Lesson 1: Definition of Bed Making

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1 Bed making o 1.1 Introduction o 1.2 Lesson Content o 1.3 Rules to be observed when making beds o 1.4 Reasons for bed making
o

1.5 Types of hospital beds

Bed making
Introduction
Patients need to be nursed in bed to make them comfortable.The nurse will also be comfortable without straining on her back. Hospital beds patients positions can easily be changed with minimal dis turbances to him.

500pxBeds to give domfort regardless of your illment, Image provided Courtesy ofFlickr.www.flickr.com

Objectives
By the end of the lesson, students should be able to:

define bed making. mention at least seven rules of bed making. mention four reasons for making beds. mention five types of bed.

Lesson Content

Definition
It is the techniques of preparing different types of bed in making a patients/clients comfortable or his/her position suitable for a particular condition.

Rules to be observed when making beds

1. All equipments should be collected before starting. 2. Two nurses are required and they should work in harmony avoiding jerky movements and jarring the bed. 3. Bed should be made in such a way that patient can be put in it without difficulty. 4. It should be suitable for treating certian conditions. eg. shock. 5. The bed should be free from crumbs and creases and should give a maximum comfort to the patient. #Pillows and other bed accessories should be well arranged to give support twhere necessary. 6. The patient's face should never be covered by sheets or blankekts. 7. The patient must never be exposed. 8. Extra assisstance should be available and, if nacessary, one should be called upon to help lift the patient.

9. When pillows are being shaken the nurse should turn away from the patient. 10. Any conversation during bed making should not be on personal matters between the nurses. 11. The open side of a pillow case should be away from the main door of the ward. 12. Always have a dirty linen bin at hand in which to put dirty linen. 13. Dirty linen should not be carried across the ward to prevent cross infectoin. 14. allow room for the patient feet for free movement or turning when placing the top sheet over the patient. 15. Always wash hands before and after bed making.

Reasons for bed making

1. 2. 3. 4. To keep the ward neat and tidy. For patients comfort. To prevent cross infection. For treatment of certian conditions.

Types of hospital beds

1. Routine beds:

Simple unoccupied bed. An occupied bed.

1. Special beds:

Cardiac bed. Orthopedic bed. Operation bed. Adimission bed. Divided bed. Aputation bed. Plaster of Paris bed.

Summary
Bed making is the tecniques of making different types of bed.Before bed making the nurse shuold observe certian rules. Lastly the nurse should know the reasons for making the patient bed.Put your summary here

Introduction

Today we shall start our lesson by looking at simple occupied bed, a continuation of the last lesson.

Objectives
By the end of the lesson, students should be able to: 1. define simple unoccupied bed. 2. metiontion and collect all the requirement needed for making simple unoccupied bed. 3. do a return demonstration on simple unoccupied bed.

Lesson Content

Definition
It is a type of hospital bed that does not have a patient in it.

Requirements

A trolley with the following

Two large cotton sheets One water proof draw mackintosh (if necessary) One draw sheet (if necessary) One or two pillows Pillow stips/covers One blanket optional One bed cover or counterpane

Procedure/steps
1. The above articles should be collected and put over two chairs placed back to back at the bottom of the bed. It is helpful to palace the linen in order which it is required. 2. Place long mackintosh on mattress if necessary. 3. Place bottom sheet evenly on the bed. 4. Tuck the sheets under the mattress using enveloped carners, starting from top. 5. Pull sheet tight so that there are no creases. 6. Place a draw mackintosh (if necessary) across the bed with the upper corner under the edge of the pillow. 7. Cover mackintosh with draw sheets and tuck it in. 8. Place the pillows on the bed so that the open ends of the slip are away from the door. 9. Place top sheet on with the wrong side uppermost. 10. Fold over about twenty inches of the sheet at the top. 11. The sheet is loosely tucked in at the bottom to prevent restriction of feet. 12. Place the bed cover or counterpane loosely over the sheet. 13. Tuck in at the bottom end under the mattress using envelop carners. 14. Fold top sheet over the counterpane with all the sides tucked under the mattress 15. After bed making the nurse must make sure that all the locker (bedside) and the two chairs used have been replaced in their proper positions. 16. Remove trolleys.

Summary
We have learnt about the definition of simple unoccupied bed, the requirements neede for making a simple unoccupied bed and the procedure for making a simple unoccupied bed.

Activity
Two students should: 1. collect the requirements neede for making a simple unoccupied bed. 2. demonstrate how to prepare a simple unoccupied bed.

