Bed Making
DEFINITION
Bed making is the technique of preparing different types of bed to promote comfort to the patients/client or provide a suitable position for a particular condition.
"Bed-making is the act of arranging the bedsheets and other bedding on a bed, to prepare it for use"
"Bed-making is an act of arranging the bedsheets and other bedding on a bed, to prepare it for therapeutic use."
Purposes
Bed-making is a patient-centred procedure. Following are the purposes of bed-making-
- To provide clean, safe and comfortable bed for patient to rest and sleep.
- To improve the aesthetics of the patient's unit/To give the unit or ward a neat appearance.
- To keep the bed ready for any emergency.
- To receive the patient comfortably.
- To provide active and passive exercises to the patient.
- To prevent bedsores.
- To promote cleanliness.
- To observe the patient during bed-making. For example: skin assessment, oral hygiene, patient's ability of self-care can be observe during bed making.
- To dispose soiled and dirty linen properly.
- To accommodate the patient's needs.
- To utilize the time to help relatives to learn to take care for sick at home.
- To establish interpersonal relationship.
- To economize time, material and energy.
- To teach relatives how to take care of patient at home.
Articles Required for Bed -Making
- Mattress cover
- Bed Sheets (bottom and top)
- Blanket
- Draw sheet
- Mackintosh
- Pillow cover
- Counterpane
- Laundry bag
- Two dusters/sponge cloth-1 for solution and 2nd to dry
- A bowl with antiseptic lotion (Savlon or Dettol solution)
- Kidney tray
- Various comfort devices like cardiac table, bed cradle, extra pillows, back rest, foot board, fracture board, sand bag, etc.
Principles of Bed-making
Basic principles of bed making are-
- Principle of patient comfort
- Principle of good body mechanics
- Principle of order
- Principle of prevention of microorganism spread
- Principle of patient safety and privacy
- Principle of assessment
A. Principle of patient comfort-Bed making is performed to ensure patient's rest, sleep and to prevent several complications by making a safe and comfortable bed. Bed should be free from lumps, creases and wrinkles and wet and dirty linen must be changed immediately.
B. Principle of good body mechanics-Nurse must utilize good body mechanics to prevent fatigue during bed making.
1. Maintain the Stability -
- Stability of the body by keeping its center of gravity over its base.
- Keeping the feet apart in standing position can create a wider base.
2. Body weight -Keep weight nearer to the centre of gravity to reduce the strain.
3. Bed height -Always raise the bed to the appropriate height before changing linen. So nurses do not have to bend or stretch over the mattress.
4. Safe handling-Body mechanics and safe handling are important when turning or repositioning the patient in bed.
5. Body positioning-When tucking the sheets under the mattress, flexing is done by knees and hips.
6. Direction- When placing the linen on the bed and tucking it under the mattress, nurse should face the direction of work and move with the work rather than twisting the body and over reaching.
C. Principle of order- Systematic ways of working save time, energy and resources. For example, assemble all the articles before starting the procedure, arrange the linen in the reverse order of use, finish on one side of the bed before going to the opposite side, fold the bedsheet in such a way that it can be replaced easily.
D. Principle of prevention of microorganism spread-
Prevent the transference of microorganisms from the source to the new host by direct or indirect contact.
- Wash hands before and after bed making
- Keep soiled linen away from the uniform
- Place soiled linen in special linen bags before placing in a hamper.
- Never shake the linen, do not place soiled linen on the floor, perform damp dusting instead of dry dusting.
- Keep distance from the patient's face to prevent droplet infection.
E. Principle of patient safety and privacy-
Use screen whenever possible and apply side rails to aid positioning and turning and maintaining the proper bed position, it helps to promote comfort and safety.
F. Principle of assessment-
Communicate with the patient and observe the patient for recovery or may be deterioration in health status during bed making.
GENERAL RULES TO BE OBSERVED IN BED MAKING
- When removing sheets from the bed, lift the mattress while loosening the bed linen. Never pull sheets with force.
- Always fold bed linen from top to bottom.
- Turn the mattress from top to bottom or with three folds when bed is unoccupied.
- Always arrange bed linen in correct order with closed side away from you before making the bed. It should not touch the floor.
- Your uniform should never touch the bed.
- While tucking the bedding under the mattress, the palm of the hand should face down in order to protect your nails.
- Keep open end of the pillow away from the entrance of the ward.
- Soiled linen should not be thrown on the floor, but it should be kept in a dirty linen box.
- Soiled woolen blankets are to be kept separately and not with the clean bed linen.
