1. Describe a standard resident unit The resident’s room is the resident’s home. Residents’ living spaces and their personal possessions should be respected. The following objects are often found in residents’ rooms: Bed Bedside stand Overbed table Chair Emesis basin

1. Describe a standard resident unit The following objects are often found in residents’ rooms (con’t.): Bedpan Urinal Bath basin Call light Privacy curtain

1. Describe a standard resident unit The following objects are often found in a residents’ bedside stand: Urinal/bedpan and covers Wash basin Emesis basin Soap dish and soap Bath blanket Toilet paper Hygiene items

1. Describe a standard resident unit Soiled items, bedpans, and urinals should not be placed on top of overbed table.

2. Discuss how to care for and clean unit equipment Define the following term: Disposable Guidelines for working in the resident’s unit: Clean the overbed table after each use. Keep call light within reach. Remove crumbs and straighten linens. Re-stock supplies. Check equipment to make sure it works. Refill water pitchers. Remove items that might cause odors or hazards.

2. Discuss how to care for and clean unit equipment Guidelines for working in the resident’s unit (con’t.): Report insects or pests. Do not move residents' belongings.

3. Identify factors affecting a resident’s comfort There are many factors that may affect a resident’s comfort: Noise level Odors Temperature Lighting

4. Explain the importance of sleep and factors affecting sleep Factors that affect sleeping patterns: Fear Anxiety Noise Diet Medications Illness

4. Explain the importance of sleep and factors affecting sleep Nursing assistants should observe for the following factors when a resident is not sleeping well: Sleeping too much during the day Too much caffeine Dressing in night clothes during the day Eating too late at night Refusing medication ordered Taking new medications Roommates who keep light or TV on Pain

4. Explain the importance of sleep and factors affecting sleep The following problems can be caused by a lack of sleep: Decreased mental function Reduced reaction time Irritability Decreased immune system function

5. Discuss two types of beds There are two types of beds commonly used in nursing homes: Manual More difficult Cranks at foot of bed Full or partial side rails Electric Simple operation Controls attached to bed Half-side rails Openings for equipment

6. Describe bedmaking guidelines and perform proper bedmaking Define the following terms: Occupied bed Unoccupied bed Closed bed Open bed Surgical bed

Describe bedmaking guidelines and perform proper bedmaking There are three reasons why bedmaking is important: Damp and wrinkled sheets keep the resident from sleeping well. Damp and unclean linen encourages infection and disease. Sheets that are not flat increase risk for pressure sores.

6. Describe bedmaking guidelines and perform proper bedmaking Guidelines for bedmaking include: Carry linens away from your uniform. Do not shake linens. Check linen for personal items before removing it. Use a wide stance when making beds. Avoid bending from waist.

Identify yourself by name. Identify the resident by name. Making an occupied bed Equipment: mattress pad, fitted or flat bottom sheet, waterproof bed protector if needed, cotton draw sheet, flat top sheet, blanket(s), bath blanket, pillowcase(s), gloves (if you are going to be touching linens soiled with body fluids) Wash your hands. Identify yourself by name. Identify the resident by name. 15

Provide for the resident’s privacy with curtain, screen, or door. Making an occupied bed 3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. Provide for the resident’s privacy with curtain, screen, or door. Place clean linen on clean surface within reach (e.g., bedside stand, overbed table, or chair). Adjust bed to a safe working level, usually waist high. Lock bed wheels. Lower head of bed. 16

Put on gloves if linens are soiled with body fluids. Making an occupied bed Put on gloves if linens are soiled with body fluids. Loosen top linen from the end of the bed or working side. Cover the resident with a cotton bath blanket or the loosened top sheet on the bed. You will make the bed one side at a time. Raise side rail on far side of bed. After raising side rail, help resident to turn onto side, moving away from you toward raised side rail (Fig. 12-6). Fig. 12-6 17

Loosen bottom soiled linen on working side. Making an occupied bed Loosen bottom soiled linen on working side. Roll bottom soiled linen toward resident. Tuck it snugly against resident’s back. Place and tuck in clean bottom linen. Finish with bottom sheet free of wrinkles. If you are using a flat bottom sheet, leave enough overlap on each end to tuck under the mattress. 18

Making an occupied bed 12. (con’t.) If the sheet is only long enough to tuck in at one end, tuck it in securely at the top of the bed. Make hospital corners to keep bottom sheet wrinkle-free (Fig. 12-7). 13. Smooth the bottom sheet out toward the resident. Be sure there are no wrinkles in the mattress pad. Roll the extra material toward the resident. Tuck it under the resident’s body. Fig. 12-7 19

Making an occupied bed If using a waterproof pad, unfold it and center it on the bed. Tuck the side near you under the mattress. Smooth it out toward the resident. Tuck as you did with the sheet. If using a draw sheet, place it on the bed. Tuck in on your side, smooth, and tuck as you did with the other bedding. Help resident to turn onto clean bottom sheet (Fig. 12-8). Raise side rail nearest you. Fig. 12-8 20