Lesson 3: Making a Simple Occupied Bed

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1 Introduction 2 Lesson Content 3 Requirements 4 Methods 5 Procedures/steps

Introduction
A simple occupied bed is also a type of hospital bed. It is similar to the simple unoccupied bed. With our knowledge in the previous lesson, todays lesson will not be difficult.

A patient relaxing in her sick bed,Image provided by Courtesy of Fkickr.www.flickr.com

Objectives
By the end of the lesson, students should be able to:

define a simple occupied bed. mention and collect the requirements needed for simple occupied bed. deferentiate between simple unoccupied bed and simple occupied bed.

Lesson Content

Definition
It is a hospital bed with a patient in it.

Requirements
Extra requirement in addition to simple unoccupied bed is Dirty linen bin.

Methods

1. Side to side 2. Top to bottom

Procedures/steps
1. Explain procedure to patient if he is conscious. 2. Provide privacy by placing a screen across the ward door (routine bed making). NB: If routine bed making is not in progress the individual bed is screened. 1. Place two chairs at the foot end of the bed. 2. Untuck the bed clothes beginning from the top. 3. Remove counterpane or blanket, if present, by folding it into three parts on to the chair. 4. Do not expose patient. 5. Remove all pillows and other bed accessories where necessary. 6. If side to side method is employed 7. Roll the patient gently from side to side and support him in this position (lateral position). 8. Roll draw sheet and mackintosh up to the patients back. 9. Turn patient over to the other side and remove draw sheet if soiled. 10. If top to bottom method is employed. 11. Lift patient to the bottom of the bed and remove draw sheet if soiled. 12. Pull draw sheet if dirty or wet and change it. 13. Replace pillows and other bed accessories. 14. Replace top linen and leave patient comfortable. 15. Discord trolley.

Note

Clean patient if he has soiled himself before puttting him on tje clean sheet. The bed clothes should not be tucked in too tightly around the patient, particularly over the feet. He should be allowed freedom to move.

Summary
Simple occupied bed is that bed with patient in it. The extra requirement needed in addituin to simple unoccupied bed is the dirty linen bin. Two methods are employed:

Side to side method or Top to bottom method.

Activity
Teacher calls two students to:

mention and collect the requirements for making a simple occupied bed. demonstrate how to prepare a simple occupied bed.

Lesson 4: Making an Admission Bed

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1 Introducton 2 Lesson Content 3 Definition 4 Purpose 5 Requirements 6 Steps/Procedure

Introducton
Special beds are those beds used for patients with specific conditions. In the wards, the nurse does not care for all kind of patients using the same bed but rather special condition calls for special beds. We will look at one of them called the admission bed.

Objectives
By the end of the lesson, students should be able to: 1. define admission bed. 2. mention the requirements needed for making admission bed. 3. demonstrate how to prepare an admission bed.

Lesson Content

Definition
It is a specailly made bed for patients who are admitted into the ward. It is made in such a way that a patient or client is admitted without delay.

Purpose
1. 2. 3. 4. To provide womth for the patient. To allow immediate admission. To facilitate bathing of patient in bed without undue disturbance. To give promt treatment.

Requirements
Extra requirements to be added to those for simple unoccupiep bed. A trolley with the following items:

long mackintosh sheet or mackintosh if necessary one or two blankets if necessary bed accessories depending on patient's condition eg. bed blocks or elevator, bed cradle, back rest etc.

Steps/Procedure
1. 2. 3. 4. 5. 6. 7. 8. 9. Make up bed as for simple unoccupied bed until draw sheet or mackintosh is in position. Cover with a long waterproof sheet or a long mackintosh if necessary Use one bath blanket or sheet over the waterproof sheet and tuck in all arond or fold under itself. Place second bath blanket over the bed. Put in hot waterbottles if necessary. Put on top bed clothes. Place conterpane loosely over the top bed clothes. Tuck in the bed clothes on other side. Fold the bedclothes over at the side nearest to the door, leaving it open to facilitate quick admittance.

Summary
Admission bed is a special bed used for admitting patients. Bath blankets and bed accessories are some of the special requirements needed. One of the purpose of making an admission bed is that it facilitate bathing

of patient in bed with undue disturbances.

Activity
Teacher calls two students to:

collect the requirements needed for making an admission bed. demonstrate how to prepare an admission bed.

Assignment
Explain why it is important for a patient to have his bath in bed especially on admission?

Lesson 5: Making an Operation Bed

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1 Introduction 2 Lesson Content 3 Definiton 4 Purpose 5 Requirements 6 Steps/Procedures

Introduction

Objectives
By the end of the lesson, the student should be able to: 1. define an operation bed. 2. state at least four purposes of making an operation bed. 3. list the requirements needed for making an operation bed. 4. do a return demonstration on operation bed.

