Body Mechanics and Bedmaking

NCM 103 Fundmentals of Nursing

Prepared by: NCM 103 Instructors

 Learning Objectives
1. Learn the principles of body mechanics and
bedmaking.
2. Identify the nursing responsibilities when
performing body mechanics and bedmaking.
3. Learn the procedure for making the Unoccupied
bed and the Occupied bed.
Bedmaking
 INTRODUCTION
• The bed is one of the most important parts of the patient’s
environment in the healthcare setting. Knowing how to make
various types and modify them for special situations is
paramount importance for us nurses.
• A clean, wrinkle-free bed that remains intact when a patient
moves does a great deal for the patient’s physical and
psychosocial comfort.
Infection control in
Bedmaking
 PRINCIPLES OF BASIC INFECTION CONTROL TO
ALL BEDMAKING PROCEDURE:

1. Microorganisms move through space on air

currents, therefore handle the linens carefully.
• Avoid shaking or tossing linens into the laundry
hampers
 PRINCIPLES OF BASIC INFECTION CONTROL TO
ALL BEDMAKING PROCEDURE:

2. Microorganisms are transferred from one surface

to another whenever one object touches another.
• Hold both soiled or clean linens away from your
uniforms.
• Avoid placing linens on the floor to prevent spread of any
bacteria present either on the linen or the floor.
 PRINCIPLES OF BASIC INFECTION CONTROL TO
ALL BEDMAKING PROCEDURE:

3. Proper handwashing removes many of the

microorganisms that would be transferred by the
hands from one item to another.
Body Mechanics in
Bedmaking
 PRINCIPLES OF BODY MECHANICS TO ALL
BEDMAKING PROCEDURES

1. When you must bend, bend your knees, not your back. It
is to keep the center of gravity directly above and close
to the base of support and to help prevent fatigue.

2. Face your entire Body in the direction that you are

moving. Avoid twisting to prevent back strain or Injury.
 PRINCIPLES OF BODY MECHANICS TO ALL
BEDMAKING PROCEDURES

3. Smooth, Rhythmical movements at

moderate speed requires less energy.
4. Raise the bed to an appropriate height for
maximum working comfort for yourself.
ACCESSORIES FOR THE BED
BEDBOARDS
➢Used directly under a
mattress when the patient
needs an especially firm bed.

➢Often used for Orthopedics

patients or patients have
history of back pain.
 FOOTBOARDS
➢Placed on the bed to keep the
feet at right angles to the legs
when patient is in Supine position
to prevent prolonged plantar
flexion.
➢The feet are positioned to rest
firmly against the footboard.
➢Used to prevent footdrop.
• Footdrop is an abnormal shortening
of the achilles tendon from a
prolonged period of plantar flexion.
SPECIAL MATTRESSES
➢It is manufactured to diminish
pressure on patient’s skin and
help prevent the formation of
Pressure ulcers (decubitus
ulcers).

