FON - UNIT 9
Types of beds, purpose & bed
making
DEFINITION
It is the techniques of preparing different types of bed in
making a patients/clients comfortable or his/her position
suitable for a particular condition.
PURPOSES
• To provide the client with a safe & comfortable bed to take rest & sleep.
• To keep the ward neat and tidy.
• To adapt to the needs of the client and to be ready for any emergency or
critical condition of illness.
• To economize time, material & effort.
• To prevent bedsores.
• To observe the client.
• For patients comfort.
• To prevent cross infection.
• For treatment of certain conditions.
PRINCIPLE OF BED MAKING
PRINCIPLE 1 :- Micro organisms are found everywhere on the skin, on the articles
used by the client and in the environment. The nurse takes care to prevent the
transference of micro organisms from the source to the new host by direct or
indirect contact or prevent the prevent the multiplication of the microorganisms.
The nurse washes her hands before and after bed making to protect the client and
herself from cross infection.
When changing bed linen, follow principles of medical asepsis by keeping soiled
linen away from the uniform.
Place soiled linen in special linen bags before placing in a hamper.
To avoid air currents that spread microorganisms, never shake the linen.
To avoid transmitting infection, do not place soiled linen on the floor. If
clean linen touches the floor or any unclean surface, immediately place it
in the dirty linen container.
Dry dusting raises dust. Damp dusting is recommended.
The nurse keeps a reasonable distance from the client’s face to prevent
droplet infection.
Cleaning an area where there are less number of organisms before
cleaning an area where there are numerous organisms minimizes the
spread of organism to the clean area.
Eg. Clean the bed first before cleaning the bedside locker.
The linen removed from the isolation unit is disinfected first before they
are sent to laundry.
PRINCIPLE 2:-A safe and comfortable bed will ensure rest, sleep and
prevent several complications in bedridden patients. E.g. bedsore,
foot drop etc.
The body exerts uneven pressure against the mattress, the pressure is
greatest over the bony prominences. Lumps and creases in the bed
can cause bedsores due to friction between the bed and mattress or
wrinkled sheets. Therefore the nurses should take care to make the
bed smooth and unwrinkled.
Pull the bottom sheet tightly so that there is no wrinkles.
Keep the linen tucked far enough under the mattress, keep it fixed,
tight and smooth.
While tightening the sheets, do not alter theshape of the mattress.
No wet linen should remain on the bed.
A bed made for a client should allow enough freedom for moving from side to side.
The movement of the client stimulates circulation, prevent bed sores and
maintains muscle tone. Comfort devices are used to provide additional comfort to
the client.
If the client is in bed for longer time , tight upper bedding may cause foot drop.
It can be prevented by making a pleat in the top sheet and blanket across the foot
of the bed.
While tucking the upper bedding, ask the client to flex his knees.
Place a pillow, foot board or cradle at the foot of the bed to take the weight of the
upper bedding.
PRINCIPLE 3 :- Good body mechanisms maintain the body alignment and
prevents fatigue.
During bed making use safe patient handling procedures and proper body
mechanics.
The stability of the body is assured by keeping its centre of gravity over its base.
When the base is wide it ensures that the center of gravity will fall through its
base. In standing position the nurse can have a wide base by separating her feet.
The nearer to centre of gravity a weight is held, the less is the strain produced. Eg.
When opening the linen it should be placed on the edge of the bed rather than
holding it above the shoulder level.
Always raise the bed to the appropriate height before changing linen so you do not
have to bend or stretch over the mattress. You move back and forth to opposite
sides of the bed while applying new linen.
Body mechanics and safe handling are important when turning or repositioning the
patient in bed.
When tucking the sheets under the mattress flexing is done by
knees and hips. This position shifts the work to the long and
strong muscles of the thighs and keep the back in good
alignment. This reduces strain on the back.
When placing the linen on the bed and tucking them under
the mattress face the direction of work and move with the
work rather than twisting the body and over reaching.
PRINCIPLE 4:- Systematic ways of functioning saves time, energy and materials.
When patients are confined to bed, organize bed-making activities to conserve time
and energy.
Assemble all articles and arrange them conveniently before starting the bed making.
Arrange the linen in the reverse order of use.
Finish on one side of the bed before going to the opposite side.
When stripping the bed, remove the bed linen one by one holding the open end towards
the floor, so that the client’s possessions and the hospital articles are not send to the
laundry.
The bed sheets are folded in such a way that itcan be replaced easily.
GENERAL PRINCIPLES
The patient’s privacy, comfort, and safety are all important when making a bed.
Using side rails to aid positioning and turning, keeping call lights within the
patient’s reach and maintaining the proper bed position help promote comfort
and safety.
After making a bed, return it to the lowest horizontal position and verify that the
wheels are locked to prevent accidental falls when the patient gets in and out
alone.
