Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany...

Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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Textbook For Nursing Assistants

Chapter 15 – Bedmaking


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Linens and Other Supplies for Bedmaking


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Many types of linens are used to make a bedLinens that you may commonly see in use in a health care facility include the following:

Mattress padsBottom and top sheetsDraw sheetsBed protectorBlanketsBedspreadsPillows and pillowcasesBath blankets

Occasionally, other equipment or supplies are used on a person’s bed, depending on the specific needs of the patient or resident. Some of the items used include the following:

A pressure-relieving mattress A bed board A bed cradle A footboard

Linens


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A mattress pad is a thick layer of padding that is placed on the mattress to help make the bed more comfortable for the patient or resident, and to protect the mattress from moisture and soilingFitted mattress pad:

Has elasticized sides that wrap around and underneath the mattress, holding the pad securely to the mattress

Flat (non-fitted) mattress pad:Pad is not secured to the mattress

Rubberized mattress:A mattress with a rubber coatingWhen a rubberized mattress is in use, a mattress pad may be used to help pull moisture away from the person’s skin

Linens: Mattress Pads


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A bed is made with two sheets, a bottom sheet and a top sheetBottom sheet may be:

Flat, or non-fittedFitted

The top sheet is a flat sheetThe sheets may be white or colored, plain or print

Linens: Bottom and Top Sheets


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A draw sheet is a small, flat sheet that is placed over the middle of the bottom sheet, covering the area of the bed from above the person’s shoulders to below his or her buttocks

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

Linens: Draw Sheets


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A bed protector is a square of quilted absorbent fabric backed with waterproof materialIt measures approximately 3 feet by 3 feetIt may be disposable, or it may be laundered and reusedIt is used for people who are incontinent or have draining woundsSometimes, only the bed protector needs to be changed, resulting in more efficient and economical care

Linens: Bed Protector


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Blankets are usually woven cotton and should be available as requested by a person for his or her comfortBlankets may be of wool, cotton, or synthetic, depending on the person’s preference and the climateElectric blankets should be checked for faulty wiring or plugs and may not be safe to use if the person is incontinent or unable to adjust the controls independently; should only be used according to facility policy

Linens: Blankets


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A bedspread adds the finishing touch to a well-made bed and can add a decorative touch to a person’s roomHospitals and extended-care facilities may supply bedspreads for their patients to useOther types of health care facilities or agencies may encourage their residents to use their own bed coveringsAllowing a person to use his or her bedspread from home is one way to foster a sense of independence and individuality in residents

Linens: Bedspreads


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Pillows are used for comfort and to aid in positioning

They may be available in many sizes, are made from a variety of materials and may be covered with waterproof material or treated with a waterproofing substance

Pillows are always covered with clean pillowcases

Linens: Pillows and Pillowcases


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A bath blanket is a lightweight cotton blanket or flannel sheet that is used to provide modesty and warmth during a bed bath or a linen change

A flat sheet may also be used for this purpose if the facility does not provide a special bath blanket

Linens: Bath Blankets


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May be 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

Newer versions of pressure-relieving mattresses may be filled with air or water, and are made out of a material that is easily cleaned

Linens: Pressure-Relieving Mattress


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A bed board is a piece of wood (usually plywood) that is placed under the mattress to provide extra support

It keeps the mattress from sagging, helping to keep the person’s body properly aligned

Linens: Bed Board


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A bed cradle is 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 Bed cradles are often used for people who are recovering from burns to prevent the top sheet from touching the burned skin, which would be very painfulThey are also often used for people who are at risk for developing pressure ulcers on their feet

Linens: Bed Cradle


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A footboard is a padded board that is placed upright at the foot of the bedThe person’s feet rest flat against the footboard, helping to keep the feet in proper alignment

Linens: Footboard


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Handling of Linens


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Guidelines for Handling Linens

1. WHAT YOU DO WHY YOU DO IT

Always wash your hands before collecting clean linens

Washing your hands prevents microbes on your hands from being transferred to the clean linens


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Do not hold linens, clean or dirty, against your uniform

If you hold clean linens against your uniform, microbes on your uniform could be transferred to the linens

If you hold dirty linens against your uniform, microbes from dirty linens could be transferred to your uniform


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When collecting linens, collect only those that you will need for that person’s bed

Extra linens brought into a person’s room are considered soiled, and therefore must not be returned to the clean linen cart or used for another person

These linens must now be laundered, which costs the facility extra money and manpower and creates additional wear on the linens, shortening their lifetime of use


