Bed Making

Changing an Unoccupied Bed

Nurse: Good morning. Today I will be changing an unoccupied bed. First, an unoccupied bed has two types. They are the closed bed and the open bed. The close bed is a bed prepared when a new patient is admitted. While open bed is made when the patient is out for a while but will come back after a few time. The purpose of this concept is to first, promote the clients comfort. Second, provide a neat and clean environment for the client. And third, provide a smooth, wrinkle-free foundation which will minimize the sources skin irritation. The special considerations are as follows. 1. Confirm that there is a physicians order allowing the client out of bed. 2. Asses pulse, respirations and physical status before getting the client out of bed. 3. Use aseptic technique 4. Place the bed in low position and make sure the wheels are locked before returning the client to the bed. 5. Make sure the signal cord is accessible to the patient. 6. Use only clean linen to change bed. 7. Foundation of the bed should be smooth and without wrinkles. 8. Allow sufficient toe room for the client. Thats all and now I will first wash my hands for the safety and protection of my client. Assuming that I have done my hand washing, I will then gather the all the linen and the things that I need in changing an unoccupied bed. Gathering data beforehand would save time and helps ensure organized carrying out of procedure. I need: A mattress Bottom sheet to cover the mattress Draw sheets (cotton used for carrying the client and rubber used trapping any liquids from soiling the bottom sheet) Top sheet for temperature purposes and for privacy Blanket Bedspread Chair where I place the equipments Hamper container for soiled linens

After I have gathered everything that I need, I will explain to the patient my procedure. This decreases anxiety and increases cooperation. Then when the client is already out of the bed, I will adjust the bed to a comfortable working height. I will lower the side rails. Then strip the bed. When stripping the bed: 1. Check the bed for any items belonging to the patient and detach any drainage tubes from the bed. 2. Starting from the head of the bed, I loosen the linens. 3. Then I will remove the pillow cases. 4. I will now grasp the top edge of the bedspread and fold it into half until it reaches the bottom edge of the bedspread. 5. If the linen is soiled, I will put it on the bedside chair near the foot of the bed. But if not soiled, I will pick it up carefully by grasping it at the center of the middle fold and the bottom edges and put it on the back of the chair. 6. I will repeat the steps for the blanket and the top sheet. 7. I will pick up the cotton draw sheet at the center of the top and bottom edges and lay it over at the back of the bedside chair. If soiled, I will place it on the hamper. 8. I will repeat the steps for removing the bottom sheet similar to the removal of the bedspread. I have already removed all the soiled and used linens, so its time for me to place new linens. When applying the bottom sheet. 1. From the foot of the bed, I will place the bottom sheet, folded into four layers, on the center of the bed with an excess of 1 inch at the bottom end of the bed. 2. I will open and extend the bottom sheet folded into four layers to the head of the bed. Then open it on the left side. Then I will go to the right side and also open it. 3. I will tuck the excess sheet under the mattress at the top edge. 4. Then I will miter the sheet at the top corner and tuck the corner under the mattress side working from the head of the bed to the foot. 5. I will lay the rubber sheet at the center or the cite where the buttocks is located. 6. After I have placed the rubber sheet, I will place the cotton draw sheet folded into half at the center line of the bed. The cotton draw sheet should be placed 12 15 inches from the head of the bed. 7. Next, I will tuck both the rubber draw sheet and the cotton draw sheet. Tucking and mitering the bottom sheet and both the cotton and rubber draw sheet would make the linens tighter thus removing wrinkles.

Wrinkles can cause discomfort for the client. So we must check if the bed is wrinkled-free. 8. Now, I am going to complete this procedure by placing the three top linens which are the top sheet, blanket, and the bedspread. 9. I will place the top sheet on the center top of the bed with 1 inch excess. The top sheet is folded opposite of the other linens. The right side is facing inward and the wrong side is facing outward. But when we open the top sheet the right side will be facing outward and the wrong side will be touching the patients skin. 10. I will spread it just like what I have done with the bottom sheet. 11. I will make a toe pleat in the lower part of the bed. So there are two types of toe pleat: Vertical: I will make a fold about 2 4 inches perpendicular to the foot of the bed. Horizontal: I will fold the sheet into 6 8 inches on both the left and right side. Toe pleat provides additional room for the clients foot. It is an additional comfort measure. 12. After I have placed a toe pleat, I will then place a blanket on the bed. The blanket should be 6 inches from the head of the bed and the center fold should always be at the center of the bed. 13. Then I will place the bedspread about 1 inch beyond the blanket. 14. I will tuck in the excess of the spread. 15. I will then miter the three top linens. Leaving the sides of these three blankets hanging freely. Mitering makes the corner secure even though they are left hanging freely. 16. I will next fold the remainder of the top sheet under the blanket over the bed spread to make a cuff. 17. I will tuck all the three linens on the bottom edge of the bed. If a toe pleat is made, I will maintain it. 18. So there you have it a clean bed but a bed is not complete without a pillow. So first, I will change the cover of the pillow 19. When changing a pillow, first grasp the closed end of the pillowcases at the center with one hand. 20. Then gather the sides of the pillowcase and place the over the hand grasping the case. 21. With a free hand, pull the pillowcase over the pillow. 22. Adjust the pillowcase so that the pillow fits into the corners of the case. A smoothly fitting pillowcase is more comfortable than a wrinkled one. 23. Finally, I will place the pillow at the head of the bed. The open end of the pillowcases should be facing away the door. Assuming that this is the door, I will place it there so that it would not be seen which will be neat in appearance. 24. After I have made a clean and wrinkled-free bed I will then provide the client comfort and safety by attaching the signal cord so

