Post on 20-Jan-2016
BED MAKING
Provide Support to Meet Personal Care Needs
Bed Making
Ongoing provision of basic cleanliness, comfort and safety
Clients may spend long periods of time in bed, undertaking various activities – depending on individual health state, and on situational factors (ie if at home, or in a health care agency)
Principles
Factors to consider with each bedmaking
episode:
Prevention of cross-infection Safety and comfort for the client Maintenance of good body mechanics
Prevention of cross-infection
Wash hands or use alcohol hand rub before and after making each bed
If linen is very soiled, wear gloves for removal
Dirty linen is put immediately into soiled linen bag (white or brown bag) or as per organization – never onto floor !!
Don’t shake or flick linen excessively Linen shouldn’t touch floor, or be held up
against carer’s clothing Linen should only be put onto a clean
surface prior to bed making NO interchange of linen between clients
Client safety and comfort
Ensure that bed brakes are on, and that bed is returned to its original position (usually to a height the resident can easily access), after bed making is complete
Promote comfort, by having sheets free of rough areas, wrinkles or creases, food crumbs and foreign bodies
Avoid areas of potential pressure, i.e. hems of sheets away from direct contact with client’s skin
If waterproofing layer is used, must not come into contact with client’s skin
Need to particularly consider safety and comfort, if client occupies bed whilst it is being made
Body mechanics of the carer
Maintain good body alignment when bed making – avoid bending, stretching and twisting
Use large leg muscles (bend knees), rather than back muscles
Work smoothly and rhythmically – 2 people to make beds together is optimal
If able, raise bed to a comfortable working height (usually waist high) – to avoid bending and back strain
Prepare well – gather all equipment initially, and avoid legwork
Bed features
Many types of beds available, with multiple modifications possible
In health agencies, most are “hi-lo”, allowing adjustment of the bed base up and down
Most also allow position changes, ie head/feet up/down
Different types of operation – some have hand-winding action, others with hydraulic foot pump mechanism and release button, some are electric
Bed brakes Bed heads and feet are detachable, for
emergency access situations, or for transfer of clients on their beds
Bed “attachments”
Trapeze/overhead “monkeybar” Bedstick
Drainage tube bag hangers Client call bell Bed siderails – may constitute restraint!
Bed aids
Most bed aids relate to the comfort and correct positioning of a client
If bed aids used, need to be appropriately selected and used
Pillows – with waterproof cover
Bed aids - Mattress
Many different types Air alternating Egg carton
Bed cradle Sheepskin – for under buttocks, or
elbow/heel protectors Wedges/wedge shaped pillows Footboards/foot bolsters Absorbent layers
Sheepskins
Medical sheepskins – green in color
30mm pile (springy), especially tanned
High density-creates a cushion that distributes body weight & pressure points over a large area-each fibre acts as a spring
Sheepskins Cont.
Wool can absorb moisture up to 33% of its weight without feeling wet
Reduces friction & shear
Medical sheepskins are stamped
The steps to making an unoccupied bed
Wash & dry hands
Place clean linen & soiled linen skip near the bed
Ensure that there is a chair on which to place the bed clothes
Ideally there would be two people to make the bed
PATIENT POSITIONING
Fowler's Position- A person in the Fowler's position is sitting straight up or leaning slightly back. Their legs may either be straight or bent.
High fowlers’ position is when the patient is sitting upright.
Low fowlers’ position is when the patient’s head is only slightly elevated.
Trendelenberg Position - A person in the Trendelenberg position is lying supine with their head slightly lower than their feet.
PATIENT POSITIONING
PATIENT POSITIONING
Supine- Someone in the supine position is lying on his or her back.
Prone - Someone in the prone position is lying face down.
PATIENT POSITIONING
PATIENT POSITIONING
Right Lateral Recumbent- The Right lateral recumbent, or RLR, means that the patient is lying on their right side.
Left Lateral Recumbent -The left lateral recumbent, or LLR, means that the patient is lying on their left side.
PATIENT POSITIONING
PATIENT POSITIONING
Abduction is movement away from the midline, or to abduct.
Adduction is movement toward the midline, or to add.
PATIENT POSITIONING
PATIENT POSITIONING
Flexion-decreasing the angle between two bones.
Extension-movement by which the two ends of any jointed part are drawn away from each other.
