BED MAKING

Types of Bed Making

1. Unoccupied Bed
• Open bed – top cover of the bed are folded to make it easier for a client to get in.
(Welcomes the patient)
• Close bed – top cover are drawn up to the top of the bed and under the pillow.
2. Occupied Bed
Unoccupied Bed Making:
Preparatory Phase:
1. Assess the patient’s readiness to be out of bed during the bed making procedure.
2. Introduce yourself and explain to the patient what you are going to do, why it is necessary
or how he or she can participate.
3. Perform handwashing and observe appropriate infection control procedures.
4. Assemble and arrange materials in order of use on the tray and within easy reach (Chair or
overbed table):
• Pillow
• Pillow case
• Bottom sheet
• Rubber draw sheet
• Cotton draw sheet
• Top sheet
5. Adjust the bed in a comfortable working level.
6. Lock the bed wheels.
7. Strip the bed (Use clean gloves if linen and equipment have been soiled with secretions.
• Remove attached equipment / personal belongings from the bed
• Remove cases from pillow
• Loosen top and bottom linen from the mattress. (Head of the bed on the far side
and moving around the bed up to the head of the bed on the near side)
• Remove remaining linen and place in hamper.
• Remove gloves
Performance Phase:
8. Wash hands.
9. Place bottom sheet lengthwise across the center line of the mattress.
10. Miter top corner of the bottom sheet.
11. Tuck remainder of the sheet under the mattress all the way to the foot of the bed.
12. Place the rubber draw sheet on bed using center fold as guide.
13. Place the cotton draw sheet over the rubber draw sheet. Then tuck.
14. Place the top sheet on bed using center fold in the center of the bed and with hem even
with the head of the mattress.
15. Miter corner of the top linen at the foot part of the bed.
16. Move to the other side of the bed, straighten, miter and tuck bottom sheet.
17. Straighten rubber draw sheet and cotton draw sheet. Tuck together.
18. Straighten, miter and tuck top linen at the foot part of the bed.
19. Fanfold top sheet back.
20. Hold pillowcase in a cuff like manner then insert pillow.
21. Placed cover pillow mattress with the opening away from the door.
22. Put back the call light and other items previously removed to original place if necessary.
23. Make sure that the bed conforms to the following:
• Smooth, wrinkle free surface.
• Tight corners
• Low position ( if applicable)
 24. Document linen change
25. Integrate principles of infection control
• Avoid flapping and shaking of linens.
• Hold both soiled and clean linen away from the uniform
• Wash hands before and after bed making or when needed.
26. Integrate principles for body mechanics.
• When bending, bend knees, not stooping
• Face with entire body towards the desired direction

Occupied Bed Making:

Preparatory Phase:
1. Introduce yourself and explain to the patient what you are going to do, why it is necessary
or how he or she can participate.
2. Perform handwashing and observe appropriate infection control procedures.
3. Provide patient’s privacy.
4. Assemble and arrange materials in order of use on the tray and within easy reach (Chair or
overbed table):
• Pillow
• Pillow case
• Bottom sheet
• Rubber draw sheet
• Cotton draw sheet
• Top sheet
5. Adjust the bed in a comfortable working level.
6. Lock the bed wheels.
Performance Phase:
7. Strip the bed (Use clean gloves if linen and equipment have been soiled with secretions.
• Remove attached equipment / personal belongings from the bed
• Remove cases from pillow
• Loosen all top linen over the patient. (Head of the bed on the far side and moving
around the bed up to the head of the bed on the near side)
• Spread bath blanket over the top sheet.
• Ask the client to hold the top edge of the blanket
• 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.
8. Change the bottom sheet and the draw sheets.
• Raise the side rail that the patient will turn toward.
• Assist the client to turn on the side.
• Fanfold the dirty linen towards the center of the bed.
• Place the new bottom sheet on the bed (vertically) fanfold the half to be used on the
far side of the bed as close to the patient as possible. Tuck the sheet under near
half of the bed and miter the corner.
• Place the clean rubber draw sheet on the bed with the center fold at the center of
the bed. Fanfold the uppermost half vertically at the center of the bed.
• Place the clean cotton draw sheet on the bed with the center fold at the center of the
bed. Fanfold the uppermost half vertically at the center of the bed. Tuck the near
side edge under the side of the mattress.
• Assist the client to roll over towards you.
• Move the pillows to the clean side for patient’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.
• Remove the soiled linens and place and place on the portable hamper.
• Unfold the fanfolded bottom sheet from the center of the bed.
• 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.
• Unfold the rubber draw sheet and cotton draw sheet at the center of the bed and pull
it tightly with both hands.
• Tuck the excess sheets under the mattress.
9. Reposition the patient in the center of the bed.
• Reposition the pillow at the center of the bed
• Assist the patient to the center of the bed. Determine what position the patient
requires or prefers to assist the Patient to that position.
10. Complete the top bedding
• Spread the top sheet over the patient either ask the client to hold the top edge or
tuck under the shoulders. The sheet should remain over patient when the bath
blanket is removed.
• Complete the top of the bed.
11. Ensured continue safety of the patient
• Raise te side rails. Place the bed in a low position before leaving the bed side.
• Put items used by the patient within easy reach.

