Rest and SleepRest and SleepBed MakingBed Making

Skill and RationalSkill and Rational

Why is it so important?Why is it so important?

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

Physical ComfortPhysical Comfort

Psychological comfortPsychological comfort

Rest and SleepRest and Sleep

• Healing and Optimal HealthHealing and Optimal Health• Promoting SleepPromoting Sleep

Nursing ProcessNursing Process

• AssessmentAssessment– Usual pattern of rest/sleep Usual pattern of rest/sleep – bed routinesbed routines

• Nursing diagnosisNursing diagnosis– Sleep pattern disturbanceSleep pattern disturbance

• PlanPlan– Sleep aids Sleep aids

Nursing processNursing process

• ImplementaionImplementaion– Regular habitsRegular habits– Nutrition/exerciseNutrition/exercise– Quiet time prior to sleepQuiet time prior to sleep– Warm milkWarm milk– Sleep/wake cycleSleep/wake cycle– Back rubBack rub– Comfortable bedComfortable bed

Nursing ProcessNursing Process

• EvaluationEvaluation– Good night sleepGood night sleep

Promoting Rest and Promoting Rest and SleepSleep

• Rest periodRest period• Nonessential tasksNonessential tasks• Night time/early am bathingNight time/early am bathing• Lab workLab work• Cluster activityCluster activity• Visitor controlVisitor control• Interventions prnInterventions prn

Comfort Measures for Comfort Measures for Promoting SleepPromoting Sleep

Administer hygiene measures for Administer hygiene measures for clients on bedrestclients on bedrest

Loose fitting nightwearLoose fitting nightwear Remove or change any irritants Remove or change any irritants

against the client’s skin (moist dsg., against the client’s skin (moist dsg., drainage tubes)drainage tubes)

Position and support dependent body Position and support dependent body parts to protect pressure points and parts to protect pressure points and aid muscle relaxationaid muscle relaxation

Comfort Measures for Comfort Measures for Promoting SleepPromoting Sleep

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

Void before bedtimeVoid before bedtime Analgesics or sedatives 30 min. prior Analgesics or sedatives 30 min. prior

H.S.H.S. Bedtime massage/backrubBedtime massage/backrub Comfortable mattress and a clean Comfortable mattress and a clean

dry bed!dry bed!

Noisy NightshiftNoisy Nightshift

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

• Telephone/paging equipmentTelephone/paging equipment• Noisy footwearNoisy footwear• EquipmentEquipment• Bedside monitorsBedside monitors• TV/radioTV/radio• ConversationsConversations

Client’s EnvironmentClient’s Environment

• ChairsChairs– Straight back post surgeryStraight back post surgery– Lounge chairLounge chair

• LightingLighting– OverbedOverbed– Night lightNight light– Call lightCall light

• Overbed tableOverbed table• Bedside tableBedside table

Special MattressesSpecial Mattresses

Types Types Regular firm, plastic coveredRegular firm, plastic coveredMattresses used to prevent & treat Mattresses used to prevent & treat

decubitus ulcersdecubitus ulcersKCI bedsKCI bedsEggcrateEggcrateSheepskinSheepskin

Special mattresses are not a Special mattresses are not a substitute for nursing care substitute for nursing care

• Turn patients Q2hTurn patients Q2h• Skin careSkin care• positioningpositioning

ConsiderationsConsiderations

• Bed positionBed position– SafetySafety– Body mechanicsBody mechanics– GatchsGatchs

• Infection controlInfection control• Skin breakdown Skin breakdown

–

The bed changing The bed changing processprocess

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

• EconomicalEconomical– TimeTime– EquipmentEquipment– Energy, patients and nursesEnergy, patients and nurses

Assembling EquipmentAssembling Equipment

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

• PillowcasesPillowcases• Cotton/rubber drawsheet as neededCotton/rubber drawsheet as needed• SoakerSoaker• BedspreadBedspread• BlanketBlanket

Linen OverloadLinen Overload

• Just what you needJust what you need• Cost controlCost control

Once linen brought into a client’s Once linen brought into a client’s room, if unused, must be discarded room, if unused, must be discarded for launderingfor laundering

Excess linen causes clutter and Excess linen causes clutter and obstacles in a cramped spaceobstacles in a cramped space

Rubber drawsheetRubber drawsheet

• Save on linenSave on linen• TimeTime• Turning and positioningTurning and positioning• Placed under cotton drawsheetPlaced under cotton drawsheet

Drawsheet extends from above waist Drawsheet extends from above waist to midthigh.to midthigh.

