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Bed Making

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					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.   Maintain good body alignment
2.   Use the large muscles of the body
3.   Work smoothly and rhythmically
4.   Push or pull rather than lift
5.   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

				
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posted:12/1/2009
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