BEDS AND BED MAKING

INTRODUCTION:
As comfort, safety, rest and sleep are all important in maintaining health and promoting
recovery from disease , special care should be taken to provide comfortable beds to patients
during their stay in hospital. Making a comfortable bed is the responsibility of the nurse. She
should provide clean, dry wrinkle free and comfortable beds to their patients.

PURPOSE:
 To provide clean and comfortable bed for the patient.
 To give a neat and tidy appearance to the unit.
 To keep bed ready for any emergency.
 To receive the patient comfortably.
 To provide active and passive exercise to the patient.
 To establish inter personal relationship(IPR)
 To economize time material and energy.
 To teach relatives how to take care of patient at home.
 To prevent bed sores.

GENERAL RULES TO BE OBSERVED IN BED MAKING:

 Have all equipments on hand and arrange conveniently to handle in the order of use.
 Wash hands before and after procedure.
 Do not expose the patient unnecessarily.
 Protect the patient from draught.
 Do not cover the patients face while placing the linens.
 Do not mix clean linen with soiled linen.
 Never place woolen blanket directly on patients body , and never allow the mackintosh
to touch the patient.
 Fold dirty linen away from your uniform and body.
 Avoid placing dirty linen on the floor.
 Start work from head to foot , near to far and from clean to unclean area.
 Make bed smooth, unwrinkled and firm.
 Avoid using torn linen.
 Periodically sunning and airing of the mattress to be done.
 Maintain body mechanics.
 Keep reasonable distance from the face of the patient to prevent cross infection.

TYPES OF BED:
 Open bed
  Closed bed
 Occupied bed
 Admission bed
 Post operative bed
 Cardiac bed
 Amputation bed/ divided bed
 Fracture bed
 Therapeutic bed: renal bed, rheumatism bed, blanket bed.

PROCEDURE FOR MAKING OPEN BED:

PREPARATION OF PATIENT AND THE UNIT:
 Explain the procedure to the patient.
 Screen the patient to provide privacy.
 Remove comfort devices if any.

PREPARATION OF ARTICLES:
S.NO. ARTICLES REQUIRED RATIONALE
1 Damp duster and dry duster to clean To prevent spread of infection
the metal bed
2 Kidney tray To receive waste
3 Mattress with cover To protect the mattress
4 Bed sheet -2 To use as bottom sheet and top sheet
5 Draw sheet-1 To protect bed linen and cover the
mackintosh
6 Mackintosh -1 To protect bed linen
7 Pillow cover -1 To protect the pillow
8 Pillow To provide comfort
9 Counter pane To protect top linen
10 Blankets if required To provide warmth
11 Stool/ chair To keep articles
12 Dirty linen trolley To discard soiled linen

1) OPEN BED :
It is a bed made when it is about to be occupied by either a new patient or an
ambulatory patient.

STRIPPING AND MAKING AN OPEN BED:

