Chapter 18: Bedmaking

a patient who will be arriving on a stretcher

A bed that has top linens fanfolded to the side has been prepared for what type of patient?

a cotton draw sheet

An incontinent resident's bed is to be prepared. The nursing assistant uses a rubberized draw sheet in place of a rubberized mattress. What should she place over the plastic draw sheet to protect the person's skin from contact with the rubber?

by pulling straight up on the top linens

How do you make a toe pleat?

flat

The top sheet used to make a patient's bed should be what?

true

True/False: Allowing a person to use his or her bedspread from home is one way to foster a sense of independence and individuality in residents

true

True/False: Long-term care facilities may encourage their residents to use their own bed coverings

true

True/False: Mark everything with their name and room number

true

True/False: No matter what type of bed or type of linens used, it is important to always handle the linens in the proper manner to help prevent spreading of any potential infections.

true

True/False: When a closed bed is "opened", the top sheet blanket and bedspread are "fanfolded" to the foot of the bed

true

True/False: When making an occupied bed, it is a good idea to keep the side rail up on the opposite side from which you are working.

gloves

What PPE should be worn when removing used bed linens?

- Many long-term care facilities use flannel-type sheets for extra warmth - Encourage use of personal bedding to promote "touch of home" and own individuality - Be sure to handle personal items with care when changing bed linens

What are the concerns for long term care?

1. The bottom of the sheet has been tucked under the end of the mattress 2. Grasp the edge of the sheet about 12 inches from the foot of the bed and lift it up 3. Forming a triangle, tuck the hanging portion of the sheet underneath the mattress while holding the triangular fold against the top of the bed 4. Bring the triangular fold back down over the edge of the mattress, and leave the side hanging loose

What are the steps to make a mitered corner?

1. bath blanket (to cover the patient) 2. bottom sheet 3. draw sheet 4. incontinence pad 5 top sheet 6. pillow case(s)

What are the supplies that you need to make an occupied bed (in correct order)?

- Patient and resident comfort - Infection control - Prevent skin breakdown

What do clean linens contribute to?

1. Mattress Pad (if needed) 2. Bottom Sheet 3. Draw Sheet 4. Incontinence Pad 5. Top Sheet 6. Blanket 7. Bedspread 8. Two Pillowcases (when you get to the bed, flip the stack over so that the pillowcases are on the bottom and the mattress pad is on top)

What is the correct order to collect linens?

bedspreads

What linen might a nursing home resident bring from home and use?

when they become wet or soiled, according to facility policy, when they become excessively wrinkled

When are bed linens changed (not routinely)?

in the morning, before visiting hours, and while patients are bathing or dressing (on their shower days, every other day)

When is routine bedmaking usually done?

hold the linens away from your body

When you are handling linens, always remember to do what?

back of head, heels, shoulder blades, hips, elbows, etc

Where are the bony prominences (pressure points)?

- Prevents microbes being transferred to clean linen

Why do you always perform hand hygiene first?

- Personal items may become lost in linens - If bundled up and removed with linens, can be difficult to find, possibly damaged, and even lost forever - If they hold sentimental value, may be irreplaceable

Why do you check linens for personal items (dentures, eyeglasses, jewelry)?

- Prevent discomfort from pulling on or possibly accidental removal of tubes and drains

Why do you disconnect the call light control, any tubes or drains from the linens?

- Wrinkles and extra layers can contribute to skin breakdown and lead to pressure ulcers

Why do you pull linens tight to avoid wrinkles and keep layering to a minimum?

- Prevent stress, frightening the individual, embarrassment, possible combativeness - Always talk reassuringly to the individual even if unconscious - Always provide privacy and protect modesty

Why do you you always explain to the individual in the occupied bed what you are going to do before starting to change the linens and provide privacy?

- Promote comfort and well-being of patient or resident - Important for infection control - Will help prevent skin breakdown and pressure ulcer formation - A neat, well-made bed is a sign of capable, competent care by the facility

Why is bedmaking important?

- Helps to prevent complications such as pressure ulcers (wrinkled sheets can cause friction)

Why is it important to use clean, dry, wrinkle free linens?