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Collect linens in the order that they will be used and flip the stack over so that the item you will need first is on the top of the stack

Collecting linens in the order that they will be put on the bed helps you to remember which linens you need to collect

You will be able to make the bed more efficiently, without searching through the stack for the proper item


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Place clean linens on a clean surface in the room, such as the over-bed table or a chair

Do not place clean linens on the floor

Clean linens can become contaminated with microbes if you place them on a “dirty” surface, such as the floor


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Wear gloves when removing used linens from a bed

Roll the linens toward the center of the bed to confine the soiled area inside

Any item contaminated with blood or other body substances is a potential source of exposure to pathogens for the health care worker

Following the standard precautions and wearing proper personal protective equipment (PPE) will help to minimize your exposure

Confining the soiled area to the inside of the linens helps to ensure that other people, such as the people in the laundry, do not come in contact with the potentially infectious material


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If body fluids or substances leak through the linens to the mattress or bed frame, the mattress or bed frame should be wiped with an appropriate cleaning solution before placing clean linens on the bed

Remove your gloves and wash your hands before handling the clean linens

These infection control methods help to prevent the clean sheets from becoming contaminated


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8. WHAT YOU DO WHY YOU DO IT After removing the dirty linens

from the bed, place them in the linen hamper immediately

Your facility may require you to place dirty linens in a plastic bag or pillowcase before placing them in the linen hamper

Do not place dirty linens on the floor or on any other surface.

Placing the dirty linens in the linen hamper immediately helps to control the spread of infection


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Standard Bedmaking Techniques


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Routine bedmaking is usually done in the morning, before visiting hours, while your patients or residents are bathing or dressingHow often the linens on a person’s bed are changed will vary according to the type of health care facility and the person’s needs However, a person’s bed must be remade each time any of the linens become soiled or excessively wrinkled, regardless of the time of dayChange as many of the bed linens as necessary to ensure a clean, dry, wrinkle-free bed for your patient or resident

Standard Bedmaking Techniques


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Mitering is a way of folding and tucking the sheet so that it lies flat and neat against the mattress

How to Make a Mitered Corner


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A closed bed is an empty bed

A bed that is unoccupied because the previous patient or resident has been discharged from the facility and a new patient or resident has yet to arrive is considered a closed bed

A bed that is unoccupied because the patient or resident is simply not in it at the moment

(and is not expected back

any time soon) is also

considered a closed bed

Closed Bed


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When the top sheet, blanket, and bedspread of a closed bed are turned back, or fanfolded, the closed bed becomes an open bed, or a bed ready to receive a patient or resident

The wheels of an open bed should always be locked and the bed should be in the lowest position

Open Bed


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A surgical bed is a closed bed that has been opened to receive a patient or resident who will be arriving by stretcher

Surgical Bed


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Some conditions make it difficult or impossible for a person to get out of bed for a linen change. When this is the case, it is necessary to change the linens while the person is still in the bed. This is called making an occupied bed.

Occupied Bed


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Guidelines for Bedmaking


Always place linens on the bed so that the seams of the sheets face away from the person’s skin

The seams of the sheets can rub the person’s skin, causing irritation and leading to skin breakdown


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Linens must be pulled tightly to avoid wrinkling. Layering should be kept to a minimum

The wrinkles and extra layers of linens can cause skin breakdown and contribute to the formation of pressure ulcers


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Linens should be changed whenever they become soiled or wet, regardless of the time of day

Besides causing discomfort, soiled or wet sheets can cause skin breakdown and contribute to the formation of pressure ulcers


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Do not shake linens when placing them on the bed

Recall that dust is a transport mechanism for microbes. Shaking linens stirs up dust from the floor. The dust then settles on surfaces in the room and can be easily transferred onto eating utensils or into a wound, causing an infection.


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When you need to change the linens on a person’s bed with the person still in the bed, always be sure to explain what you are doing throughout the procedure

Close the door, pull the privacy curtain, and keep the person covered

This can be a very frightening experience for a bedridden person, particularly if the person is unconscious

Even if the person is conscious, movement may cause pain, and incontinence can be very embarrassing if it occurs

If the person is mentally impaired, he or she may become combative

Talk reassuringly to the person, even if the person is unconscious

Always provide for privacy and modesty by keeping the person covered at all times


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Check the bed linens for personal items before removing the linens from the bed

Personal items may become lost in the bed linens

Personal items may be expensive and inconvenient to replace

If they hold sentimental value, they may be irreplaceable


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End of Presentation

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