Babitha's Note On Bed making

MAKING PATIENTMAKING PATIENT
BEDSBEDS
Mrs. Babitha K DevuMrs. Babitha K Devu
Asstt. ProfessorAsstt. Professor
SMVDCoNSMVDCoN

Objectives:-
• At the end of the class the students will be able
to:
o Define bed making
o Demonstrate/perform the various methods in
preparing patient bed
o Know principles and purpose of bed making
o State the articles used for bed making
2

Introduction
A hospital bed is the piece of equipment most
frequently used by the hospitalized patient.
Hospital beds are also found in long-term
care facilities, as well as patient’s homes.
The ideal hospital bed should be selected for
its impact on patient’s comfort, safety,
medical condition and ability to change
positions.
3

Definition:-
• The technique of preparing different types of
patient's comfortable bed in his/ her suitable
position for a particular condition.
• It is the process of making neat and clean
bed for the client in hospital.
• Stripping the Bed: Removal of used linen
and the airing of the mattress.
5

Purpose:-
1. To provide clean, safe and comfortable bed for the
patient to promote rest and sleep.
2. To reduce the risk of infection by maintaining a
clean environment.
3. To prevent bed sores by ensuring there are no
wrinkles to cause pressure points.
4. To economize time, material and energy.
5. To observe patient and to prevent complications.
6

Principles:-
1. Barrier nursing to prevent cross infection
7

Principles:-
5. Make all beds in a nursing unit alike for uniformity
of appearance.
8

Guidelines for Bed Making:-
• Wash hand thoroughly before and after handling
clients bed linen which helps to control nosocomial
infection.
• Gather all the required linen and accessories before
making the bed.
• Avoid shaking the linen to prevent the spread of
microorganisms and dust particles.
• Avoid placing linens clean or dirty on another patient’s
bed.
• Don’t place dirty linen on floor instead put in linen bag.
10

Guidelines for Bed Making:-
• Do not hold dirty linen against your uniform.
• Always use good body mechanics.
• Stay on one side of the bed until it is completely
made.
• Observe the patient and document any nursing
observations made.
• Move any furniture away from the bed to provide
ample working space. 11

Kinds of Linens:-
A- Blanket: a large piece of cloth often soft, woollen and
is used for warmth as a bed cover.
B- Top sheet: used to cover the patient to provide
warmth, made of thick cotton, thermal material.
C- Cotton draw sheet: a piece of cloth spread over the
rubber sheet and is used to absorb and moisture.
12

Kinds of Linens:-
D- Bottom sheet: used to cover the bed after mattress
cover.
E- Rubber sheet/Mackintosh: used to protect the bottom
sheet from soiling due to patient secretions and
prevent the patients from getting bedsore. It's usually
placed over the center of the bottom sheet.
13

Types of Bed Making:-
Common types of bed:
A- Occupied Bed: Is made when the patient is not able
or not permitted to get out of the bed. Or when patient
is already occupied in the bed.
B- Unoccupied Bed: Is made when there is no patient
confined in bed, while a patient in the shower or sitting
up in a chair.
Types of unoccupied Bed:
1- Open bed: the top covers are folded back so the
patient can easily get back in to bed. And is
prepared for ambulatory patients. 14

15
Occupied Bed: Open bed:

2- Closed bed: the top sheet blankets and bedspreads
are drawn up to the head of the mattress and under
the pillow; this is prepared in a hospital room before a
new client is admitted to the room. So also called
admission bed.
3- Post-operative bed: known as recovery bed or
anaesthetic or surgical bed, and used for a patient
with large cast or other circumstance that would make
it difficult for him to transfer and make it easy to
receive patient into bed from OT.
4- Amputation or Divided bed: This is a bed that is
prepared for a patient having amputed limb.
16

17
Open bed:Closed bed:
Post-operative bed:

5- Fracture bed: This is a hard firm bed designed for
the patient with fracture particularly of spine, pelvis or
femur.
6- Cardiac bed: this is prepared for patient with
breathing difficult and make use of cardiac table to
relieve their dyspnoea.
7- Therapeutic bed: are used to treat clients with
severe joint contractures, prolonged immobility, or skin
wounds such as pressure ulcers or severe burns.
These beds reduce or relieve the effects of pressure
against the skin through various mechanisms. Few
examples are blanket bed or rheumatic/renal bed,
burn bed etc.
18

Making an Un-occupied Bed
(Closed Bed):
An unoccupied bed is one that is made when not
occupied by a patient. In this bed all linen
beneath the bed spread is fully protected from
dust and dirt until the admission of new patient.
It is other wise called admission bed.
Indication: keep the bed ready for receiving the
new patient.
19