S.NO. STEPS OF PROCEDURE RATIONALE SCIENTIFIC NURSING
PRINCIPLES PRINCIPLES
1 Wash hands To prevent cross microbiology Safety
infections
2 Loosen the top linen Allows easy removal of Body Economy of
starting from head end linen and prevents mechanics time and
and proceed to foot end tearing of sheet energy
3 Remove the sheets one Prevents the sheet If shaken safety
by one, after making from touching the vigorously,
four folds. If reused floor microorganism
arrange them back on will spread
the back of the chair through dust.
after shaking them microbiology
gently.
4 Roll the mackintosh and To avoid creases Rolling Economy of
place it over the chair. prevents early material
damage of
rubber articles
and prolongs
durability
5 Remove the bottom Prevents sheet from Reduce spread Safety
sheet, folding it into touching the floor of
four or six. microorganisms
6 Remove mattress cover Damp dusting prevents Reduce spread Safety
if soiled and dust the the spread of dust of
mattress and cot with a microorganisms
damp duster. While
cleaning start from
cleaner area to less
cleaner area and replace
the cover of the
mattress.
7 Place the folded bottom To cover the mattress Saves time and Economy of
sheet on the head and and to spread evenly energy time and
corner of the mattress on all sides energy
on your side and spread
it straight.
8 Tuck 12- 18 inches Anchors bottom sheet Body Good
under the mattress on so that the sheet will mechanics and workmanship,
head end. When tucking not come off easily. prevents body
the linen, keep the feet fatigue. mechanics
slightly apart and flex
knees while bending.
9 Make mitered corners Not loosened easily. Neat and tidy Comfort.
while tucking. keeps bed neat and appearance
tidy. gives
psychological
appeal to the
patient.
10 Tuck at foot end and Prevents slipping of A firm , wrinkle Safety
secure the mitered the sheet and keeps free bed
corner on your side. bed firm. prevents bed
sores.
11 Spread the mackintosh To protect mattress Wet surfaces safety
at the center of the bed and keep it dry enhances the
and tuck from your side growth of
micro
organism.
12 Place draw sheet over Prevents chilling and It avoids Safety
the mackintosh about direct contact of the friction
3.5 inches above and rubber sheet with the
tuck it along the right patient.
side.
13 Go to other side and To maintain good body Prevents Good
tuck in each of the mechanics and fatigue and workmanship
bottom linens as done posture. exhaustion and safety
before
14 Come back to previous Top liner covers the Exposure can Safety
side and spread the top patient so as to lead to chills.
sheet over the bottom provide privacy
linen in the same
manner as with bottom Toe pleat allows free Prevents comfort
sheet. make toe pleat at movement of patient’s friction against
the foot end of the bed feet. surface of toes.
if required
15 If a blanket is used , Provide warmth to the Direct contact Comfort,
spread it over the top patient. of skin to the safety.
sheet. blanket fibers
can cause skin
irritation.
16 Spread the counter pan Counter pan gives a The layers of air Comfort.
over the blanket placing neat appearance and trapped
its center at the center provides extra between the
of the bed such that it warmth. blanket and
covers the blanket. Tuck sheets, help in
top edges of the counter preservation of
 pan over and under the heat.
top edges of the
blanket.
17 Tuck at the foot end Keeps linen fixed on Provides a Comfort and
altogether and make bed , provides warmth, sense of well good
mitered corners on the security, And neatness. being to the workmanship
sides. patient and
helps in
recovery.
18 Place the pillow with Maintains neat Provides a comfort
cover, keeping the open appearance. sense of well
end away from being
entrance.

TERMINATION OF PROCEDURE :
AFTER CARE OF PATIENT , UNIT AND ARTICLES:
 Help patient to get into the bed, as required.
 Comfort devices to be provided if needed.
 Remove equipments and soiled linen.
 Leave the whole unit clean and tidy.
 Wash duster and kidney tray and replace them.
 Wash hands thoroughly.

2) CLOSED BED:
It is an unoccupied or empty bed made to receive the patient and is fully covered
with counter pane to protect it from dust and dirt.
On admission of the patient, the closed bed is converted into an open bed.

PURPOSE:
 To keep bed ready for occupancy.
 To provide neat and tidy appearance to the unit.

3) OCCUPIED BED:
This bed is made with the patient in it.

PURPOSES:
 To make a bed with least possible discomfort to the patient.
  To handle bed clothes skillfully while the patient is on bed, giving least
disturbance to the occupant
 To provide a neat, clean and tidy appearance.

