Textbook For Nursing Assistants Chapter 15 – Bedmaking Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens and Other Supplies for Bedmaking Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens Many types of linens are used to make a bed Linens that you may commonly see in use in a health care facility include the following: Mattress pads Bottom and top sheets Draw sheets Bed protector Blankets Bedspreads Pillows and pillowcases Bath 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens: Mattress Pads 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 soiling Fitted 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 coating When a rubberized mattress is in use, a mattress pad may be used to help pull moisture away from the person’s skin Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens: Bottom and Top Sheets A bed is made with two sheets, a bottom sheet and a top sheet Bottom sheet may be: Flat, or non-fitted Fitted The top sheet is a flat sheet The sheets may be white or colored, plain or print Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

Linens: Bed Protector A bed protector is a square of quilted absorbent fabric backed with waterproof material It measures approximately 3 feet by 3 feet It may be disposable, or it may be laundered and reused It is used for people who are incontinent or have draining wounds Sometimes, only the bed protector needs to be changed, resulting in more efficient and economical care Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens: Blankets Blankets are usually woven cotton and should be available as requested by a person for his or her comfort Blankets may be of wool, cotton, or synthetic, depending on the person’s preference and the climate Electric 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens: Bedspreads A bedspread adds the finishing touch to a well-made bed and can add a decorative touch to a person’s room Hospitals and extended-care facilities may supply bedspreads for their patients to use Other types of health care facilities or agencies may encourage their residents to use their own bed coverings Allowing a person to use his or her bedspread from home is one way to foster a sense of independence and individuality in residents Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens: Pillows and Pillowcases 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

Linens: Pressure-Relieving Mattress 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

Linens: Bed Cradle 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 painful They are also often used for people who are at risk for developing pressure ulcers on their feet Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Linens: Footboard A footboard is a padded board that is placed upright at the foot of the bed The person’s feet rest flat against the footboard, helping to keep the feet in proper alignment Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

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

Guidelines for Handling Linens 2. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Handling Linens 3. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Handling Linens 4. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Handling Linens 5. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Handling Linens 6. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Handling Linens 7. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

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

Standard Bedmaking Techniques Routine bedmaking is usually done in the morning, before visiting hours, while your patients or residents are bathing or dressing How 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 day Change as many of the bed linens as necessary to ensure a clean, dry, wrinkle-free bed for your patient or resident Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

How to Make a Mitered Corner Mitering is a way of folding and tucking the sheet so that it lies flat and neat against the mattress Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

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

Surgical Bed A surgical bed is a closed bed that has been opened to receive a patient or resident who will be arriving by stretcher Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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

Guidelines for Bedmaking 1. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Bedmaking 2. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Bedmaking 3. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Bedmaking 4. WHAT YOU DO WHY YOU DO IT 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. Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Bedmaking 5. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

Guidelines for Bedmaking 6. WHAT YOU DO WHY YOU DO IT 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 Copyright © 2005.  Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants.

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