that the client can conveniently use it. If the bed is currently used, either fold the top covers in a triangular fold or fanfold them down to the center of the bed. This makes it easier for the client to get into bed. Then if the client is in bed, raise the rails in the highest position. 25. Dispose any soiled linens. 26. Wash hands thoroughly

Changing an Occupied bed

A bed made with the client in it because the client is too weak to get out of the bed is called an Occupied bed. The purpose of this procedure are first, to conserve clients energy and maintain current health status. Next, to provide comfort to the client, Third, to provide a clean and neat environment for the client. Lastly, to provide a smooth wrinkled-free bed foundation. The special considerations of this procedure are as follows: 1. Maintain the client in good body alignment. Never position the client in a contraindicated position. 2. Move the client gently and smoothly. 3. Explain every step to the client to decrease the clients anxiety and increase cooperation 4. Use bed making time to assess and meat the clients needs. 5. Use side rails to protect the client from falling 6. Change all soiled linens. We must always take not of specific orders and precautions in moving and positioning the client. And make sure that there are no lubricants and drainage attached to the bed. We need the following materials: Bottom sheet Rubber and cotton draw sheet Top sheet Blanket Bed spread Towel Assistant for moving the client Chair Hamper After I have gathered the equipments I will now start changing the occupied bed. 1. Inform the client and prepare the unit. 2. First I will loosen all the linens so that it will be easy to remove.

3. I will remove the blanket and the bedspread by pulling it at the center. 4. Then I will place a bath towel above the top sheet for the clients privacy. 5. I will gently pull the top sheet which is below the bath towel. 6. Then after that, I will call my assistant to help me carry the patient. But before moving the patient I will first raise the side rails for the patients safety and protection. 7. When moving the patient, grasp the cotton draw sheet. Raise the cotton draw sheet at the same time. Then place the client gently and smoothly. 8. Roll or fanfold the cotton draw sheet and the rubber draw sheet towards the clients back. Tuck it. 9. Remove the bottom sheet and also fanfold it just as what I have did with the draw sheets. 10. Place the new bottom sheet on the side. Roll it just as what I have did with the unoccupied bed. 11. Then I will place new draw sheets on the new bottom sheet. 12. After that, I will gently move my patient by pushing him/her gently to the clean and new side of the bed. 13. I will remove the soiled linens then roll over the new ones until it reaches the edges. 14. I will miter and tuck the bottom sheet, and the draw sheets. 15. Then I will place the top sheet. 16. Remove the bath towel. 17. Place the blanket and the bedspread. 18. Dispose soiled linens 19. Wash hands

Surgical Bed
It is a bed made for clients who are having surgical or diagnostic procedures that require the use of an anaesthetic. It is also known as anaesthetic bed. It purposes are: to arrange the top linens so that the client can be readily transferred to the bed, To provide clean environment, To provide foundation that can be changed quickly and easily if it becomes soiled, to provide extra warmth thru the use of flannelette sheets. Here are the special considerations, 1. Use clean bed linen 2. Fold the top bed clothes for the clients easy access 3. Leave the bed in high position 4. The nurse must obtain and set up special equipment as needed. 5. The surgical bed needs to be made as soon as the client goes to the operating room.

6. The surgical bed is also known as the recovery bed, anaesthetic bed or postoperative bed. It may be used only for clients who have undergone surgical procedures or given anaesthesia. 7. I need: Bottom sheet Rubber draw sheet Cotton draw sheet Top sheet Chair First, place the bottom sheet the same as the unoccupied bed. Then miter and tuck the bottom sheet. Second, place the rubber draw sheet and the cotton draw sheet. Do not tuck it in. Just leave it freely. Third, place the top sheet the same as what I have did with the occupied bed but do not miter, tuck them in, or make a toe pleat. Just leave it freely. Be sure to lock the wheels of the bed and leave the bed in high positions to meet the level of the stretcher. Locking the wheels would avoid accidents and would prevent the bed from rolling. Lastly, notify the appropriate people that the surgical bed is ready. Be sure to wash hands for every bed changing or procedure. Check the materials