Making Closed Bed:
Suggested Action Rationale
Assessment:
Check the room/ward for the
need of disinfection or hygienic
level
To determine what all
type of disinfection
activities are required
Planning:
Prepare all required
equipments: Trolley with -
1.Mattress (1)
2.Bed sheets(2):
Bottom sheet (1)
Top sheet (1)
3. Pillow (1)
Save time and make
procedure more
organized
20

Making Closed Bed:
4. Pillow cover (1)
5. Mackintosh (1)
6. Draw sheet (1)
7. Blanket (1)
8. A Tray containing:
Savlon water or Dettol water
in basin
Sponge cloth (2): to wipe with
solution (1) to dry (1)
Kidney tray or paper bag (1)
9. Laundry bag or Bucket or
hamper bag (1)
21

Making Closed Bed:
Implementation:
Perform hand hygiene.
equipments and bring the
articles to the bedside.
Move the chair and bed side
locker
Clean Bed-side locker:
Wipe with wet and dry.
To prevent the spread
of infection
Organization facilitates
accurate skill
performance
It makes space for bed
making and helps
effective action.
To maintain the
cleanliness
22

Making Closed Bed:
Implementation:
Clean the mattress:
1)Stand in right side.
2)Start wet wiping from top to center
and from center to bottom in right side
of mattress.
3)Gather the dust and debris to the
bottom.
4)Collect them into kidney tray.
5)Give dry wiping as same as
procedure
6)Move to left side and Wipe with wet
and dry as same as above.
To prevent the
spread of
infection
23

Making Closed Bed:
Implementation:
Move to right side.
Bottom sheet:
1)Place and slide the bottom sheet
upward over the top of the bed leaving
the bottom edge of the sheet.
2)Open it lengthwise with the center fold
along the bed center.
3)Fold back the upper layer of the sheet
toward the opposite side of the bed.
Unfolding the
sheet in this
manner allows
you to make the
bed on one
side.
24

25
Place and slide the bottom sheet

Making Closed Bed:
Implementation:
4. Tuck the bottom sheet securely
under the head of the
mattress(approximately 20-30cm).
Make a mitered corner.
➀Pick up the selvage edge with
your hand nearest the hand of the
bed.
➁Lay a triangle over the side of the
bed
➂Tuck the hanging part of the
sheet under the mattress.
A mitered corner
has a neat
appearance and
keeps the sheet
securely under the
mattress.
26

Making Closed Bed:
Implementation:
➃ Drop the triangle over
the side of the bed.
⑤Tuck the sheet under
the entire side of bed.
5) Repeat the same
procedure at the end of the
corner of the bed
6) Tuck the remainder in
long the side
Tucking the bottom sheet
will be done by turn, the
corner of top firstly and the
corner of the bottom later.
To secure the bottom
sheet on one side of the
bed.
27

Making Closed Bed:
Implementation:
Mackintosh and draw sheet:
1)Place a mackintosh at the
middle of the bed
2)Lift the right half and spread it
forward the near Side.
3)Tuck the mackintosh under the
mattress.
4)Place the draw sheet on the
mackintosh. Spread and tuck as
same as above procedure (1-3).
Mackintosh and
draw sheet are
additional protection
for the bed and
serves as a lifting or
turning sheet for an
immobile client.
29

Making Closed Bed:
Implementation:
Move to the left side of the bed.
Spreading Bottom sheet,
mackintosh and draw sheet:
1) Fold and tuck the bottom sheet
as same in the above procedure
2) Fold and tuck both the
mackintosh and the draw sheet
under the mattress as in the
above procedure.
Secure the bottom
sheet, mackintosh
and draw sheet on
one side of the bed
30

Making Closed Bed:
Implementation:
Return to the right side.
Top sheet and blanket:
1)Place the top sheet evenly on the bed,
centering it in the below 20-30cm from
the top of the mattress.
2)Spread it downward.
3)Cover the top sheet with blanket in the
below 1 feet from the top of the mattress
and spread downward.
4)Fold the cuff (approximately 1 feet) in
the neck part
5)Tuck all these together under the
bottom of mattress. Miter the corner.
6)Tuck the remainder in along the side
A blanket
provides
warmth.
Making the cuff
at the neck part
prevents
irritation from
blanket edge.
Tucking all
these pieces
together saves
time and
provides a neat
appearance.
31

