1. Chapter 19
What must you do to keep patient beds neat and clean?
Bedmaking

2. Bedmaking To keep beds neat and clean:
Change linens whenever they become wet, soiled, or damp.
Straighten linens whenever loose or wrinkled.
Straighten loose or wrinkled linens at bedtime.
Check for and remove food and crumbs after meals.
Check linens for dentures, eyeglasses, hearing aids, sharp objects, and other items.
Follow Standard Precautions and the Bloodborne Pathogen Standard.
Beds are made every day.
Clean, dry, and wrinkle-free linens:
Promote comfort
Prevent skin breakdown and pressure ulcers

3. Types of Beds Beds are made in these ways. A closed bed is not in use.
The bed is ready for a new patient or resident.
The bed is made for a resident who is up during the day.
An open bed is in use.
Top linens are fan folded back so the person can get into bed.
An occupied bed is made with the person in it.
A surgical bed is made
To transfer a person from a stretcher
For persons who arrive by ambulance
Top linens are not folded back for a closed bed.
A closed bed becomes an open bed by fan-folding back the top linens.

4. Are you paying attention?
A resident is on bedrest. The person is in bed at all times. The person does not use bed rails. You need to make an occupied bed. How will you promote the person’s safety while make their bed?
To protect the person from falling out of bed, ask a co-worker to help you make the person’s bed. You work on one side of the bed, and your co-worker works on the other side.

5. Linens When handling linens and making beds, practice medical asepsis.
Your uniform is considered dirty.
Always hold linens away from your body and uniform.
Never shake linens.
Shaking them spreads microbes.
Place clean linens on a clean surface.
Never put clean or dirty linens on the floor.

6. Linens (cont’d) Collect enough linens.
Do not bring unneeded linens to a person’s room.
Collect linens in the order you will use them.
Place the clean linen on a clean surface.
Remove dirty linen one piece at a time.
Roll each piece away from you.
Change wet, damp, or soiled linens right away.
Wear gloves and follow Standard Precautions and the Bloodborne Pathogen Standard.
Once in the person’s room, extra linen is considered contaminated. Do not use it for another person.
Refer to p. 304 in the Textbook for the order in which linens are collected.
In hospitals, top and bottom sheets, the cotton drawsheet, and pillowcases are changed daily. The mattress pad, plastic drawsheet, blanket, and bedspread are reused for the same person. They are not reused if soiled, wet, or wrinkled.
Review the Focus on Long-Term Care and Home Care: Linens Box on p. 306 in the Textbook.

7. Linens (cont’d) Drawsheets
A drawsheet is a small sheet placed over the middle of the bottom sheet.
A cotton drawsheet helps keep the mattress and bottom linens clean.
A waterproof drawsheet protects the mattress and bottom linens from dampness and soiling.
Many agencies use:
Incontinence products
Waterproof pads or disposable bed protectors
A cotton drawsheet protects the person from contact with plastic and absorbs moisture.
Waterproof drawsheets are hard to keep tight and wrinkle-free.

8. Linens (cont’d)
Cotton drawsheets are often used without waterproof drawsheets.
Cotton drawsheets are often used as assist devices to move and transfer persons in bed.
When they are used for this purpose, do not tuck them in at the sides.
Ask the nurse about the type of drawsheets used in your agency.
Plastic-covered mattresses cause some persons to perspire heavily. This causes discomfort. A cotton drawsheet reduces heat retention and absorbs moisture.
Review the Focus on Long-Term Care and Home Care: Drawsheets Box on p. 307 in the Textbook.

9. Making Beds Safety and medical asepsis are important.
Closed beds are made:
For residents and home care patients who are up for most or all of the day
For new patients or residents
After the bed frame and mattress are cleaned and disinfected
The open bed is made for:
Newly admitted persons arriving by wheelchair
Persons who are getting ready for bed
Persons who are out of bed for a short time
Follow the rules in Box 19-1 on p. 307 in the Textbook.
Review the Focus on Children and Older Persons: Making Beds Box on p. 308 in the Textbook.
Review the Focus on Long-Term Care and Home Care: Making Beds Box on p. 308 in the Textbook.
Review the Delegation Guidelines: Making Beds Box on p. 308 in the Textbook.
Review the Promoting Safety and Comfort: Making Beds Box on p. 309 in the Textbook.
Review the Teamwork and Time Management: Making Beds Box on p. 309 in the Textbook.

10. Making Beds (cont’d)
You make an occupied bed when the person stays in bed.
Keep the person in good alignment.
Follow restrictions or limits in the person’s movement or position.
Explain each procedure step to the person before done.
The surgical bed (recovery bed, post-operative bed) is made for persons:
Returning to their rooms from surgery
Who arrive at the agency by ambulance
Who go by stretcher to treatment or therapy areas
Using portable tubs
Explain each procedure step to the person even if the person cannot respond to you or is in a coma.
Review the Focus on Communication: The Occupied Bed Box on p. 313 in the Textbook.
Review the Promoting Safety and Comfort: The Occupied Bed Box on p. 313 in the Textbook.
Review the Promoting Safety and Comfort: The Surgical Bed Box on p. 317 in the Textbook.

11. D&S Skill: Making an Occupied Bed

12. One more…
You are making a bed in a patient’s home. The person asks you to use a plastic trash bag as a mattress protector. Explain why you cannot use plastic trash bags as mattress protectors.
Plastic trash bags are not strong enough to protect linens and the mattress. They slide easily and move out of place. Suffocation is a risk if the bag covers the person’s nose & mouth.