BED MAKING: HOW TO MAKE HOSPITAL BEDS FOR PATIENTS
BED MAKING:
Bed making is the technique of preparing different types of beds in order to make patients comfortable or his position suitable for the particular condition.PURPOSE OF BED MAKING
To provide rest, comfort and safety to the patient by providing the right
body alignment for patient’s condition.
To give the room or ward a neat and tidy appearance.
To help patient have a good relaxed sleep.
To keep it ready for an emergency (for quick admittance) in order to
economies time and energy.
To prevent cross infection
To provide warmth to patient.
RULES OF BED MAKING
All requirements should be collected before starting.
Two nurses are required and they should work in harmony, avoiding jerky movements
and jarring the bed.
The patient’s face must never be covered by sheets or blankets.
The patient must never be exposed.
Extra assistance should be available and if necessary, should be called
upon to help lift the patient.
When pillows are being shaken the nurse should turn away from the patient.
Any conversation during bed making should include the patient and should
not be on personal matters between the nurses.
POINTS TO NOTE WHEN MAKING BED
The bed should be free from crumbs and creases and should give maximum
comfort to patient.
Pillows and other bed accessories should be well arranged to give support
where necessary.
Bed should be made in such a way that the patient can be put into it
without difficulty.
It should be suitable for treating certain conditions e.g. shock.
It should facilitate bathing patients without undue disturbances
It is required that two nurses make the bed work in harmony avoiding jerky
movements and jarring the bed.
All requirements needed should be collected before starting bed making.
INFECTION PREVENTION IN BED MAKING
The nurse must wash her hands before and after bed making to prevent cross infection. Wear a disposable glove if bed is soiled. Bed clothes must be changed frequently to ensure cleanliness. When the bed linen of a patient is removed, it should not touch the floor or other patient’s bed or even the nurses’ uniform. To prevent droplet infection, the nurse should not come very close to the patient’s face. The linen removed from the isolation unit is first disinfected and then sent to laundry. Daily dusting of the surroundings and bed and proper disposal of excreta to keep the room /ward free from micro-organism.
Examples of bed accessories:
Bed cradle.
Sandbags.
Hot water bottle.
Heart or cardiac table.
Foot rest.
Back rest.
Polly for orthopedic patients.
MAKING A SIMPLE UNOCCUPIED BED
REQUIREMENTS FOR MAKING A SIMPLE UNOCCUPIED BED
A trolley with the following items:
Two large cotton sheet.
One water proof or draw mackintosh if necessary.
One long mackintosh
One or two pillows
One blanket if necessary or optional
One counterpane.
STEP/ METHOD FOR MAKING A SIMPLE UNOCCUPIED BED
Collect, arrange items on trolley and send to bedside
Arrange items in order of use on a chair or heart table
Place long mackintosh on mattress if necessary
Place bottom sheet evenly on the bed
Tuck the sheet under the mattress at the top and bottom using envelops
corners.
Pull sheet tight so that there are no creases and tuck in at the sides.
Place draw mackintosh across the bed with the upper Corner under the edge
of the pillow and cover with draw sheet.
Place the pillows on the bed so that the open ends of the slip are away
from the door.
Place top sheet on bed with the wrong side uppermost.
Fold over at the bottom and tuck in loosely to prevent restriction of
patient’s feet.
Place the bed cover or counterpane loosely over the bed.
Tuck in at the bottom end under the mattress using envelope corners.
Fold top sheet over the counterpane.
Tuck in all sides under the mattress.
Remove trolley and chair.
Washes and dries hands or uses alcohol rub if applicable.
MAKING SIMPLE OCCUPIED BED
Extra requirement in addition to simple unoccupied bed include;
Dirty linen bin
Clean line
2 chairs/ heart table
The requirement is same as for that of simple unoccupied bed. Two nurses should always work together. In case it is needed clean linen is taken to the bed side on a trolley together with receptacle for soiled linen. Two chairs are place at foot end of the bed and the bed side locker moved to allow free access to all parts of the bed. For routine bed making the ward is closed that is a screen is placed across the ward door and the only persons allowed to enter are the nursing staff. If routine bed making is not in progress the individual bed is screened.
