Bed Making

Rest and Sleep Bed Making Skill and Rational

Why is it so important? The bed is particularly important to people who are ill. It is essential the nurse keep the bed as clean and comfortable as possible. Physical Comfort Psychological comfort

Rest and Sleep • Healing and Optimal Health • Promoting Sleep

Nursing Process • Assessment – –

Usual pattern of rest/sleep bed routines

• Nursing diagnosis – Sleep pattern disturbance

• Plan – Sleep aids

Nursing process • Implementaion – – – – – – –

Regular habits Nutrition/exercise Quiet time prior to sleep Warm milk Sleep/wake cycle Back rub Comfortable bed

Nursing Process • Evaluation – Good night sleep

Promoting Rest and Sleep • Rest period • Nonessential tasks • Night time/early am bathing • Lab work • Cluster activity • Visitor control • Interventions prn

Comfort Measures for Promoting Sleep ♥ Administer hygiene measures for clients on bedrest ♥ Loose fitting nightwear ♥ Remove or change any irritants against the client’s skin (moist dsg., drainage tubes) ♥ Position and support dependent body parts to protect pressure points and aid muscle relaxation

Comfort Measures for Promoting Sleep ♥ Provide caps and socks for older clients and those prone to cold ♥ Void before bedtime ♥ Analgesics or sedatives 30 min. prior H.S. ♥ Bedtime massage/backrub ♥ Comfortable mattress and a clean dry bed!

Noisy Nightshift • Close doors to clients’rooms/work areas if possible • Telephone/paging equipment • Noisy footwear • Equipment • Bedside monitors • TV/radio • Conversations

Client’s Environment • Chairs – –

Straight back post surgery Lounge chair

• Lighting – – –

Overbed Night light Call light

• Overbed table • Bedside table

Special Mattresses Types  Regular firm, plastic covered  Mattresses used to prevent & treat decubitus ulcers KCI beds Eggcrate Sheepskin

Special mattresses are not a substitute for nursing care • Turn patients Q2h • Skin care • positioning

Considerations • Bed position – – –

Safety Body mechanics Gatchs

• Infection control • Skin breakdown –

The bed changing process • Every health care agency wants the end product to be neat, clean, comfortable and durable. • Economical – – –

Time Equipment Energy, patients and nurses

Assembling Equipment • 2 sheets – Fitted/flat for bottom – Flat for top

• Pillowcases • Cotton/rubber drawsheet as needed • Soaker • Bedspread • Blanket

Linen Overload • Just what you need • Cost control Once linen brought into a client’s room, if unused, must be discarded for laundering Excess linen causes clutter and obstacles in a cramped space

Rubber drawsheet • Save on linen • Time • Turning and positioning • Placed under cotton drawsheet Drawsheet extends from above waist to midthigh. Absorbs secretions due to urinary/fecal incontinence

Linen Change • As per hospital protocol – – – – – –

Cost Pillow cases/drawsheet OD Soiled or bath day Laundry shute/hamper If soiled with feces/blood Use of gloves

Skill Under no circumstances do you place dirty linen on floor, footstool, another patient’s bed or on over the bed tables. Assessment What needs to be changed Client’s condition

When does the bed get changed? • 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

Effective Body Mechanics and Bed Making 1. 2. 3. 4. 5.

Maintain good body alignment Use the large muscles of the body Work smoothly and rhythmically Push or pull rather than lift Use your own weight to counteract the weight of an object.

Nursing Diagnosis • Activity intolerance • Impaired physical condition

Types of Bed • Occupied • Unoccupied • Surgical/post-op beds

Occupied Bed • Gloves if drainage • Check chart/kardex for client’s activity • Talk to the client, explain procedure • Privacy • Assemble all equipment, incontinent pads prn • Safety with side rails/call bell • Wash hands before and after

Planning • Expected outcomes • Best time to change linen • Equipment needed

Implementation • Wash hands • Gloves prn • Equipment • Adjust bed height-HOB down • Lower side rail- remove call bell • Loosen linen • Keep soiled linen away from uniform

Infection Control and Bed Making 1. Microorganisms are present on the skin and in the general environment. 2. Some microorganisms are opportunists; that is, they can cause infections when conditions are favorable ( break in skin, mucous membranes) 3. Clients are often less resistant to infections because of the stress resulting from an existing disease process.

Infection Control and Bed Making 4. Microorganisms may be transferred from one person to another or from one place to another by air, by inanimate objects or by direct contact among people. Therefore:  Avoid holding soiled linen against uniform  Never shake linen  Always wash hands before going to another patient.

Avoid shaking linen for infection control purposes • Linen to be reused – fold and place on chair

• Soak and rinse linen soiled with feces or blood before placing in hamper • Make sure no tripads, personal articles or anything besides linen is placed in hamper

Evaluation • Inspect bed – – –

Clean Neat Wrinkle free

Always be alert to client comfort and safety during bedmaking.

• When finished evaluate – – – – –

Safety re bed position Call light Side rails Unit tidy Personal belongings are within reach

Accessories • Bed cradle/foot cradle • Fracture board • Foot board • Toe pleat Therapeutic Frames allow movement for immobilized patients & help prevent complications R/T immobility

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