Making Closed Bed:
Implementation:
Repeat the same as in the
above procedure in left side.
Return to the right side.
Pillow and pillow cover:
1)Put a clean pillow cover on
the pillow.
2) Place a pillow at the top of
the bed in the center with the
open end away from the door.
To save time in this
manner
A pillow is a
comfortable measure.
Pillow cover keeps
cleanliness of the pillow
and neat.
The open end may
collect dust or
organisms. The open
end away from the door
also makes neat.
32

Making Closed Bed:
Implementation:
Make horizontal toe pleat:
Stand at the foot of bed and
fan-fold top sheet 5 to 10 cm (2
to 4 inches) across bed.
This allows room for
the person’s feet to
move and avoids skin
sores or foot drop.
33
Pre- folding the linen is also
practicing in some hospitals
when making admission bed.
toe pleat

Making Closed Bed:
Mrs. Babitha K Devu, Asstt.
Professor, SMVDCoN
34
Evaluation:
Return the bed, the chair and
bed-side table to their proper
place.
Replace all equipments in proper
place. Discard lines appropriately.
Document:
Document on the chart with your
signature and report any findings
to senior staff.
Date & time
Type of bed
Assessment findings observed
during procedure.
 Bedside necessities will
be within easy reach for
the client
 It makes well-setting for
the next. Proper line
disposal prevents the
spread of infection.
 To prevent the spread of
infection
 Documentation provides
coordination of care.
 Giving signature
maintains professional
accountability

Making an Un-occupied Bed
(Open Bed):
An unoccupied bed is one that is made for an
ambulatory patient. The open bed has the linens
folded down, making it easier for the client to get
into bed. Open a bed for a new client or leave it
open when the client is out of bed for a short
time.
Indication: Provide a clean, smooth and
comfortable bed to the patient.
35

Making Open Bed:
Assessment:
level
Explain the purpose and
procedure to the client
Fosters cooperation
Planning:
1.Mattress (1)
2.Bed sheets(2):
Bottom sheet (1)
Top sheet (1)
procedure more
organized
36

Making Open Bed:
3. Pillow (1)
4. Pillow cover (1)
5. Mackintosh (1)
6. Draw sheet (1)
7. Blanket (1)
in basin
hamper bag (1) 37

Making Open Bed:
Implementation:
Assist the patient out of bed
Remove the client’s personal
belongings from bed side and
keep in locker/safe place
locker
Strip the bed clothes, fold them
one by one and place them.
of infection
accurate skill
performance
To prevent the
loss/damage
making and helps
effective action.
To prevent bed clothes
touching the floor 38

Stripping the Bed:
39
Removal of used linen and the airing of the mattress.
Procedure:
1- Place chair at the foot of the bed.
2- Locked the bed.
3- Remove pillow case from pillow. Place pillow on
chair.
4- Loosen all bed linens starting at center of head of
bed, raising the mattress with one hand and draw out
bed clothes with other.
5- Remove sheet separately. Fold each linen with
soiled part inside. Wrap them all in a sheet and place
on lower bar of the bed.
6- Roll rubber sheet and place on chair.
7- Remove mattress cover.

Making Open Bed:
Implementation:
Clean Bed-side locker:
Wipe with wet and dry.
Clean the mattress:
1)Stand in right side.
2)Start wet wiping from top to center and
from center to bottom in right side of
mattress.
3)Gather the dust and debris to the
bottom.
4)Collect them into kidney tray.
5)Give dry wiping as same as procedure
6)Move to left side and Wipe with wet and
dry as same as above.
To maintain
the
cleanliness
To prevent
the spread of
infection
40

Making Open Bed:
 Place clean linens on chair in order of use.
 Cover mattress.
 Place bottom sheet with center fold in center in line with
rim of matters at foot part, spread across bed. Make
mitered corner of head part, tuck extra sheet at side
from head of food.
 Put rubber sheet 12-15 inches from the head of
mattress. Cover with draw sheet. Spread a cross bed.
Tuck together extra length.
 Place top sheet in line with mattress at head part and
spread a cross bed. Similarly spread the blanket. Form
a toe pleat as in the procedure of closed bed. Tuck
extra length of sheet at foot part, mitered corner; allow
hanging free at sides. 41

Making Open Bed:
 Go to opposite side and repeat same procedure.
 Grasp one corner of top sheet, fanfold at foot part or
diagonally to one side.
42

Making an Occupied Bed:
Some clients are unable to get out of bed as a
result of their specific condition or generalized
weakness. Changing bed linens with the client in
the bed is known as making an occupied bed.
Work quickly and disturb the client as little as
possible.
Indications: provide clean and comfortable bed
with least disturbance to the patient in it.
43

Making Occupied Bed:
Assessment:
level
Planning:
1.Mattress (1)
2.Bed sheets(2):
Bottom sheet (1)
Top sheet (1)
procedure more
organized
44