METHOD FOR MAKING SIMPLE OCCUPIED BED
Place a chair or two at the foot end of the bed.
Un-tuck the bed cloth beginning from the top.
Remove counterpane or blanket if present and fold it into 3 parts stating
from the bottom and lift it unto chair.
Do not expose patient
Remove all pillows except one and bed accessories where necessary.
If side to side method is employed, roll the patient gently from side to
side and support him in this position.
Brush out cramps and dust found on the bottom sheet with a special brush or
duster.
Roll separately to the patient’s back the draw sheet, mackintosh and the
bottom sheet brushing all along.
Check the mattress cover, examine the mattress and bed stead to see if they
are in good condition.
If the bottom sheet does not need changing, roll them back one after the
other and tuck in firmly making envelope (miter) corners at the top.
Roll the patient to the finished side and support him.
Make the other side of the bed as previously described.
Both nurses then lift the patient to sitting up position and as one
supports the patient, the other nurse arranges the pillows and makes them comfortable.
Both nurses move to the bottom part of the bed and one lift the patient’s
feet while the other brushes crumbs from the bed. They both pull the sheet and
tuck in under the mattress.
Replace all pillows and bed accessories removed.
Replace the top sheet as for simple bed.
Discard trolley.
Wash hands and document procedure in the nurses note.
NB: Clean patient if he has soiled himself before putting him on a clean
sheet.
CHANGING BOTTOM SHEET FROM TOP TO BOTTOM
Requirements for changing bottom sheet from top to bottom
Same as for making occupied bed
1. Assembles the necessary equipment and materials
2. Explains procedure to patient and provides privacy
3. Places two chairs at the foot end of the bed
4. Loosens sheet at sides and foot of bed and places it on chairs
5. Leaves patient covered with the top sheet
6. Holds top sheet over patient’s shoulder with hand nearest to the head of bed
7. Moves patient to foot end of bed with help of an assistant and let him/her lean on heart table with pillow
8. Supports patient and remove pillow and places it on chair
9. Rolls the soiled sheets down from the top end of the bed to the patients buttocks
10. Makes top half foundation bed with clean sheets and arranges pillows at the top half of the bed.
11. Helps patient back to position keeping him covered.
12. One nurse lifts the patient’s legs whiles the other removes the soiled bottom sheet and places it in the dirty linen container
13. Pulls down the clean bottom sheet, mackintosh and the draw sheet
14. Both nurses pull the bottom sheet tight and tuck it in.
15. Finishes making bed using top sheet
16. Clears items and remove screen
17. Washes and dries hands
18. Document findings
CHANGING OF PATIENT’S BOTTOM SHEET FROM SIDE TO SIDE.
Requirement, same as above
1. Explain procedure to patient and ensure privacy.
2. Collect and arrange items on trolley
3. Arrange sheet in order of use on chairs or heart table.
4. Loosen sheets at the side of the bed and leave patient with only one pillow and cover her or him with top sheet.
5. Turn patient to one side of the bed supported by assisting nurse.
6. Roll dirty bottom sheet and mackintosh under patient.
7.Cover the bed with a clean rolled bottom sheet halfway in the middle of the bed
8. Put on draw mackintosh and draw sheet across bed tucking in greater part nearest to the door.
9. Remove dirty bottom sheet and place it in a receptacle.
10. Pull sheet tight and tuck in bottom sheet using envelope corners.
11. Cover patient with top sheet and leave him comfortable.
12. Clear equipment and remove screen.
13. Wash and dry hand.
14. Inform charge nurse about any observations made on patient.
ADMISSION BED
OBJECTIVES OR REASONS FOR MAKING ADMISSION BEDS
It makes it easy and quick to admit patient especially those who are
acutely ill.
To have it warm if necessary, for the comfort of the patient.
To admit certain cases such as accident, shock and hemorrhage.