- After completing the bed making ensure that the locker and chair are in place and that all beds are in line.
- When making an occupied bed try not to cause discomfort by shaking the bed or moving the patient unnecessary.
TYPES OF BEDS
- Un-Occupied bed
- Open bed
- Closed bed
- Occupied bed
- Admission bed
- Postoperative bed
- Cardiac bed
- Amputation bed/Divided bed
- Fracture bed
- Burn Bed
- Therapeutic bed e.g., renal bed, rheumatism bed, blanket bed.
Preparation of Articles and their Purposes
| Articles | Purposes |
|
Damp duster and dry duster to clean the metal bed |
To prevent spread of infection |
| Kidney tray | To receive wastes |
| Mattress with cover | To protect the mattress |
| Bed sheets-2 | To use as bottom sheet and top sheet |
| Draw sheet-1 | To protect the bed linen and to cover the mackintos |
| Mackintosh-1 | To protect the bed linen |
| Pillow cover-1 | To protect the pillow |
| Pillow | To provide comfort |
| Counter pane | To protect the top linen |
| Blankets (if required) | To provide warmth |
| Stool/chair | To keep articles |
| Dirty linen trolley | To discard soiled linen |
Un-Occupied bed-A bed prepared to receive a new patient is an unoccupied bed. There are two types of unoccupied bed-
- Open bed
- Closed bed
Open bed-
It is a bed made when it is about to be occupied by either a new patient or an ambulatory patient.
"The term open bed is used to designate the hospital bed when it is about to be occupied by a client."
CLOSED BED-
An unoccupied empty bed made to receive the patient and is fully covered it with counter pane to protect it from dust and dirt. On admission of the patient, the closed bed is converted into an open bed.
"It is an empty bed in which the top covers are so arranged that all linen beneath the spread is fully protected from dust and dirt"
Occupied bed-
This is bed is made with the patient in it
- An occupied bed is making the bed where the patient physically available in the bed or the bed is being retained for the patient.
- An occupied bed is made while the patient is still in the bed.
Purposes
- To make a bed with least possible discomfort to the patient.
- To provide clean and tidy appearance.
- To prevent skin breakdown due to soiled linen.
- To handle the bed linen skilfully while the patient is on bed.
- To establish effective nurse patient relationship.
Admission bed-
This is a bed which is prepared to receive a newly admitted patient.
"It is a specailly made bed for patients who are admitted into the ward. It is made in such a way that a patient or client is admitted without delay"
Postoperative bed-
It is a bed prepared for a patient who is recovering from the effects of anesthesia following surgery.
A postoperative bed or surgical bed is a special type of bed made for the patient who is coming from the operation theatre or from another procedure that requires anesthesia.
Purposes
- To receive the patient conveniently.
- To prevent shock.
- To provide warmth and comfort.
- To meet any emergency.
Additional Articles Required for Making
- Large Mackintosh and towel
- Vital signs tray
- IV stand
- Oxygen cylinder
- Suction apparatus
- Hot water bags
Cardiac bed-
A bed prepared for patients with cardiac diseases.
"The cardiac bed is a type of bed that is mainly arranged in such a way that the patient is kept in a sitting position on the bed with the help of pillows and a Cardiac table"
Additional Articles Required
- Back rest
- Cardiac table
- Extra pillows
- Foot board.
Amputation bed/Divided bed-
It is a bed in which top linen is divided into parts to visualize the amputated part without disturbing the patient.
Purposes
- To watch stump for hemorrhage.
- To take the weight of the bed clothes of the patient.
- To keep the stump in position.
Additional Articles Required
- Extra set of top linen (top sheet and blanket)
- Extra draw sheets
- Sand bags.
Fracture bed-
It is a bed prepared for patients with fracture, bone diseases and deformity.
Fracture bed is one which is use for a patient with fracture of the trunk or extremities to provide a firm support by the use of firm matters that rest on the bed board of fracture board.
Purposes
- To immobilize the fractured part.
- To restrict sudden jerky movements.
- To prevent the undue sagging of mattress.
- To keep the traction in position.
Additional Articles Required
- Fracture board
- Sand bags with cover
- Bed cradle
- Extra pillows.
Burn Bed
It is a special type of bed designed for hospital patient who have suffered severe skin burn across large portion of their body.
Purposes
- To provide comfort to the patient
- To relieve pain
- To prevent infection
- To distribute the weight of top sheet equally over the cradle.
Additional Articles Required
- Bed Cradle