Lesson Content Definiton

It is a type of bed that is made ready to receive a patient returning from operating theatre.

Purpose

To provide wormth. To receive patient from theatre. To combact shock. To protect linen from vomit and saliva.

To clear mouth of any saliva for which purpose a tray is set.

Requirements
Extra requirement to be added to those required for a simple unoccupied bed.

Mackintosh or any waterproff material and or dressing towel. One or more blanket if necessary.

Bed accessories to suit patients condition.

Drip stand. A post aneasthetic tray by the bedside containing the following: o vomiit bowl. o dressing towel. o kidney dish contianing: swab holding forceps tongue holding forceps spatula o agallipot with gauze swabs o an injection tray o mouth gag o a receiver for soiled swabs o a gallipot with cold water o a receiver to receive mouth wash o temperature, pulse and respiration tray o blood pressure apparatus o charts for recording

Steps/Procedures
1. 2. 3. 4. 5. 6. 7. 8. Make up simple unocupied bed until drwa sheet is in position. Place water proof and dressing towel at top of bed. Leavve pillow on chair. Place hot water bottle on bed if necessary. Place blanket on bed, if necessary. Put top clothes on as for admission bed. Turn back the bottom end of the top clothes. Fold the top clothes at the openside and three part over the bed for easy admissoin of the patient.

Note: Remove hot waer bottle before patient is put in bed.

Summary
Operation bed is used to nurse patients who have undergone surgery. The bed is made in such a way that nursing the patient becomes more easier. The use of some bed accessories also help to prevent complications

Activity
Teacher calls two students to:

collect the requirement for making an operation bed. demonstrate jow to prepare an operation bed.

Assignment

Define an operation bed in your own words. State four reasons for making an operation bed. List three bed accessories that are used in prepareing an operation bed.

Definition
A hospital bed is the piece of equipment most frequently used by the hospitalized patient. Hospital beds are also found in long-term-care facilities, as well as patients' homes. The ideal hospital bed should be selected for its impact on patients' comfort, safety, medical condition, and ability to change positions.

Purpose
The purpose of a well-made hospital bed, as well as an appropriately chosen mattress, is to provide a safe, comfortable place for the patient, where repositioning is more easily achieved, and pressure ulcers are prevented.

Precautions
When selecting a bed, the nurse should consider the patient's mobility, overall medical condition, and risk for pressure ulcer development. Safety factors should also be considered. Unless a patient is accompanied by a health care professional or other caregiver, the bed should always be placed in its lowest position to reduce the risk of injury from a possible fall. Another precaution to take, especially for weak or bed-bound patients, or for those with altered mental status, is to elevate the side rails. However, health care professionals should be aware of a safety alert issued by the Food and Drug Administration (FDA) in 1995 concerning the use of hospital beds' side rails. Because of a number of injuries and deaths related to side rail entrapment, the FDA recommends the following actions to prevent potential deaths and injuries related to side rail entrapment:

All hospital bed frames, side rails, and mattresses should be inspected regularly to identify potential areas of entrapment. The alignment of the bed frame, side rail, and mattress should leave no gap that is wide enough to entrap a patient's head or any other part of the body. Be alert for side rails or mattresses that have been replaced. Not all of these are interchangeable, and may increase the potential for entrapment.

Check side rails for proper installation. Consider additional safety measures for those patients at high risk for entrapment. Side rail protective barriers may be used to close off open spaces. Do not use side rails as a substitute for patient protective restraints.

Description
The usual hospital bed consists of a mattress on a metal frame that can be raised or lowered horizontally. The frame is separated into three sections so the head and foot of the bed can be raised and lowered, in addition to inclining the entire bed with the headboard up or down. The majority of hospital beds are powered by electrical motors, but some are run manually (using a crank) or by hydraulic methods. The bed's position is typically changed by using electrical controls that may be located on the side or foot of the bed, in a bedside table, or on a pendant. The electrical controls enable patients to reposition the bed with very little effort. Patients should be instructed how to use the bed controls. They should also be cautioned against raising the bed to a position that may contribute to injuries or falls. At its lowest level, a hospital bed is usually about 268 inches (650 cm) above the floor.

Two nurses change bedsheets with the patient in the bed. (Photograph by Cliff Moore. Science Source/Photo Researchers. Reproduced by permission.) Various safety features are present on hospital beds. These features include:

Wheel locks: These should be used whenever the bed is stationary. Side rails: They help to protect patients from accidentally falling out of bed, as well as provide support to the upper extremities as the patient gets out of bed. Removable headboard: This feature is important during emergency situations, especially during cardiopulmonary resuscitation.