➢When making a bed using special

mattresses, do not tuck the linen
tightly under the mattress.
• Do not tuck to allow the mattress to
expand and defeats the purpose of
the special mattress.
CRADLES
• Designed specifically to keep
linen up off the feet and lower
legs of patient when necessary,
as in cases of Edema, Leg ulcers
and burns.
• Place the device on the bed over
the patient’s legs and feet.
• Linen must be simply be tucked
as securely as possible around
the frame.
Procedures for changing
UNOCCUPPIED BED
 ASSESSMENT
1. Assess the client’s health
status to determine that the
person safely can get out of
bed.
2. Assess the client’s pulse and
respirations, if indicated.
 ASSESSMENT
3. Check the condition of the
Linen on the bed.
4. Note all the tubes and
equipment’s connected to
the client.
 PLANNING
1. Handwashing is done for Infection
Control.
2. Gather the linen to be used and place it
in order.
a) Two flat sheets, or one fitted and
one flat sheet
b) One cloth drawsheet
 PLANNING
c) One blanket
d) One spreadsheet
e) Pillowcase(s) for the head
pillow(s)
f) Plastic laundry bag or portable
hamper, if available
 PLANNING
3. Obtain any other needed items or equipment.
You will need clean gloves if you will be handling
soiled linens with body secretions.
 IMPLEMENTATION
1. Introduce yourself and verify the client’s
identity. Explain to the client what you
are going to do, why it is necessary, and
how the client can cooperate.
2. Perform hand hygiene and observe
other appropriate infection control
procedures.
 IMPLEMENTATION
3. Provide for client privacy.
4. Place the fresh linen on the
client’s chair or over the bed; do
not use another client’s bed.
 IMPLEMENTATION
5. Assess and assist the client out of bed.
▪Make sure that this is an appropriate and
convenient time for the client to be out of
bed.
▪Assist the client to a comfortable
position.
 IMPLEMENTATION
6.Raise the bed to a comfortable working
height.
7. Strip the bed.
▪Check bed linens for any items belonging
to the client, and detach the call bell or
any drainage tubes from the bed linen.
 IMPLEMENTATION
▪Loosen all bedding
systematically, starting at
the head of the bed on the
far side and moving around
the bed up to the head of the
bed on the near side.
 IMPLEMENTATION
▪Remove the pillowcase, if soiled,
and place the pillows on the
bedside chair near the foot of the
bed.
▪Fold reusable linens such as the
bedspread and topsheet on the
bed, into fourths.
 IMPLEMENTATION
▪Remove the waterproof pad and
discard it, if soiled.
▪Roll all soiled linen inside the
bottom sheet, hold it away from
your uniform, and place it directly
in the linen hamper, not on the
floor.
 IMPLEMENTATION
▪Grasp the mattress securely, using the lugs,
if present, and move the mattress up to the
head of the bed.
8. Apply the bottom sheet and draw sheet.
▪Place the folded bottom sheet with its center
fold on the center of the be.
 IMPLEMENTATION
▪Miter the sheet at the top corner on the near side and tuck
the sheet under the mattress, working from the head of the
bed to the foot.
▪If a waterproof drawsheet is used, placed it over the bottom
sheet so that the center fold is at the center line of the bed
and the top and bottom edges extend from the middle of the
client’s back to the area of the mid-thigh or knee.
 IMPLEMENTATION
▪Lay the cloth drawsheet over the waterproof
sheet in the same manner.
▪Optional: before moving to the other side of
the bed, place the top linens on the bed hem-
side up, unfold them, tuck them in and miter
the bottom corners.
 IMPLEMENTATION
9. Move to the other side and
secure the bottom linens.
▪Tuck in the bottom sheet under
the head of the mattress, pull
the sheet firmly, and miter the
corner of the sheet.
 IMPLEMENTATION
▪Pull the remainder of the
sheet firmly so that there
are no wrinkles.
▪Complete the same process
for the drawsheet(s).
 IMPLEMENTATION
10. Apply or complete the top sheet, blanket
and spread.
▪Place the top sheet, hem-side up on the bed
so that its center fold is at the center of the
bed and the top edge is even with the top
edge of the mattress.
 IMPLEMENTATION
▪Unfold the sheet over the bed.
▪Optional: make a vertical or horizontal
toe pleat in the sheet to provide
additional room for the client’s feet.
 IMPLEMENTATION
Vertical toe pleat:
➢Make a fold in the sheet 5-10 cm
(2-4 inches) perpendicular to the foot of the bed.
Horizontal toe pleat:
➢Make a fold in the sheet 5-10 cm
(2-4 inches) across the bed near the foot.
 IMPLEMENTATION
▪Follow the same procedure for the blanket
and the spread, but place the edges about
15cm (6 inches) from the head of the bed to
allow a cuff of sheet, blanker, and spread
hanging freely, unless toes pleats were
provided.
 IMPLEMENTATION
▪Fold the top of the top sheet down over
the spread, providing a cuff.
▪Move to the other side of the bed, and
secure the top bedding in the same
manner.
 IMPLEMENTATION
11. Put clean pillowcases on the pillows as
required.
▪Grasp the closed end of the pillowcase at the
center with one hand.
▪Gather up the sides of the pillowcase, and
place them over the hand grasping the case.
 IMPLEMENTATION
▪With the free hand, pull the pillowcase over the
pillow.
▪Adjust the pillowcase so that the pillow fits into the
corners of the case and the seams are straight.
▪Place the pillows approximately at the head of the
bed.
 IMPLEMENTATION
12. Provide for client comfort and
safety.
▪Attach the signal cord so that the
client can use it conveniently.
▪If the bed currently is being used by
the client, either fold back the top
covers at one side or fanfold them
down to the center of the bed.