ARTICLES REQUIRED ARE THE SAME AS FOR OPEN BED:

PROCEDURE:
S.NO STEPS RATIONALE SCIENTIFIC NURSING
. PRINCILES PRINCIPLES
1 Explain the procedure to For cooperation psychology Comfort
the patient
2 Wash hands To prevent spread of microbiology safety
microorganisms.
3 Untuck sheet from all
sides and roll it on the
right side of the patient
4 Turn covered patient to To prevent fall safety
his left side and support
with pillow.
5 Damp dust the right side Damp dusting prevents Reduce spread Safety
the spread of dust of
microorganisms
6 Roll bottom sheet, length Saves time and energy
wise and place it on the
right side.
7 Roll mackintosh and then To avoid creases Rolling Economy of
draw sheet on the right prevents early material
side. damage of
rubber articles
and prolongs
durability
8 Gently turn the patient Safety and comfort of Comfort ,
to the right side and the patient safety
support with pillow.
9 Remove the soiled linen Damp dusting prevents Reduce spread Safety
and damp dust the left the spread of dust of
side. microorganisms
10 Pull the bottom sheet
carefully, draw
mackintosh and draw
sheet carefully.
11 Make patient lie in
supine position
12 Tuck the sheets on Prevents slipping of the A firm , wrinkle Safety
respective sides and sheet and keeps bed free bed
make the mitered firm. prevents bed
corners. sores.
13 Place a clean top sheet Top liner covers the Exposure can Safety
over the patient and patient so as to provide lead to chills.
remove the soiled one. privacy
Take care not to expose
the patient and also not
to cover his face with top
sheet.
14 Put the pillows back with Maintains neat Provides a comfort
clean covers and leave appearance. sense of well
the patient comfortable. being
Leave the unit tidy, neat
and clean

4) ADMISSION BED:
This is the bed which is prepared to receive a newly admitted patient.

STEPS OF ADMISSION BED:

A long mackintosh and bath blanket are put over the open bed, until such time a
thorough bath is given on the bed at the time of admission. After the bath the
mackintosh and bath blankets are removed.

PURPOSE:
 To welcome the patient
 To provide immediate care , safety and comfort.
 To protect the bed linen while giving bath on admission.

EXTRA ARTICLES RATIONALE

A long mackintosh and a bath blanket.  To protect the foundation bed linen
Articles for bed bath while giving bath

Hot water bottles  To keep the bed warm.

5) POST OPERATIVE BED/ POST ANESTHETIC BED/ RECOVERY BED /

OPERATION BED :
 it is a bed prepared for a patient who is recovering from the effects of anesthesia
following surgery.

PURPOSE:
 To receive the patient conveniently.
 To provide warmth and comfort.
 To prevent shock.
 To prevent injury
 To prevent soiling of bed
 To meet any emergency.

PREPARATION OF ARTICLES : same as in open bed.

ADDITIONAL ARTICLES REQUIRED RATIONALE

Small mackintosh and towel To protect head end of the bed

Temp tray, B.P apparatus To record vital signs
IV stand, IV tray To administer IV fluids or restart , if blocked
Hot water bottles – 2-3 To keep the bed warm
Oxygen cylinder with tubing and catheter To meet any emergency
Suction apparatus To remove secretions
Bed block To raise foot end
A tray containing :
Gauze pieces To clean mouth off the secretions
Artery forceps To prevent falling back of the tongue
Tongue depressor To keep the air passage clear.
Airway
Kidney tray and paper bag. To discard the waste.

PROCEDURE:
 Foundation of the bed is same as that of open bed
 An extra mackintosh and towel are placed at the head end
 The foot end of the top linen is left untucked and folded back.
 Fanfold the top linen lengthwise covering 2/3rd of the bed on the right side.
 Place the hot water bottles under the top linen
 Place the pillow upright of the head end to protect the patient from injury by hitting
against the bars.

6) CARDIAC BED :
 A bed prepared for patients with cardiac diseases.it is used to help client to assume
a sitting position which can afford him greatest amount of comfort with least strain.

PURPOSES:
 To prepare the bed for the cardiac patients.
 To relieve dyspnea.

PREPARATION OF ARTICLES : same as in open bed.