When possible, make the bed while it isunoccupied.
Use judgment to determine the best time for the patient
to sit up in a chair so you can make the bed.
When making an unoccupied bed, follow the same basic
principles as for occupied bed making.
1. Open bed
2. Closed bed
3. Occupied bed
4. Admission bed
5. Post operative bed
6. Cardiac bed
7. Amputation bed/divided bed
8. Fracture bed
9. Therapeutic bed (renal bed, rheumatism bed, blanket bed)
• It is a bed, made when it is about to be occupied by either a
new patient or an ambulatory patient.
CLOSED BED
• It is an unoccupied or empty bed made to receive the patient
and is fully covered with counter pane to protect it from dust
and dirt. On admission of the patient, the closed bed is
converted in to an open bed.
PURPOSES:-
To keep the bed ready for occupancy.
To provide a neat and tidy appearance to the unit
OCCUPED BED
• This bed is made with the patient in it.
PURPOSES:-
To make a bed with least possible discomfort to the
patient.
To handle the bed clothes skillfully while the patient is on
bed, giving least disturbance to the occupant.
To provide a neat, clean and tidy appearance.
ADMISSION BED
• This is the bed prepared to receive a newly admitted
patient.
PURPOSES:-
To welcome the patient
To provide immediate care, safety and comfort
To protect the bed linen while giving bath on admission
POST-OPERATIVE BED
• It is a bed prepared for a patient who is recovering from the effects of anesthesia
following surgery.
PURPOSES:-
To receive the patientconveniently
To provide warmth and comfort
To prevent shock
To prevent injury
To prevent soiling of the bed
To meet any emergency
CARDIAC BED
• A bed prepared for patients with cardiac diseases.
PURPOSES:-
To prepare the bed for the cardiac patients
To relieve dyspnea
AMPUTATION/DIVIDED/CRADLE BED
• It is a bed in which top linen is divided into two parts to visualize the
amputed part of the lower limbs without disturbing the patient.
PURPOSES:-
To watch the stump for hemorrhage and apply tourniquet instantly
To take the weight of the bed clothes off the patient.
To keep the stump in position
FRACTURE BED
• It is a bed which is prepared for patients with fracture, bone diseases and
deformity.
PURPOSES:-
To prevent undue sagging of mattress
To immobilize the fractured part
To restrict sudden jerky movements
To keep the traction in position
THERAPEUTIC BEDS
Renal/ Rheumatism/Blanket bed:-
• it is a bed made for patients suffering from rheumatism or
renal disease.
PURPOSES:-
To carry the weight of the bed clothes off the painful joints
To keep the patient warm
To induce sweating
N u rs e ’s Re s p o n s i b i l i t y i n B e d m a k i n g
PRELIMINARY ASSESSMENT:-
Check the doctor’s order for specific precautions regarding the movement and
positioning of the client.
Assess the client’s ability for self care
Check the furniture and linen available in the client’s unit.
Assess the number of clean linen needed.
Assess the articles needed for the comfort of the client. Eg.:-blankets, backrests
Preparation of the articles – Open bed
Bottom sheet
Mackintosh
Draw sheet
Top sheet
Blanket
Pillow cover (pillow case)
Additional articles :_
• Laundry bag
• Dusters
• A bowl with antiseptic solution (savlon 1:40)
• A kidney tray
Preparation of the client & Unit
Explain the procedure to the client to winthe co operation and
confidence of the client.
Explain how the client can assist.
Screen the client to provide privacy if needed.
move furniture away from the bed and move the bed away from the
wall.
Lower the back rest if any.
Place the laundry bag within the reach.
PROCEDURE
Keep the articles near to the unit.
Explain the procedure. Make the patient to sit in a chaircomfortably.
hand washing
Remove the pillow and place it in a side.
Remove the old linens, if there(blanket,top sheet, draw sheet, mackintosh,
bottom sheet)
Dust the mattress and the cot and the furnitures.
Spread the bottom sheet, mackintosh and draw sheet.
Tuck the near side first from top to bottom. Make metre corner.
Go to opposite side. Tuck that side.
Spread the top sheet ( and blanket if needed).
Make a knee pleat. Tuck near side bottom and then the opposite side.
Allow the sides to hang freely.
Fanfold the top sheets to the bottom.
Put the pillow cover on pillow. Place it with open end away from the door side.
After care of client, unit and equipments
Help the client to get in to the bed.
Replace the comfort devises used.
See that the whole unit is clean and tidy before you leave
the unit.
Send the laundry bag with soiled linen to laundry. If stains
are present on the linen , remove them with appropriate
methods before sending them for laundry.
Soak the duster in antiseptic solution to disinfect it. Rinse it
with clean water and put to dry.
Hand washing
Record the procedure.