 IMPLEMENTATION
▪Place the bedside table and the overbed
table so that they are available to the
client.
▪Leave the bed in the high position if the
client is returning by stretcher, or place
in the low position if the client is
returning to bed after being up.
13. Document and report any pertinent
data.
 IMPLEMENTATION
▪Variation: Surgical bed
Procedure
•Strip the bed
•Place and leave the pillows on the
bedside chair
 IMPLEMENTATION
•Apply the bottom lines as for an unoccupied
bed. Place a bath blanket on the foundation of
the bed, if this is agency practice.
•Place the top covers on the bed as you would
for an unoccupied bed. Do not tuck them in,
miter the corners, or make the toe pleat.
 IMPLEMENTATION
▪Make a cuff at the top of the bed as you would for
an unoccupied bed. Fold the top linens up from
the bottom.
▪On the side of the bed where the client will be
transferred, fold up the two outer corners of the
top linens so they meet in the middle of the bed,
forming a triangle.
 IMPLEMENTATION
▪Pick up the apex of the triangle, and fanfold the
top linens lengthwise to the other side of the bed.
▪Leave the bed in high position with the side rails
down.
▪Lock the wheels of the bed if the bed is not to be
moved.
Procedures for changing
OCCUPIED BED
 ASSESSMENT
1. Assess:
▪Note specific orders or precautions for
moving and positioning the client.
▪Presence of incontinence or excessive
drainage form the other sources
indicating the need for protective
waterproof pad.
 ASSESSMENT
▪Skin condition and need for special
mattress, footboard, or heel
protectors.
 ASSESSMENT
2. Assemble equipments:
a)Two flat sheets, or one fitted one flat
sheet
b)Cloth drawsheet
c) One blanket
 ASSESSMENT
d) One bedspread
e) Waterproof drawsheet or waterproof pads
(optional)
f) Pillowcase(s) for the head pillow
g) Plastic laundry bag or portable linen
hamper
 IMPLEMENTATION
1. Introduce yourself and verify the
client’s identity.
2. Perform hand hygiene, and observe
other appropriate infection control
procedures. Put on Disposable gloves.
If linen is soiled with bodily fluids.
 IMPLEMENTATION
3. Provide for client privacy.
4. Remove the top bedding.
▪Remove any equipment attached to the
bed linen, such as a signal light.
▪Loosen all the top linen at the foot of the
bed and remove the spread and the
blanket.
 IMPLEMENTATION
▪Leave the sheet over the client, or
replace it with a bath blanket as
follows:
➢Spread the bath blanket over the
top sheet.
➢Ask the client to hold the top
edge of the blanket.
 IMPLEMENTATION
➢Reaching under the blanket from the
side, grasp the top edge of the sheet,
and draw it down to the foot of the
bed, leaving the blanket in place.
➢Remove the sheet from the bed, and
place it in the soiled linen hamper.
 IMPLEMENTATION
5. Change the bottom sheet and drawsheet.
▪Assist the client to turn on the side facing
away from the side where the clean linen
is.
▪Raise the side rail nearest the client. If
there is no side rail, have another nurse
support the client at the edge of the bed.
 IMPLEMENTATION
▪Loosen the foundation of the linen on
the side of the bed near the linen
supply.
▪Fanfold the drawsheet and the bottom
sheet at the center of the bed, as
close to the client as possible.
 IMPLEMENTATION
▪Place the new bottom sheet on the bed
and vertically fanfold the half of to be
used on the far side of the bed as
close to the client as possible. Tuck
the sheet under the near half of the
bed, and miter the corner if a contour
sheet is not being used.
 IMPLEMENTATION
▪Place the clean drawsheet on the
bed with the centerfold at the
center of the bed. Fanfold the
uppermost half vertically at the
center of the bed and tuck the
near side edge under the side of
the mattress.
 IMPLEMENTATION
▪Assist the client roll over
toward you onto the clean
side of the bed. Have the
client roll over the fanfold
linen at the center of the
bed.
 IMPLEMENTATION
▪Move the pillows to the clean
side for the client’s use. Raise
the side rail before leaving the
side of the bed.
▪Move to the other side of the
bed and lower the side rail.
 IMPLEMENTATION
▪Remove the use linen and
place it in the portable
hamper.
▪Unfold the fanfold bottom
sheet from the center of the
bed.
 IMPLEMENTATION
▪Facing the side of the bed,
use both hands to pull the
bottom sheet so that it is
smooth and tuck the excess
under the side of the
mattress.
 IMPLEMENTATION
▪Unfold the drawsheet fanfold at the center of the bed,
and pull it tightly with both hands. Pull the sheet in
three sections:
➢Face the side of the bed to pull the middle
section
➢Face the far top corner to pull the bottom
section.
 IMPLEMENTATION
➢Face the far bottom corner to pull
the top section.
▪Tuck the excess drawsheet under
the side of the mattress.
 IMPLEMENTATION
6. Reposition the client in the center of the bed.
▪Reposition the pillows at the center of the
bed.
▪Assist the client at the center of the bed.
Determine what position the client requires
or prefers and assist the client to the
position.
 IMPLEMENTATION
7. Apply or complete the top bedding.
▪Spread the top sheet over the client and
either ask the client to hold the top edge of
the sheet or tuck it under the shoulders. The
sheet should remain over the client when the
bath blanket or used sheet is removed.
▪Complete the top of the bed.
 IMPLEMENTATION
8. Ensure the continued safety of the
client.
▪Raise the side rails. Place the bed in the
low position before leaving the bedside.
▪Attach the signal cord to the bed linen
within the client’s reach.
 IMPLEMENTATION
▪Put the items used by the client with
easy reach.
9. Bed making is normally recorded.
Thank You!