3. Pillow (1)
4. Pillow cover (1)
5. Mackintosh (1)
6. Draw sheet (1)
7. Blanket (1)
in basin
hamper bag (1) 45

Implementation:
Close the curtain/door
Remove the client’s personal
belongings from bed side and
keep in locker/safe place
locker
Lift the client’s head and move
pillow from center to the left
side.
of infection
accurate skill
performance
To maintain privacy
To prevent the
loss/damage
making and helps
effective action.
The pillow is
comfortable measure
for the client. 46

Implementation:
Assist the client to turn
toward left side of the bed.
Adjust the pillow. Leaves
top sheet in place.
Stand in right side: Loose
bottom bed linens. Fanfold
(or roll) soiled linens from
the side of the bed and
wedge them close to the
client.
Wipe the surface of
mattress by sponge cloth
with wet and dry.
Moving the client as close
to the other side of the bed
as possible gives you more
room to make the bed. Top
sheet keeps the client warm
and protect his or her
privacy.
Placing folded (or rolled)
soiled linen close to the
client allows more space to
place the clean bottom
sheets.
To prevent the spread of
infection. 47

Suggested Action Rational
e
Implementation:
Bottom sheet, mackintosh and draw sheet:
1)Place the clean bottom sheet evenly on the
bed folded lengthwise with the center fold as
close to the client’s back as possible.
2)Adjust and tuck the sheet tightly under the
head of the mattress, making mitered the upper
corner.
3)Tighten the sheet under the end of the
mattress and make mitered the lower corner.
4)Tuck in along side.
5)Place the mackintosh and the draw sheet on
the bottom sheet and tuck in them together.
Soiled
linens can
easily be
removed
and clean
linens are
positioned
to make
the other
side of the
bed.
49

Implementation:
Assist the client to roll over the
folded (rolled) linen to right side of
the bed. Readjust the pillow and top
sheet.
Move to left side: Discard the
soiled linens appropriately. Hold
them away from your uniform. Place
them in the laundry bag (or bucket).
Wipe the surface of the mattress by
sponge cloth with wet and dry.
Moving the client to
the bed’s other side
allows you to make
the bed on that side.
Soiled linens can
contaminate your
uniform, which may
come into contact with
other clients.
To prevent the
51

Implementation:
Bottom sheet, mackintosh and draw sheet:
1)Grasp clean linens and gently pull them out
from under the client.
2)Spread them over the bed’s unmade side.
Pull the linens taut
3)Tuck the bottom sheet tightly under the
head of the mattress and miter the corner.
4)Tighten the sheet under the end of the
mattress and make mitered the lower corner.
5)Tuck in along side.
6)Tuck the mackintosh and the draw sheet
under the mattress.
Wrinkled
linens can
cause skin
irritation.
52

Implementation:
Assist the client back to the center of the
bed. Adjust the pillow
Return to right side:
Clean top sheet, blanket:
1)Place the clean top sheet at the top side of
the soiled top sheet.
2)Ask the client to hold the upper edge of the
clean top sheet.
3)Hold both the top of the soiled sheet and
the end of the clean sheet with right hand
and withdraw to downward. Remove the
soiled top sheet and put it into a laundry bag.
The pillow is
comfort
measure for
the client.
Tucking
these pieces
together
saves time
and provides
neat, tight
corners.
54

Implementation:
3) Place the blanket over the top sheet.
Fold top sheet back over the blanket over
the client.
4) Tuck the lower ends securely under the
mattress. Miter corners.
5) After finishing the right side, repeat the
left side.
Remove the pillow and replace the pillow
cover with clean one and reposition the
pillow to the bed under the client’s head.
The pillow is a
comfortable
measures for a
client
55

Making Closed Bed:
Professor, SMVDCoN
56
Evaluation:
place.
place. Discard lines appropriately.
Document:
to senior staff.
Date & time
Type of bed
during procedure.
the client
the next. Proper line
disposal prevents the
infection
accountability

Making a Post-operative Bed
When a client is to return from the operating room or
from another procedure that requires transfer into bed
from a stretcher and sometimes from a wheelchair, a
postoperative bed is prepared. The postoperative bed
is made in such a way as to make it easy to transfer
the client from a stretcher to the bed.
It is a special bed prepared to receive and take care of a
patient returning from surgery.
57

Making a Post-operative Bed
Purpose
• To provide warmth and comfort for the patient.
• To provide protection for the bed from vomiting,
bleeding, drainage and discharge.
• To arrange the bed and other furniture in order to
facilitate the transfer of the patient from stretcher to
bed.
58

