Topic 3: Promoting/ assisting with comfort Learning objectives By the end of this lesson, member should be able to:
v v v v
Describe the purposes of changing bed linens. List down the principles of bed making. Successfully make an unoccupied bed. Successfully make an occupied bed according to the condition of the client.
Training materials needed:
1. 2. 3. 4. 5. 6. 7. 8. 9.
A hospital bed, preferable with 2-3 cranes function. 1 bed sheet 1 or 2 pillow case 1 pillow 1 blanket 1 bucket for used linen/ linen trolley 1 bedside chair Disposable glove (for infectious cases) Disposable protective sheet
Special instruction: v Members are to wear track pants during the lesson.
3. PROMOTION/ASSISTING WITH COMFORT
Bed should be designed for comfort, safety, and adaptability for changing positions. Bed contains a number of safety features. Locks on the wheels are used to prevent movement during the performance of a procedure. Aide rails are to protect client from falls, help client position themselves, and provide upper extremity support as a client gets out of bed.
Bed making is the responsibility of the nurse to keep the bed clean and comfortable. It requires frequent inspection to make sure that the linen is clean, dry and wrinkle free. The bed is usually made during of after the client has bathe. Linen that has become wet or soiled should be changed.
Principles of bed making : ü
Keep the soiled linen away from the uniform.
ü
Never fan the linen as it can spread microorganisms.
ü
Never place the dirty linens on the floor to prevent transmitting infection.
ü
If clean linen touches the floor, it should be discarded immediately.
ü
Use proper body mechanics during bed making.
ü
Do proper hand washing before and after making a bed.
ü
Using side rails, keeping call lights within the client’s reach, and maintaining the proper bed position help to promote comfort and safety.
3.1 Bed Making: making an unoccupied bed
Nursing process Assessment: 1. The need to make a bed prior client admitted to hospital. 2. The mattress has been clean with disinfectant and feels dry after a client has discharge from hospital.
Planning: 1. Prepare needed equipment and supplies: ü Bed sheet ü One/two pillow cases ü Blanket ü Linen trolley/ basket for used linen ü Protective sheet (blue sheet) ü Disposable gown ü Disposable glove (if necessary for infectious cases) Implementation: 1. Wash your hand before the procedure. Switch off the fan.
To reduce transmission of microorganisms.
2. Assemble equipments and arrange it on bedside chair. Remove all unnecessary equipment.
Placing linen on clean surface to minimizes infection.
3. Raise the bed to the required height. Lower the side rail and remove the call bell.
Prevent straining of the body. Provides easy access to bed.
4. Loosen all linen first for easier removal. 1. Remove blanket by folding into ball and Discard into linen bag if they are not to be Reused.
To reduce the transmission of microorganisms.
6. Do not allow uniform to come in contact with soiled linen. Avoid fanning or shaking linen.
To avoid cross contamination from uniform to another client.
7. Fold each piece of remaining bed linen into balls and discard into linen bag.
Fold all at once creates bulky bundle difficult to discard.
8. Stand at side of bed where linen is placed. Spread and smooth out all wrinkles & folds.
Wrinkles or folds of linen are source of pressure sore.
9. Fit the corners of the mattress into the corner of the bedsheet.
To enhance comfort & neatness.
10. Work in unison when making up the bed with another nurse.
To expedite the procedure.
11. Turn & fluff pillows. Place open ends of the pillowcase away from the main door. Position at the center of head of the bed
To enhance the softness and comfort of the pillow and prevent dust from collecting.
12. Fold the blanket breath-wise twice & place it at the lower end of the mattress (envelope method). Tuck the free end of the blanket under the mattress. 13. Rearrange the furniture and place personal items within reach.
Promote sense of well-being.
14. Discard dirty linen in the laundry and wash hands.
Prevent transmission of Microorganisms.
3.2 Changing of bed linen Making an occupied bed for client who is not able to sit out of bed a) Changing from side to side v Roll clean bed linens length-wise & place then on the trolley ready for use. v Loosen bedsheet all round & remove blanket. v Position client in lateral position with one pillow. Step 1: Step 2: Step 3: Step 4: Step 5: Step 6: Step 7:
Roll soiled bed linens towards client’s back (Figure 30). Place clean linen in position, unroll as required & tuck in the free ends, repeat the same procedure for draw sheet if required (Figure 31). Adjust the pillow & turn client over to the clean side. Remove the dirty linen & unroll the clean linen & pull to prevent creases, tuck in the free ends. Turn client back to supine position, adjust the pillow. Position the blanket & tuck in the free ends Ensure that the client is comfortable. Replace call bell & pull up the side rail.
Figure 30
Figure 31
b) Changing from top to bottom v Roll clean bed linens breath-wise & place them on the trolley ready for use. v Position the client by letting him to sit up in bed if possible, by using Australian lift or Orthodox lift. v Repeat step 1 to 7 as the same for changing from side to side.