Rest and SleepBed Making

Skill and Rational

Why is it so important?

The bed is particularly important to people who are ill. It is essential the nurse keep the bed as clean and comfortable as possible.

Physical ComfortPsychological comfort

Rest and Sleep

• Healing and Optimal Health• Promoting Sleep

Nursing Process

• Assessment– Usual pattern of rest/sleep – bed routines

• Nursing diagnosis– Sleep pattern disturbance

• Plan– Sleep aids

Nursing process

• Implementaion– Regular habits– Nutrition/exercise– Quiet time prior to sleep– Warm milk– Sleep/wake cycle– Back rub– Comfortable bed

Nursing Process

• Evaluation– Good night sleep

Promoting Rest and Sleep

• Rest period• Nonessential tasks• Night time/early am bathing• Lab work• Cluster activity• Visitor control• Interventions prn

Comfort Measures for Promoting Sleep

Administer hygiene measures for clients on bedrest

Loose fitting nightwear Remove or change any irritants against the

client’s skin (moist dsg., drainage tubes) Position and support dependent body parts to

protect pressure points and aid muscle relaxation

Comfort Measures for Promoting Sleep

Provide caps and socks for older clients and those prone to cold

Void before bedtime Analgesics or sedatives 30 min. prior H.S. Bedtime massage/backrub Comfortable mattress and a clean dry bed!

Noisy Nightshift

• Close doors to clients’rooms/work areas if possible

• Telephone/paging equipment• Noisy footwear• Equipment• Bedside monitors• TV/radio• Conversations

Client’s Environment

• Chairs– Straight back post surgery– Lounge chair

• Lighting– Overbed– Night light– Call light

• Overbed table• Bedside table

Special Mattresses

Types Regular firm, plastic coveredMattresses used to prevent & treat decubitus

ulcersKCI bedsEggcrateSheepskin

Special mattresses are not a substitute for nursing care

• Turn patients Q2h• Skin care• positioning

Considerations

• Bed position– Safety– Body mechanics– Gatchs

• Infection control• Skin breakdown

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The bed changing process

• Every health care agency wants the end product to be neat, clean, comfortable and durable.

• Economical– Time– Equipment– Energy, patients and nurses

Assembling Equipment

• 2 sheets – Fitted/flat for bottom– Flat for top

• Pillowcases• Cotton/rubber drawsheet as needed• Soaker• Bedspread• Blanket

Linen Overload

• Just what you need• Cost controlOnce linen brought into a client’s room, if

unused, must be discarded for launderingExcess linen causes clutter and obstacles in a

cramped space

Rubber drawsheet

• Save on linen• Time• Turning and positioning• Placed under cotton drawsheetDrawsheet extends from above waist to

midthigh.Absorbs secretions due to urinary/fecal

incontinence

Linen Change

• As per hospital protocol– Cost– Pillow cases/drawsheet OD– Soiled or bath day– Laundry shute/hamper– If soiled with feces/blood– Use of gloves

Skill

Under no circumstances do you place dirty linen on floor, footstool, another patient’s bed or on over the bed tables.

AssessmentWhat needs to be changed Client’s condition

When does the bed get changed?

• Usually after client’s bath• Client is sitting in chair• Out of room for testsCheck throughout day and straighten linen prnAfter meals, if eating in bed, check for food

particlesChange linen that is soiled or wet

Effective Body Mechanics and Bed Making

1. Maintain good body alignment2. Use the large muscles of the body 3. Work smoothly and rhythmically4. Push or pull rather than lift5. Use your own weight to counteract the

weight of an object.

Nursing Diagnosis

• Activity intolerance• Impaired physical condition

Types of Bed

• Occupied• Unoccupied• Surgical/post-op beds

Occupied Bed

• Gloves if drainage• Check chart/kardex for client’s activity• Talk to the client, explain procedure• Privacy• Assemble all equipment, incontinent pads prn• Safety with side rails/call bell• Wash hands before and after

Planning

• Expected outcomes• Best time to change linen• Equipment needed

Implementation

• Wash hands• Gloves prn• Equipment• Adjust bed height-HOB down• Lower side rail- remove call bell• Loosen linen• Keep soiled linen away from uniform

Infection Control and Bed Making

1. Microorganisms are present on the skin and in the general environment.

2. Some microorganisms are opportunists; that is, they can cause infections when conditions are favorable ( break in skin, mucous membranes)

3. Clients are often less resistant to infections because of the stress resulting from an existing disease process.

Infection Control and Bed Making

4. Microorganisms may be transferred from one person to another or from one place to another by air, by inanimate objects or by direct contact among people. Therefore:

Avoid holding soiled linen against uniform Never shake linen Always wash hands before going to another

patient.

Avoid shaking linen for infection control purposes

• Linen to be reused – fold and place on chair

• Soak and rinse linen soiled with feces or blood before placing in hamper

• Make sure no tripads, personal articles or anything besides linen is placed in hamper

Evaluation

• Inspect bed– Clean– Neat– Wrinkle free

Always be alert to client comfort and safety during bedmaking.

• When finished evaluate – Safety re bed position– Call light – Side rails– Unit tidy– Personal belongings are within reach

Accessories

• Bed cradle/foot cradle• Fracture board• Foot board• Toe pleatTherapeutic Frames allow movement for

immobilized patients & help prevent complications R/T immobility

Remember

• To make bed, position is elevated• When completed, bed is lowered• If occupied, patient comfort & safety• Soiled linen away from uniform• Gloves prn• Bath before making bed if occupied