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 client’s 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 physician’s 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.
That’s 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 equipment’s
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 it’s 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 patient’s 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 client’s 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 client’s 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 client’s anxiety and
increase cooperation
4. Use bed making time to assess and meat the client’s 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 client’s 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 patient’s
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 client’s 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 client’s 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.
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Be sure to wash hands for every bed changing or procedure.
Check the materials