Most hospital beds have water-repellent mattresses. However, a number of specially designed beds, frames, and mattresses have been created to aid in caring for bed-bound patients. Some of these beds help to turn the immobile patient, and may make it easier for nurses to lift or reposition the patient. The major categories of specialized beds are:

Air-fluidized beds: These are also known as bead beds, sand beds, and high-air-loss beds. Air is circulated via silicone microspheres, creating a fluid-like state.

Low-air-loss beds. These beds have interconnected air cells with a minimum depth of five inches (123 cm). They allow air to escape from the surface of the bed.

There are also a variety of support surfaces that can be placed on top of the existing mattress, or specialized mattresses that can reduce the risk of pressure ulcer formation. These surfaces and mattresses include:

static air-filled overlays alternating air-filled mattress overlays gelor water-filled mattress overlays foam mattresses low-air-loss replacement mattresses

The rotokinetic bed is used primarily for severely immobilized patients or patients with spinal cord injuries. The bed can rotate a patient up to 270. Bariatric beds are available for especially obese patients.

Preparation
The nurse normally makes the bed in the morning after a patient's bath, or when the patient is out of the room for tests. The nurse should straighten the linens throughout the day, making certain they are neither loose nor wrinkled. Any sheets that become wet or soiled should be changed promptly. When changing bed linen, the nurse should keep the soiled linen away from the uniform, and place it in the appropriate linen bag or other designated container. Never fan or shake linens, which can spread microorganisms and, if any of the sheets touch the floor, they should be replaced. The bed can be made in a variety of ways, depending on the particular patient situation. The categories of unoccupied bed making include:

Open unoccupied: In an open bed, the top covers are folded back so the patient can easily get back into the bed. Closed unoccupied: In a closed bed, the top sheet, blanket, and bedspread are pulled up to the head of the mattress and beneath the pillows. A closed bed is done in a hospital bed prior to the admission of a new patient. Surgical, recovery, or postoperative: These techniques are similar to the open unoccupied bed. The top bed linens are placed so that the surgical patient can transfer easily from the stretcher to the bed. The top sheets and bedspread are folded lengthwise or crosswise at the foot of the bed.

The other method of making a hospital bed is an occupied bed, where the patient is in the bed while the linens are being changed. The nurse should perform the following when making the occupied bed:

Raise the bed to a comfortable working height. Loosen the top linens, and help the patient assume a side-lying position. Roll the bottom linens toward the patient. Place the bottom sheet on the mattress, seam side down, and cover the mattress. Miter the corners of any non-fitted sheets. Place waterproof pads and/or a draw sheet on the bed.

Tuck in the remaining half of the clean sheets as close to the patient as possible. Assist the patient to roll over the linen. Raise the side rail, and go to the other side of the bed. Remove the dirty linen and dispose of appropriately. Slide the clean sheets over and secure. Pull all sheets straight and taut. Place the clean top sheets over the patient and remove the used top sheet and blanket. Miter the corners of the top linens at the foot of the bed. Loosen the linens at the foot of the bed for the patient's comfort. Change the pillowcase. Return the patient's bed to the appropriate position, at its lowest level.

The nurse also needs to place the bed into one of the following positions, considering the particular needs of each patient:

Fowler's: The head of the bed is raised to an angle of 45 or more; a semisitting position. This position is appropriate when the patient is eating. It is also used during nasotracheal suctioning or during nasagrastic tube placement. Semi-Fowler's: In this position, the head of the bed is raised about 30. This position helps to promote adequate lung expansion. Trendelenburg: The entire bed frame is tilted with the head of the bed down. This helps to promote postural drainage or to promote venous return in patients with poor peripheral circulation. Reverse Trendelenburg: The entire bedframe is tilted with the foot of the bed down. This position is not frequently used, though it may help to prevent esophogeal reflux. Flat: Keeping the bed flat is appropriate for some patients with spinal injuries, and for those in cervical traction. It may also be used for patients with hypotension. It is a position preferred by many for sleeping.

Aftercare
After preparing the hospital bed, the patient should be assessed for comfort and safety.

Health care team roles

Selecting and preparing a bed for the patient are important responsibilities for the nurse. The nurse or nursing assistant normally makes up the bed, but it is important that all health care professionals be aware of the positive impact an appropriate, well-made bed has on a patient's care, safety, and sense of comfort.

KEY TERMS
Draw sheet sheet placed over the bottom sheet to help lift or move a patient and to protect the bottom sheet from soiling. Fowler's position bed position where the head of the bed is raised to an angle of 45 or more; a semisitting position.

Trendelenburg bed position where the entire frame of the bed is tilted with the head of the bed down.