- Seams can rub the person's skin, causing irritation and leading to skin breakdown

Why should you always place seams of sheets away from person's skin?

- Can lead to discomfort - Can cause skin breakdown - Contributes to pressure ulcer

Why should you change linens as needed?

- Helps you remember which linens you need to collect - More efficient---avoids searching through the stack

Why should you collect linens in the order they will be used? (flip stack over so first item in stack will be first one needed)

- Any extra linens brought into the person's room are now considered dirty - Creates additional cost, wear and tear on the linens, and shortens the life span of the linens

Why should you collect only the linens you need for that person's bed?

- Microbes could be transferred to the clean linens from your uniform - Microbes could be transferred to your uniform from the dirty linens

Why should you not hold any linens against your uniform?

- Can stir up dust, easily transferring any microbes from one surface (i.e., floor) to another surface (i.e., any other surface) - Can lead to contamination of surfaces which need to be clean

Why should you not shake linens?

- Can become contaminated with microbes if placed on "dirty" surface

Why should you place clean linens on clean surface, do not place clean linens on the floor

- Helps to prevent the spread of infection

Why should you place dirty linens in the dirty hamper immediately and not place dirty linens on any surface?

- Help to prevent contamination of the clean linens

Why should you use appropriate cleaning solution on mattress and/or bed frame if exposed to blood or body fluids with appropriate PPEs (remove gloves, perform hand hygiene before handling clean linens)

- Any item contaminated with blood or body fluids is a potential source of pathogens - Standard precautions and PPEs help limit exposure - Confining the soiled area inside helps prevent exposure to other health care workers

Why should you wear gloves when removing used sheets from bed and roll linens toward center of bed to confine soiled area inside?

miltered corner

a corner that is made by folding and tucking the sheet so that it lies flat and neat against the mattress

bath blanket

a lightweight cotton blanket used to cover a patient or resident during a bed bath or linen change to help provide modesty and warmth - a flat sheet may also be used for this purpose if the facility does not provide a special bath blanket

pressure-relieving mattress

a mattress that is placed on top of the regular mattress to help prevent skin breakdown in patients and residents who must stay in bed for long periods of time

bed cradle

a metal frame that is placed between the bottom and top sheets to keep the top sheet, the blanket, and the bedspread away from the person's feet - often used for people who are recovering from burns to prevent the top sheet from touching the burned skin, and for people who are at risk for developing pressure ulcers on their feet

footboard

a padded board that is placed upright at the foot of the bed; used to keep the patient's feet in proper alignment

bed board

a piece of wood that is placed under the mattress to provide extra support; helps to keep the patient's body properly aligned by preventing the mattress from sagging

draw sheet

a small (half-sized), flat sheet that is placed over the middle of the bottom sheet, covering the area of the bed from above the patient's shoulders to below his or her buttocks

bed protector

a square of quilted absorbent fabric backed with waterproof material that measures approximately 3 feet by 3 feet; used to prevent soiling of the bottom linens; sometimes called an incontinence pad or soaker pad - sometimes, only the bed protector needs to be changed, resulting in more efficient and economical care

mattress pads

a thick layer of padding that is placed on the mattress to help make the bed more comfortable for the patient and to protect the mattress from moisture and soiling - NOT NECESSARY for many of the more MODERN mattresses use in the healthcare setting

bedspreads

adds the finishing touch to a well-made bed and can add a decorative touch to a person's room

fanfolded

an adjective used to describe the top sheet, blanket and bedspread of a closed bed when they have been turned back (toward the the foot of the bed)

top sheet (flat sheet)

hanging down

toe pleat

loosening of the top linens over a person's feet to relieve pressure and promote comfort

fanfold bed

opened bed with top sheet, blanket, and bedspread folded back ready for a patient or resident

blankets

provided by a facility that are usually woven cotton and should be available as requested by the person for their comfort

lift sheet

simply a draw sheet that is used to help lift or reposition a patient who needs assistance with moving in bed

bottom sheet

tucked in

pillows

used for comfort and to aid in positioning and are always covered with clean pillowcases

mattresses

used for comfort and to aid in positioning that are available in many sizes and made from a variety of materials, they are always covered with sheets