves Place clean linen on one stool at the foot of the bed and the soiled linen container beside the stool chair Fold the clean sheet across in three

61. 7. Strip the bed linen as usual leaving the sheet covering the patient (blanket and sheet on cold day) Both nurses lift the patient carefully down the bed off the draw sheet One nurse supports the patient while the other removes the draw sheet and mackintosh and then rolls the dirty bottom sheet down as far as the patient’s back.

62. the same nurse puts in clean sheet tucking it in at the top and on her side as far as the dirty sheet. She then puts in mackintosh and draw sheet. 10. While the first nurse supports the patient, the other nurse does the same on the other side

63. 11. Replace the back rest, pillows, and air ring where necessary Both nurses lift the patient back up the bed and make sure the patient is comfortable Both nurses working in unison then roll the soiled sheet to the bottom of the bed from under the patient’s legs and put it in the soiled linen container

64. Remove crumbs and creases on the mattress, pull the clean sheet down to the bottom of the bed and tuck and miter the corners, straighten and tuck in mackintosh and draw sheet Put on the top bed covers as usual

65. Leave room for free movement of legs Place sand bags in position

66. B. CHANGING FROM SIDE TO SIDE METHOD: Make as for changing bottom sheet from top to bottom from step one to four Fold the clean sheet length wise and put it on the stool Strip the top bed linen as usual, leaving the patient covered with a sheet on a hot day. Remove all but one pillow

67. Place the patient’s arm and legs in position for turning and move the pillow to one side to support the head. Roll the patient onto one side The second nurse then rolls the draw sheet and mackintosh and then the bottom sheet closely up to the patient’s back

68. Put the clean sheet under the patient and tuck it in at the top side and bottom Put the clean mackintosh and draw sheet in position and tuck them in at one side and then roll closely up to the patient’s back

69. Roll the patient over the already made side and support him while the other nurse removes dirty linen and puts it in the soiled linen container Unroll the clean linen, pull it tightly and tuck in Remove the blanket if present, straight sheet and then replace linen

70. Leave the patient comfortable in appropriate position Remove the screens and dirty linen container

71. Remember To make bed, position is elevated When completed, bed is lowered If occupied, patient comfort & safety Soiled linen away from uniform Gloves prn Bath before making bed if occupied

72. Reference Nurses and Midwives Council of Malawi, 2008. Procedure manual for General Nursing.