PATIENT POSITIONING
Making an Unoccupied Bed
Move the bedside locker & over bed table if necessary
Adjust the height of the bed – it should sit about hip height
Place pillows on the bed. Place any soiled pillow slips in the skip
Loosen the upper bed clothes
Making an Unoccupied Bed
Remove each item of upper bed clothes separately, fold & place on the chair. Loosen the bottom bed clothes, fold & place on the chair. Any soiled items are placed in the linen skip
Roll, rather than fold the waterproof sheet (if applicable)
Making an Unoccupied Bed
Pull the mattress well up to the head of the bed
Commencing with the bottom sheet, each item is replaced separately
Ensure the hem of the sheets is facing outward to protect the resident’s skin
Some facilities will have fitted bottom sheets
Note the centre of the sheet follows down the middle of the bed
Making an Unoccupied Bed
If a draw sheet or Kylie sheet / Kylie pad is used it is positioned approximately 25cm from the head of the bed. The bed clothes should be centred and unless being made up as an open bed, tucked in around the mattress
The mitred or military corner
Most hospitals and residential care facilities will make their beds with the sheets having a mitred corner
The steps
Once the sheet is placed on the bed tuck the bottom end of the sheet under the end of the mattress
Pick up, about 20-30cm from the end of the sheet, and place it on the top of the bed – this should make a bit of a triangle shape
Tuck the sheet that is still hanging toward the floor under the bottom of the matteress
The steps continued
Then bring the top part of the triangle down and tuck into the mattress for the BOTTOM sheet
Each layer of linen is tucked in the same way
Often the top sheet and blankets are left without the step above so that all of the sheets are not tucked in along the side of the bed – this makes it easier to get patients and residents back into bed
A mitred corner
Making an Unoccupied Bed
At the top end of the bed, fold the top sheet over the blanket. The top layer of blanket is generally tucked under from the top
Ensure there are no wrinkles in any layer of the linen
Many facilities will have their own policies about using resident’s own linen, and how the bed should look
Some facilities do not like to have blankets underneath showing Be aware of your facility’s policy on laundering of personal linen
Replace & arrange the pillows to meet the resident’s needs If a person is to return to bed, the top corner of the upper bed
clothes may be folded back Ensure the bed is returned back to an appropriate level for the
resident to get back into bed, and place call bells etc in reach Make sure there is no linen hanging on the floor
Replace any furniture Tidy around the resident’s bed side eg serviettes, tissues etc Remove linen skip Wash & dry your hands
Now to make the occupied bed
Wash & dry hands Explain the procedure to the individual &
ensure privacy Collect clean linen & linen skip before
commencing to make the bed Move the bedside locker & over bed table if
necessary
Making an Occupied Bed
Ensure there is a nearby chair on which to place the bed clothes
Adjust the height of the bed Leaving sufficient pillows to support the individual,
place the reminder on the chair Remove each item of upper bedclothes separately.
Bed clothes to be replaced are folded and put on the chair. Cover the person with a procedure blanket before removing the top sheet. Place soiled items into the linen skip
Remove accessories such as bed cradle
Making an Occupied Bed
Support the individual & gently turn him onto one side of the bed. If only one nurse is making the bed, the side rail away from her should be elevated (if insitu)
Loosen the bottom sheets on the occupied side, and roll each one towards the centre of the bed. Brush out any debris eg crumbs. Eliminate any creases from the mattress cover
Working at the unoccupied side of the bed, either:
Unroll, pull the bottom sheets taut, and tuck in around the mattress OR If using a fresh sheet, place on the bed and unfold it so that centre laundry crease lies at the centre of the mattress. Tuck in at the top, bottom and side. Roll the excess to the centre of the bed
Making an Occupied Bed
Carefully turn the individual to the other side of the bed, providing adequate support as he is moved. If appropriate, elevate side rail
From the opposite side of the bed, either: Remove any soiled sheets and place in the linen skip
OR Untuck and roll sheet/s to the centre of the bed Ensure that side of the mattress is free from debris and
ceases, unroll and tuck the sheet/s in around the mattress Assist the individual back into the centre of the bed, arrange
the pillows to meet the need and assist him into position
Making an Occupied Bed
Replace any accessories, put on the top sheet and remove the procedure blanket
Replace the blankets and quilt, ensuring that they are positioned to cover the individual’s chest and shoulders. Make foot pleats in the upper bed clothes and avoid tucking them in to tightly
Adjust the height of the bed – ensure nurse call bell within reach
Replace any furniture. Remove the linen skip. Wash and dry hands.