To facilitate bathing the patients especially bed ridden patient etc. without undue disturbances.
REQUIREMENTS FOR MAKING ADMISSION BED
Trolley with the following items:
Long mackintosh
Two bath blankets
Bed blocks or elevator, bed cradle, back rest or any other bed accessories depending on patient’s condition.
Two covered hot water bottles.
Extra requirement needed to be added to those required for simple bed
Trolley with the following items:
Long mackintosh
Two bath blankets
Bed blocks or elevator, bed cradle, back rest or any other bed accessories depending on patient’s condition.
Two covered hot water bottles.
Method/Steps For Making Admission Bed
Collect, arrange items on trolley and send to bedside.
Arrange items in order of use on a chair or heart table.
Place bottom sheet evenly on the bed.
Tuck the sheet evenly under the mattress at the top using envelope corners.
Place draw mackintosh across bed and cover with draw sheet.
Place long mackintosh on bed.
Use one bath blanket or sheet over and tuck in all around or fold under itself
Put in hot water bottles if necessary-
MAKING A CARDIAC BED
A bed specially made for patient with chronic heart disease, pulmonary conditions and those having difficulty in breathing. The aim of this type of bed is to keep patient in an upright position preventing pressure on the heart and the abdominal organs. The upright position eases breathing, making patient more comfortable.
Extra Requirements To Those Of Admission Bed
A back rest, extra pillows, bed table /cardiac table with plastic covered soft pillows, air ring in a cotton cover, foot rest or sand bags, bed cradle, extra sheet if necessary.
STEPS/METHOD FOR MAKING CARDIAC BED
1. Collect and arrange items on trolley and sends to bedside.
2. Arranges items in order of use on a chair or heart table.
3. Places bottom sheet evenly on the bed and tuck the sheet under the mattress at the top and bottom using envelope corners.
4. Pull sheet tight so that there are no creases and tuck in at the sides under the mattress at the top and bottom using envelope corners.
5. Places draw mackintosh across bed and covers with draw sheet and tucks in.
6. Place covered air ring in between the mackintosh and the draw sheet.
7. Places/elevates back rest at top of bed and arrange pillows in an arm chair -like fashion.
8. Place top sheet on bed with the wrong side upper most and fold sheet over at the bottom.
9. Place foot rest in position.
10. Place heart table with covered pillow in position.
11. Place sputum mug and bell within reach of patient.
12. Provide pen and paper if patient is literate
13. Clears chairs/heart table, trolley, washes, dries hand or use alcohol rub if applicable
Method/ steps FOR MAKING AN OCCUPIED BED
Make bed as for a simple bed until the draw sheet is in position.
Place back rest at the top of bed.
Arrange as many pillows as necessary behind the patient.
Keep him comfortable in the sitting up position.
Place covered airing at the patient buttocks to prevent press sores.
Place bed cradle to lift weight of bed cloth off patient.
Cover patient with an extra sheet if required.
Place heart table in position with covered pillow for leaning on.
Place foot rest in position at foot end of the bed.
Place top sheet and counter pane in position.
Leave patient comfortable.
NB
In many instances the patient finds it more comfortable to lean slightly
forward resting his hands and heads on the pillow. place over the bed table
when drawn up. The position also gives the patient a slight change in his
breathing.
OPERATION BED
This is a type of bed made ready to receive a patient from surgery or
operation
OBJECTIVES FOR MAKING OPERATION BED
Have the bed ready to receive patient on his return from the operating theater.
To counteract shock.
To get the patient into bed as quickly as possible.
To protect the linen from vomitus and saliva
To clean the mouth of any saliva or vomitus for which purpose a tray is prepared.
REQUIREMENTS FOR MAKING AN OPERATION BED
Extra requirement to be added to those required for a simple bed’- Mockintosh or simple towel, one or more blanket if necessary, hot water bottle if necessary, bed blocks or bed elevators, bed-cradle, intravenous infusion stand and oxygen apparatus depending on the condition of the patient.