ADDITIONAL ARTICLES REQUIRED RATIONALE
Back rest/ fowler’s bed To support the patient while sitting
Cardiac table To provide support and comfort
Extra pillows To provide support and comfort
Air cushion To relieve pressure from sacral area
Knee pillow To provide support and comfort
Foot rest To prevent slipping down

PROCEDURE:
 Make bed as in open bed
 Place the backrest and arrange pillows
 Place the air cushion and knee pillow
 Adjust the cardiac table and keep the pillow as needed for the patient to lean on it.
Support the feet on foot rest.
 Make the patient comfortable.

7) AMPUTATION / DIVIDED / CRADLE BED:

It is a bed in which top linen is divided into 2 parts to visualize the amputated part of the lower
limbs without disturbing the patient .

PURPOSES:
 To watch the stump for hemorrhage and apply tourniquet instantly.
 To make the weight of the bed clothes off the patient.
 To keep stump in position.

PREPARATION OF ARTICLES:
ADDITIONAL ARTICLES REQUIRED RATIONALE
 Extra set of top linen  To make a divided bed
 Bed cradle  To take weight of top clothes off the
patient
  Sand bag- 2
 Tourniquet and dressing tray
 Pillow with water proof cover
 Hot water bottles-2
 To keep stump in position
 To control hemorrhage in case of
emergency
 To elevate the stump and protect the
pillow
 To keep bed warm.

PROCEDURE:
 The foundation and head end is same as that of open bed
 The foot end side of top linen is folded back towards the head end at the level of the
part / stump to be observed.
 Spread the second set of top linen starting from the level of the stump .
 Receive the patient and elevate the stump on a small pillow and place the sandbags on
either side to support the stump.
 Place the bed cradle in position .
 Cover the patient.

8) FRACTURE BED:
It is a bed which is prepared for patients with fracture , bone disease and deformity.

PURPOSE:
 To prevent undue sagging of the mattress
 To immobilize the fractured part
 To restrict sudden jerky movements
 To keep the traction in position

PREPARATION OF ARTICLES:
ADDITIONAL ARTICLES REQUIRED RATIONALE
Fracture board To provide firm support to the patient

PROCEDURE:
Arrange the fracture board on the cot. The bed is made as in open bed.

9) THERAPEUTIC BEDS
RENAL / RHEUMATISM/ BLANKET BED:
 It is a bed made for patients suffering from rheumatism or renal diseases.

PURPOSES:
 To carry the weight of bed clothes off the painful joints.
 To keep patient warm.
 To induce sweating.

PREPARATION OF ARTICLES: same as in open bed

ADDITIONAL ARTICLES REQUIRED RATIONALE
Narrow mackintosh and draw sheet  To protect bed linen
Woolen blanket or bath blanket  To keep under and over the patient
and to induce sweating
Bed cradle  To take the weight of the bed linen off
the patient.
Sand bags  To immobilize painful joints
Hot water bottles  To provide warmth .
In a renal bed the cradle and sand bags are not required.

PROCEDURE:
 Bed is made as in open bed.
 Place a narrow mackintosh and a draw sheet under the patient’s buttocks.
 Place the extra blankets one over and one under the patient .
 Place bed cradle and sand bags, if required

SUMMARY :
Providing a comfortable and wrinkle free bed is entirely the responsibility of a nurse. The nurse
should be able to make different kinds of beds as per the needs of the patient , keeping in mind
the principles of body mechanics and nursing principles
REFERENCES :

 Sr. Nancy. Stephanie’s principles and practice of nursing : nursing arts

procedure. Vol 1. 7th edition. New delhi: N. R publishing house ; 2016. Pg 96-
99
 The Trained Nurses Association of India . Fundamentals of Nursing :1st
edition .New delhi ;2010 . pg 150-155
 Kozier, Brabara B, Gas D, Witter B. Fundamentals of patient care : A
comprehensive approach to nursing . 3rd edition . WB saunders company; pg
800-805