1. Copyright © 2008 Delmar Learning. All rights reserved. Low Bed Safety for Nursing Assistants Barbara Acello, RN

2. Copyright © 2008 Delmar Learning. All rights reserved. Low Bed Information Up to 54 percent of all falls from bed occur over the elevated side rails Low beds reduce the risk of falling from a great height

3. Copyright © 2008 Delmar Learning. All rights reserved. Low Bed Information They are usually used without bed rails Patients who are at risk for falling from bed are usually good candidates for low bed use

4. Copyright © 2008 Delmar Learning. All rights reserved. Low Bed Information Patients who have had hip replacement surgery within the previous 90 days –Should not use low beds

5. Copyright © 2008 Delmar Learning. All rights reserved. Working with Low Beds Low beds are wonderful tools for reducing injuries related to patient falls –But having one or more low beds on the unit increases the risk for staff injuries

6. Copyright © 2008 Delmar Learning. All rights reserved. Working with Low Beds Nursing assistants must have good organizational skills and use common sense when preparing to work with the patient or make the low bed Using good body mechanics is essential when lifting, moving, caring for patients, and making beds

7. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds For maximum safety –Place the far side of the bed against a wall Move other furnishings far enough away from the bed to prevent injury Keep the bed in the lowest horizontal position with the wheels locked when the patient is in bed

8. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds If the bed you are using has a high low feature –Use it whenever caring for the bedfast patient, transferring the patient and making the bed

9. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Place a high impact, padded, plastic covered mat on the floor next to the low bed to protect and cushion the patient in the event of falls

10. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Although a floor pad or mat reduces the risk of patient injury from falls –It presents a trip hazard for staff –Fold and store the mat when the patient is out of bed

11. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Move slowly and carefully when working near a floor mat Avoid entering the room in total darkness Leave a night light on –Or turn the light on when entering

12. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Avoid leaning forward or down at the waist to provide patient care –Elevate the height of the bed Sit in a chair, squat, kneel on one or both knees, or sit on the mat –Depending on the nature of your activity at the bedside

13. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Elevate the bed to the proper height for the patient when transferring him or her out of bed A one quarter size side rail or pole that extends from floor to ceiling should also be available for the patient to grasp when getting into or out of bed

14. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Discourage the patient from grabbing items such as: Overbed table, chair, or sink

15. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Use good body mechanics, a transfer belt, a ceiling or mechanical lift when assisting patients into and out of bed Follow the instructions on the care plan

16. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Caring for Patients in Low Beds Evaluate the overall safety of the room and bed Remove trip and fall hazards and other items that may cause injury

17. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds When making a low bed, modify the regular bedmaking procedure by using these adaptations to reduce your risk of injury You should: Plan to make low beds with a partner, if possible

18. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Mentally plan and prepare yourself for the procedure Wash your hands before handling clean linen

19. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Gather everything you will need before entering the room Double check to make sure you have all needed items

20. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Think about what you are doing Organize and plan your work –To reduce the total number of motions needed to complete the task Elevate the height of the bed, if possible

21. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Place linen and needed items on the chair or within close reach of the bed Avoid moving quickly –Rapid motion increases your risk of injury

22. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Use good body mechanics, maintain a neutral posture and bend from the legs. Avoid bending at the waist or twisting.

23. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds During the bedmaking procedure: –You may squat, sit, or kneel on the plastic mat (with one or both knees) –Position yourself next to the bed if doing so is easier for you and helps keep your spine straight.

24. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Your position is somewhat determined by height. A tall person may be able to sit on the mat while making the bed –Whereas a shorter person may need to squat

25. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Wear gloves when removing soiled linen. Remove them and wash your hands before making the bed and handling clean linen a second time. Never handle clean linen while wearing soiled gloves.

26. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Avoid environmental contamination with your used gloves. Check bed for lost items –Glasses, hearing aid, or dentures, and remove them if found.

27. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Remove linen several pieces at a time Avoid rolling the linen up and trying to remove it all in one bundle. –Weight of linen and your posture increase risk of back injury. –Roll used side of linen inward and remove one or two pieces at a time.

28. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Place soiled linen in a plastic bag well to the side on the mat –In a pillowcase draped over back of chair –In a plastic bag on seat of a second chair Or according to facility policy –Despite your proximity to floor, avoid placing clean or soiled linen on the floor

29. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Do not change position or waste steps by removing linen from the room until you have finished the bedmaking procedure. Remove your gloves and discard in a second plastic bag or according to facility policy.

30. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds After removing soiled linen, handwashing is necessary before handling clean linen. Do not be tempted to omit this important step.

31. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Carry a pocket size bottle of alcohol- based hand cleaner. Do a 15 second handwash with the alcohol cleaner before handling clean linen.

32. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Make one side of the bed at a time: –This is faster, more efficient, requires fewer physical motions, and conserves energy.

33. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Use a fitted bottom sheet to reduce the number of movements necessary for making the bed –Thereby lowering the risk of back strain

34. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds If one side of the bed is next to the wall –Leave the bed in the high position –If permitted by your facility

35. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds If the bed is not near a wall –Raise the rail on the far side, or position it at the lowest horizontal height –Or position according to facility policy

36. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Wipe the mat with disinfectant –Then fold and store it under the bed, or according to facility policy Wash your hands Perform a safety check of the room

37. Copyright © 2008 Delmar Learning. All rights reserved. Guidelines for Making Low Beds Perform your procedure completion actions Remove and discard soiled linen, gloves, and other procedural trash when you leave the room