A tray by the bed side containing the following:
(a) Vomit bowl
(b) Dressing towel,
(c) Tray containing the following
Tray for vital signs
Swab holding forceps
Tongue holding forceps.
Spatula
Galipot with gauze swabs
Galipot with cold water
A receiver for used swabs
A receiver for mouth wash
Blood pressure apparatus
A chart for recording vital signs
STEPS FOR MAKING OPERATION BED
Collect and arrange items on trolley and send to bedside.
Arrange items in order of use on a chair or heart table
Places bottom sheet evenly on bed and tuck it under the mattress at the bottom using envelope corners.
Pull sheet tight so that there are no creases and tuck it under the mattress at the bottom using envelope corners.
Places draw mackintosh across bed and cover with draw sheet.
Places protective dressing towels at top of bed towards the side
Leave pillows on chair by the bed.
Spread blanket on bed.
Place top sheet on with the wrong side uppermost and turn back the bottom end.
Fold the top bed cloth at the open side in 3 parts over the bed for easy admission of the patient.
Places a post anaesthetic tray by the bed side containing vomit bowl, dressing towel, kidney dish containing swab holding forceps, dissecting forceps, tongue holding forceps and spatula.
Arrange other bed accessories by the bedside- drip stand, bed rails, and blood pressure apparatus.
Washes, dries hand or use alcohol rub if applicable.
DIVIDED BED
Definition: A bed made to facilitate observation, examination and treatment
of the following condition with minimum disturbances
1. Pelvic and abdominal wound
2. Lower limb amputation to observe for bleeding and to avoid weight of bed clothes from the part.
3. haemorrhage from the lower of the abdomen, pelvis and limbs
Objective for Making divided bed
1. To examine the lower part of the body or abdomen.
2. To examine the rectum and vagina for e.g.Heamorrhoidectomy – Removal of heamorrhoid. Heamorrhoid is the enlargement of the vein of the anus as consequence of prolongs constipation and frequent diarrhea.
3. For catheterization
4. In dressing of the perianal region e.g. heamorrhoidectomy.
5. In treatment of fracture of the femur.
Extra requirements added to those of simple bed are...
Two bed sheets
Two counterpanes
Dressing mackintosh or waterproof sheet and towel
Two sand bags
Roller towel or strong calico,
tourniquet and towel
Bed elevators/blocks
Bed cradle – to be used when necessary.
METHOD FOR MAKING OPERATION BED
Make bed as for simple bed until the draw sheet is in position.
Place dressing mackintosh and sheet in position.
Put bed accessories in position if necessary.
put sand bag with roller towel in position
Put towel and tourniquet in tray by the bed side.
Elevate foot end on bed.
Put bed cradle in position
Put to bed clothes over the bed cradle in two sections with the bottom part overlapping the top by 10 – 15 cm.
The bed clothes are folded back at the sides of the division for observation, examination and treatment where necessary.
FRACTURE BED
This is a type of bed with firm base or support for nursing patient with
fractures. The aim is to prevent further damage and minimize pain.
Fracture boards
Bed blocks or elevators
Sand bags with covers
Bed cradle if necessary
STEPS/ METHODS FOR MAKING FRACTURE BEDS
a)Place fracture boards under the mattress to provide firm support and
prevent sagging.
b)Make bed as for a simple bed until the draw sheet is in position.
c)Put bed accessories in position if necessary.
d)Place top bed cloths in position and tuck them in neatly.
BED MAKING FOR DRYING WET PLASTER OF PARIS (POP) BED
Note:
Care must be taken not to dent plaster.
Extra requirement to be added to simple bed are...
1 Fracture board,
2 Pillow with plastic covers
3 Mackintosh
4 Towel and bed cradle.
METHOD FOR BED MAKING FOR DRYING PLASTER OF PARIS
Place fracture boards under mattress to prevent sagging and possible cracking of plaster.
Make bed as far simple bed until draw sheet is in position.
Place bed cradle on bed
Put on top cloth and fold them neatly over the cradle.
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