Textbook for Nursing Assistants Chapter 15 Bedmaking Copyright

Linens and Other Supplies for Bedmaking Copyright © 2012 Wolters Kluwer Health | Lippincott

Learning Objectives • 1. Describe ways that a properly made bed can increase a person’s comfort and well-being. • 2. List the different types of linens and their uses. • 3. Demonstrate the proper way to handle and care for linens. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 protectors – Blankets Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Linen and other supplies –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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 • Long-term care facilities 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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Handling of Linens Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 • Clean linens can become contaminated with microbes if you place them on a “dirty” surface, such as the floor • Do not place clean linens on the floor Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Guidelines for Handling Linens 6. WHAT YOU DO • Wear gloves when removing used linens from a bed • Roll the linens toward the center of the bed to confine the soiled area inside WHY YOU DO IT • 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 –wearing proper (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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 • These infection control methods help to prevent the clean sheets from becoming contaminated • Remove your gloves and wash your hands before handling the clean linens Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 • Placing the dirty linens in the linen hamper immediately helps to control the spread of infection • 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 Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

STOP & THINK • Case Study 1 • You are making an occupied bed. There is no linen hamper in the room, and you have already removed the soiled linens from the bed. Mrs. O’Shea, the patient, is lying on her side in the bed, covered with a bath blanket. Discussion Points • What should you do with the soiled linens until you can take them to the linen room or hallway hamper? Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

STOP & THINK • Case Study 2 • Barbara is a PCT on 3 West. She has already changed the bed linens twice during her shift for one of her patients, Mrs. Bridges is receiving chemotherapy for cancer, and one of the side effects of the medication is uncontrollable diarrhea. When Barbara answers Mrs. Bridges’ call light, she sadly informs her that she just could not wait and has soiled the bed again. As Barbara heads toward the linen closet to collect her supplies, she is mentally making a list of the items she needs to collect. • Discussion Point---What are some items that Barbara should remember to collect along with clean sheets? Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Standard Bedmaking Techniques Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Learning Objectives • 1. Describe the different techniques used to prepare a closed, opened, surgical, and occupied bed. • 2. Understand the infection control measures that are used during bedmaking. • 3. Demonstrate techniques of proper bedmaking, including making a closed bed, opening a bed, preparing a surgical bed, and making an occupied bed Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Open Bed • When the top sheet, blanket, and bedspread of a closed bed are turned back, or fanfolded, the closed becomes an open bed, or a bed ready to receive a patient or resident. • The wheels of an open bed should always be loked and the bed should be in the lowest position Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Guidelines for Bedmaking 4. WHY YOU DO IT WHAT YOU DO • Recall that dust is a • Do not shake linens when placing transport mechanism for microbes. Shaking them on the bed 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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Guidelines for Bedmaking 5. WHAT YOU DO • 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 WHY YOU DO IT • This can be a very frightening experience for a bedridden person, particularly if the person is unconscious • Even if the person is conscious, • Close the door, pull the privacy movement may cause pain, and curtain, and keep the person incontinence can be very covered 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 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Guidelines for Bedmaking 6. WHAT YOU DO WHY YOU DO IT • Check the bed linens • Personal items may for personal items before become lost in the bed removing the linens from linens the bed • Personal items may be expensive and inconvenient to replace • If they hold sentimental value, they may be irreplaceable Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins