Rest and Sleep

Bed 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 Comfort
Psychological 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 covered
 Mattresses used to prevent & treat
decubitus ulcers
KCI beds
Eggcrate
Sheepskin
 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

–
 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 control
Once linen brought into a client’s
room, if unused, must be discarded
for laundering
Excess linen causes clutter and
obstacles in a cramped space
 Rubber drawsheet
• Save on linen
• Time
• Turning and positioning
• Placed under cotton drawsheet
Drawsheet 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.

Assessment
What 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 tests
Check throughout day and straighten
linen prn
After meals, if eating in bed, check for
food particles
Change linen that is soiled or wet
Effective Body Mechanics
and
Bed Making
1. Maintain good body alignment
2. Use the large muscles of the body
3. Work smoothly and rhythmically
4. Push or pull rather than lift
5. 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 pleat
Therapeutic 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