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
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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
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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
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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
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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
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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
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Maintain good body alignment
Use the large muscles of the body
Work smoothly and rhythmically
Push or pull rather than lift
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
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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
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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
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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
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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