Making Post Operative Bed:
Assessment:
level
Planning:
equipments:
The same linen as those used for
making on occupied bed plus the
following -
Bath towel
procedure more
organized
59

Small rubber sheet
Woollen blanket
3 hot water bags w/cover p.r.n.
On the Bedside Table:
Stethoscope
Sphygmomanometer
Kidney basin
Swipes
Padded tongue depressor
p.r.n.
Observation Sheet
In the Room
Oxygen tank with complete
Tubing's,
60

humidifier and nasal catheter
Suction apparatus
Stand
Drainage bottles
Shock blocks
Iv stand
61

Implementation:
equipments and bring
the articles to the
bedside.
Move the chair and bed
side locker
Strip bed. Make
foundation bed as usual
with a large mackintosh,
and cotton draw sheet.
To prevent the spread of
infection
accurate skill performance
It makes space for bed making
and helps effective action.
Mackintosh prevents bottom
sheet from wetting or soiled by
sweat, drain or excrement.
Cotton draw sheet makes the
client felt dry or comfortable
without touching the mackintosh
directly.
62

Implementation:
Place top bedding as for closed
bed but do not tuck at foot
Fold back top bedding at the
foot of bed.
Tuck the top bedding on one
side only.
On the other side, do not tuck
the top sheet.
1)Bring head and foot corners of
it at the center of bed and form
right angles.
Tuck at foot may
hamper the client to enter
the bed from a stretcher
To make the client’s
transfer smooth
Tucking the top bedding
on one side stops the
bed linens from slipping
out of place
The open side of bed is
more convenient for
receiving client than the
other closed side.
63

Implementation:
2) Fold back suspending
portion in 1/3 and repeat folding
top bedding twice to opposite
side of bed
Remove the pillow.
Place a kidney-tray on bed-
side.
Place IV stand near the bed.
Check locked wheel of the
bed.
To maintain the airway
To receive secretion
To prepare it to hang I/V
soon
To prevent moving the
bed accidentally when the
client is shifted from a
stretcher to the bed.
65

Implementation:
Put the hot water bags at the
foot and center of the bed if the
weather is cold.
Place the necessary articles on
the bedside table and the
irrigating stand, suction machine
and oxygen set-up adjacent to
the bed.
Arrange unit.
Hot water bags (or hot
bottles) prevent the client
from taking hypothermia
& remove it before
receiving the patient.
67

Professor, SMVDCoN
68
Evaluation:
place.
place.
Document:
to senior staff.
Date & time
Type of bed
during procedure.
the client
the next.
infection
accountability

Making an Amputation Bed/Divided bed
Amputation is the cutting or removal of body parts
by surgery to prevent spread of infection or
gangrene or some cancers. Common parts are
usually limbs both upper and lower limbs.
Amputation bed is a bed that is prepared for a patient
having amputated limb.
69

71
Articles Required:-
All the article as per unoccupied bed

Procedure:
• Gather all the needed supplies.
• Make the bed as though you are making an unoccupied
bed.
• The foot end side of the top linen is folded back to the
head end at the level of the part to be observed. (if below
knee amputation).
• Spread the second set of linen starting from the level of
stump.
• The second set of top linen should overlap the first by 8
to 12 inches.
• Receive the patient and elevate the stump on a small
pillow and place the sand bag on either side to support
the stump.
• Place the bed cradle in position & cover the patient. 72

Fracture Bed
Indications:
Aid in immobilizing the fracture
Prevent unnecessary pain
Provide warmth and comfort to the patient
Prevent undue sagging of the mattress
74

Articles Required:
• Supplies as in open bed
• Extra supplies like fracture boards, bed cradle, sand
bags, cover sheet, hot water bottles with cover, p.r.n
75

Procedure:
• Gather all needed supplies. Place the fracture board
directly over the bed/cot.
• Make the bed as an open bed and spread cover sheet
between the bottom and top sheet. Place hot water
bottles in between to warm the bed. (Optional)
• Place the sand bags to support the part in order to
maintain the position.
• When the patient is received in bed, place the cradle
over the fractured part and cover it.
76

Cardiac Bed:
Cardiac bed is made with special
arrangements, which are
required by a cardiac patient.
Cardiac patient’s bed is made
in a manner to ease the
respiration of patient. Bed is
provided with extra pillows to
be kept on head side of
patient to keep the patient in
prop up position for better
airflow.
77
There is special cardiac table provided with the patient’s bed
with all equipment available for emergency cardiovascular
support, like oxygen masks, nasogastric tubes etc.

Babitha's Note On Bed making

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