Chapter 16 Bedmaking All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Bedmaking Clean, dry, and wrinkle-free linens are important for all residents. Comfort is promoted. Skin breakdown and pressure ulcers are prevented. Beds are made every day. Beds are made and rooms straightened before visitors arrive. Consider that food, fluid, hygiene, and elimination needs can be met while residents are in bed. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 2

Bed Care To keep beds neat and clean: 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. Change linens whenever they become wet, soiled, or damp. Follow Standard Precautions and the Bloodborne Pathogen Standard. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 3

Types of Beds A closed bed is not in use until bedtime. It also is one that is ready for a new resident. 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 In a closed bed, top linens are not folded back (Fig. 16-1 on p. 251). A closed bed becomes an open bed by fan-folding back the top linens. In an open bed, top linens are fan-folded back so the person can get into bed (Fig. 16-2 on p. 251). Occupied bed (Fig. 16-3 on p. 251). Surgical bed (Fig. 16-4 on p. 251). All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 4

Linens Linens are not changed every day. A complete linen change is usually done on the person’s bath day. This may be once or twice a week. Pillowcases, top and bottom sheets, and drawsheets (if used) are changed twice a week. Linens are changed if wet, damp, soiled, or very wrinkled. When handling linens, practice medical asepsis. Always hold linens away from your body and uniform. Never shake linens. Place clean linens on a clean surface. When handling linens and making beds, practice medical asepsis. Your uniform is considered dirty. Shaking linens spreads microbes. Never put clean or dirty linens on the floor. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 5

Linens (Cont’d) Collect enough linens. Do not bring unneeded linens to a person’s room. Once in the person’s room, extra linens are considered contaminated. Collect linens in the order you will use them. Remove dirty linens one piece at a time. Roll each piece away from you. The side that touched the person is inside the roll and away from you. If the person has two pillows, get two pillowcases. The person may need extra blankets for warmth. Once in the person’s room, do not use linens for another person. Linens are to be collected in the order you will use them. Review the list in the textbook. Use one arm to hold the linens. Use your other hand to pick them up. The first item to use is at the bottom of your stack. You need the mattress pad first. To get it on top, place your arm over the bath blanket. Then turn the stack over onto the arm on the bath blanket (Fig. 16-5 on p. 251). All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 6

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 and dry. A plastic drawsheet (waterproof drawsheet) protects the mattress and bottom linens from dampness and soiling. A cotton drawsheet is always used when a plastic drawsheet is used. Cotton drawsheets are often used without plastic drawsheets. A cotton drawsheet reduces heat retention and absorbs moisture. Some waterproof drawsheets are disposable. They are discarded when wet, soiled, or wrinkled. Cotton drawsheets are often used as assist devices to move and transfer persons in bed. If used as an assist device, do not tuck it in at the sides. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 7

Making Beds Safety and medical asepsis are important. Closed beds are made: For persons who are out of bed most of the day For a new resident A closed bed becomes an open bed by fan-folding back the top linen. Make this bed for: Newly admitted persons arriving by wheelchair Residents who are getting ready for bed Residents who are out of bed for a short time Review the rules for bedmaking in Box 16-1 on p. 253. Review Delegation Guidelines: Making Beds on p. 252. Review Promoting Safety and Comfort: Making Beds on p. 253. Review Teamwork and Time Management: Making Beds on p. 253. Review the Making a Closed Bed procedure in the textbook on pp. 253-255. Review the Making an Open Bed procedure in the textbook on pp. 257-258. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 8

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 it is done. The surgical bed (recovery bed or postoperative bed) Top linens are folded to transfer the person from a stretcher to the bed. These beds are made for: Persons who arrive at the center by ambulance Persons who are taken by stretcher to treatment or therapy areas Persons using portable tubs Review Focus on Communication: The Occupied Bed on p. 258. Review Promoting Safety and Comfort: The Occupied Bed on p. 258. Review the Making an Occupied Bed procedure on pp. 258-260. Review Promoting Safety and Comfort: The Surgical Bed on p. 261. Review the Making the Surgical Bed procedure on p. 262. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 9

Quality of Life The bed must be neat, clean, and well made. The person, family, and visitors question the quality of care and the person’s quality of life if the bed is unmade, messy, or dirty. The bed helps provide an orderly and pleasant setting. If the person stays in bed, straighten and tighten sheets and other linen as needed. Some persons bring bedspreads, pillows, blankets, afghans, and quilts from home. Allow personal choice when possible. Use the linens brought by the resident when making the bed. Such items are the person’s property. Handle them with care and respect. Make sure they are labeled with the person’s name. This protects them from loss. It also prevents them from becoming confused with the property of others. If the center uses colored or printed linens, let the person choose which linen to use. Also, let the person decide how many pillows or blankets to use. If possible, the person chooses when the bed is made. The more choices allowed, the greater the person’s sense of control and quality of life. All items and derived items © 2015, 2011 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 10