Absorbs secretions due to urinary/fecal Absorbs secretions due to urinary/fecal incontinence incontinence

Linen ChangeLinen Change

• As per hospital protocolAs per hospital protocol– CostCost– Pillow cases/drawsheet ODPillow cases/drawsheet OD– Soiled or bath daySoiled or bath day– Laundry shute/hamperLaundry shute/hamper– If soiled with feces/bloodIf soiled with feces/blood– Use of glovesUse of gloves

SkillSkill

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

AssessmentAssessment

What needs to be changed What needs to be changed

Client’s conditionClient’s condition

When does the bed get When does the bed get changed?changed?

• Usually after client’s bathUsually after client’s bath• Client is sitting in chairClient is sitting in chair• Out of room for testsOut of room for tests

Check throughout day and straighten Check throughout day and straighten linen prnlinen prn

After meals, if eating in bed, check for After meals, if eating in bed, check for food particlesfood particles

Change linen that is soiled or wetChange linen that is soiled or wet

Effective Body Mechanics Effective Body Mechanics and and

Bed MakingBed Making1.1. Maintain good body alignmentMaintain good body alignment

2.2. Use the large muscles of the body Use the large muscles of the body

3.3. Work smoothly and rhythmicallyWork smoothly and rhythmically

4.4. Push or pull rather than liftPush or pull rather than lift

5.5. Use your own weight to counteract Use your own weight to counteract the weight of an object.the weight of an object.

Nursing DiagnosisNursing Diagnosis

• Activity intoleranceActivity intolerance• Impaired physical conditionImpaired physical condition

Types of BedTypes of Bed

• OccupiedOccupied• UnoccupiedUnoccupied• Surgical/post-op bedsSurgical/post-op beds

Occupied BedOccupied Bed

• Gloves if drainageGloves if drainage• Check chart/kardex for client’s activityCheck chart/kardex for client’s activity• Talk to the client, explain procedureTalk to the client, explain procedure• PrivacyPrivacy• Assemble all equipment, incontinent Assemble all equipment, incontinent

pads prnpads prn• Safety with side rails/call bellSafety with side rails/call bell• Wash hands before and afterWash hands before and after

PlanningPlanning

• Expected outcomesExpected outcomes• Best time to change linenBest time to change linen• Equipment neededEquipment needed

ImplementationImplementation

• Wash handsWash hands• Gloves prnGloves prn• EquipmentEquipment• Adjust bed height-HOB downAdjust bed height-HOB down• Lower side rail- remove call bellLower side rail- remove call bell• Loosen linenLoosen linen• Keep soiled linen away from uniformKeep soiled linen away from uniform

Infection Control and Infection Control and Bed MakingBed Making

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

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

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

Infection Control and Infection Control and Bed MakingBed Making

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

Avoid holding soiled linen against Avoid holding soiled linen against uniformuniform

Never shake linen Never shake linen Always wash hands before going to Always wash hands before going to

another patient.another patient.

Avoid shaking linen for Avoid shaking linen for infection control purposesinfection control purposes

• Linen to be reused Linen to be reused – fold and place on chairfold and place on chair

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

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

EvaluationEvaluation

• Inspect bedInspect bed– CleanClean– NeatNeat– Wrinkle freeWrinkle free

Always be alert to client Always be alert to client comfort and safety during comfort and safety during

bedmaking.bedmaking.• When finished evaluate When finished evaluate

– Safety re bed positionSafety re bed position– Call light Call light – Side railsSide rails– Unit tidyUnit tidy– Personal belongings are within reachPersonal belongings are within reach

AccessoriesAccessories

• Bed cradle/foot cradleBed cradle/foot cradle• Fracture boardFracture board• Foot boardFoot board• Toe pleatToe pleat

Therapeutic Frames allow movement Therapeutic Frames allow movement for immobilized patients & help for immobilized patients & help prevent complications R/T prevent complications R/T immobilityimmobility

RememberRemember

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