Move to other side of bed and lower side rail. Making an occupied bed Move to other side of bed and lower side rail. Turn resident away from you toward side rail Loosen soiled linen. Look for personal items. Roll linen from head to foot of bed. Avoid contact with your skin or clothes. Place it in a hamper/bag, at foot of the bed, or in a chair. Pull and tuck in clean bottom linen just like the other side. Finish with bottom sheet free of wrinkles (Fig. 12-9) Fig. 12-9 21

Making an occupied bed Place resident on his back. Keep resident covered and comfortable, with a pillow under the head. Raise side rail. Unfold the top sheet. Place it over the resident and center it. Ask the resident to hold the top sheet. Slip the blanket or old sheet out from underneath (Fig. 12-10). Put in the hamper/bag. Fig. 12-10 22

Making an occupied bed Place a blanket over the top sheet. Tuck the bottom edges of top sheet and blanket under the bottom of the mattress. Make hospital corners on each side. Loosen the top linens over the resident’s feet. This prevents pressure on the feet. At the top of the bed, fold the top sheet over the blanket about six inches. 23

Making an occupied bed Remove the pillow. Do not hold it near your face. Remove the soiled pillowcase by turning it inside out. Place it in the hamper/bag. With one hand, grasp the clean pillowcase at the closed end. Turn it inside out over your arm. Next, using the same hand that has the pillowcase over it, grasp one narrow edge of the pillow. Pull the pillowcase over it with your free hand (Fig. 12-11). Fig. 12-11 24

Return bed to appropriate position. Remove privacy measures. Making an occupied bed (con’t.) Do the same for any other pillows. Place them under resident’s head with open end away from the door. Make resident comfortable. Make sure sheets are free from wrinkles and the bed free from crumbs. Return bed to appropriate position. Remove privacy measures. Put call light within resident’s reach. 25

Dispose of soiled linen in the proper container. Making an occupied bed Dispose of soiled linen in the proper container. Remove gloves if worn. Wash your hands. Report any changes in resident to the nurse. Document procedure using facility guidelines. 26

Make an unoccupied bed Equipment: clean linen: mattress pad, fitted or flat bottom sheet, waterproof bed protector if needed, blanket(s), cotton draw sheet, flat top sheet, pillowcase(s), gloves (if you are going to be touching linens soiled with body fluids) Wash your hands. Place clean linen on clean surface within reach (e.g., bedside stand, overbed table, or chair). 27

Put on gloves if linens are soiled with body fluids. Make an unoccupied bed Adjust bed to a safe working level, usually waist high. Lock bed wheels. Put bed in flattest position. Put on gloves if linens are soiled with body fluids. Loosen soiled linen. Roll soiled linen (soiled side inside) from head to foot of bed. Avoid contact with your skin or clothes. Place linen in a hamper/bag, at foot of the bed, or in chair. 28

Remove gloves. Wash your hands. Make an unoccupied bed Remove gloves. Wash your hands. Remake the bed. Spread mattress pad and bottom sheet, tucking under. Make hospital corners to keep bottom sheet wrinkle-free. Put on mattress protector and draw sheet. Smooth and tuck under sides of bed. Place top sheet and blanket over bed. Center these, tuck under end of bed and make hospital corners. 29

Return bed to appropriate position. Make an unoccupied bed (con’t.) Fold down the top sheet over the blanket about six inches. Fold both top sheet and blanket down so resident can easily get into bed. (Fig. 12-12). If resident will not be returning to bed immediately, leave bedding up. Remove pillows and pillowcases. Put on clean pillowcases (as described above). Replace pillows. Return bed to appropriate position. Fig. 12-12 30

Dispose of soiled linen in the proper container. Make an unoccupied bed Dispose of soiled linen in the proper container. Remove gloves if worn. Wash your hands. Document procedure using facility guidelines. 31

Making a surgical bed Equipment: clean linen (see procedure: “Making an unoccupied bed”), gloves Discuss the preparation for the arrival of a resident on a stretcher with the nurse. When preparing the room, you may need to set up equipment in the room. Check with the nurse for instructions on gathering any extra equipment/supplies. Wash your hands. 32

Making a surgical bed Place clean linen on clean surface within reach (e.g., bedside stand, overbed table, or chair). Adjust bed to a safe working level, usually waist high. Lock bed wheels. Put on gloves. Remove all soiled linen, rolling it (soiled side inside) from head to foot of bed. Avoid contact with your skin or clothes. Place it in a hamper/bag, at foot of the bed, or in chair. 33

Remove gloves. Wash your hands. Making a surgical bed Remove gloves. Wash your hands. Make an unoccupied bed with bedding left up (a closed bed). Do not tuck top linens under the mattress. Fold top linens down from the head of the bed and up from foot of the bed (Fig. 12-13). Fig. 12-13 34

Leave bed in its highest position. Leave both side rails down. Making a surgical bed Fanfold linens lengthwise to the side away from door. Fanfolded means folded several times into pleats (Fig. 12-14). 10. Put on clean pillowcases. Place the pillows on a clean surface off the bed (e.g., bedside stand, overbed table, or chair). Leave bed in its highest position. Leave both side rails down. Move all furniture to make room for the stretcher. Fig. 12-14. 35

Dispose of soiled linen in the proper container. Wash your hands. Making a surgical bed Do not place call light on bed. That is placed after the resident returns to bed. Dispose of soiled linen in the proper container. Wash your hands. Document procedure using facility guidelines. 36