WOUND DRESSING

CLASSIFICATIONS:

1. Aseptic Wounds
• Clean wounds
• Occurred or done in a sterile environment

2. Septic Wounds
• Dirty wounds
• Occurred or done in a non-sterile field or dirty environment

TYPES:

INCISION WOUND: PUNCTURE:

✓ Cause: ✓ Cause:
Sharp Instrument Sharp Instrument
✓ Knife or scalpel ✓ Penetration of the skin
✓ Open wound and often the underlying Unintentional
✓ Example. Operative tissue
wound ✓ Open Wound

Intentional
CONTUSION: LACERATION:
✓ Cause: ✓ Cause:
Blow from a blunt Accidents like
Instrument machinery
✓ Closed wound ✓ Tissue torn apart
✓ Open Wound
 ABRASION: PENETRATING WOUND:
✓ Cause: ✓ Cause:
Surface Scrape Sharp Instrument
✓ Open wound involving skin ✓ Penetration of the skin and often the
underlying tissue usually unintentional
✓ Open Wound
✓ Example: bullet, metal splinter

Unintentional Intentional

PRINCIPLES:
1. The medical aseptic technique is being observed at all times.
2. Universal precaution against blood-borne infection are observed at all times.
3. Aseptic wound dressing is done in circular motion from the center of the wound going
outward.
4. Septic wound dressing is done in circular motion starting from the area around the wound to
the center of the wound.
5. Avoid contact with patient’s body fluids.

PURPOSES:
1. To prevent infection from entering the break in the skin membrane
2. To prevent further tissue damage
3. To provide means for absorbing inflammatory exudates and to promote drainage
4. To Promote Healing
5. To clean wound of foreign debris or dead tissues
6. To prevent hemorrhage
7. To prevent skin excoriation around the draining wounds

MATERIALS NEEDED:
1. Cotton balls with alcohol
2. Cotton balls with antiseptic solution
3. Pick-up forceps in a receptacle
4. Tongue depressor or cotton applicator
5. Gauze dressing
6. Plaster
7. Drape
8. Dressing Forceps
9. Waterproof bag

Preparatory Phase:
1. Observe, assess the old dressing if present for blood and discharges.
2. Assess patient’s condition prior to the procedure ( an assistant maybe necessary for
children, etc.)
3. Prepare equipment needed.
 4. Wash hands.
Performance Phase:
5. Explain the procedure to the patient.
6. Provide patient’s privacy.
7. Assists patient in a comfortable position, in which the wound can readily be exposed.
8. Makes a cuff on a waterproof bag for disposal of soiled dressing, places bag within easy
reach (optional)
9. Remove soiled dressing.
• Moisten plaster using CB with alcohol
• Remove plaster by holding down the skin and pulling the tape gently but firmly
towards the wound
• Remove dressing ( a disposal gloves may be used)
• Place soiled dressing in a waterproof bag without touching the outside portion of the
bag.
• Note the type of discharges present and the appearance of the wound.
• Get CB with antiseptic solution using pick-up forceps properly.
10. Clean the wound using CB with antiseptic solution with dressing forceps
• Aseptic- Clean the wound going outward in circular motion using aseptic wound
dressing forceps
• Septic – clean the area of the wound towards the center of the wound in a circular
motion using septic wound dressing forceps.
11. Apply slight pressure around the wound while dressing to observe for drainage of exudates
unless contraindicated.
12. Dries the area around the wound with operating sponge pad.
13. Apply ointment with applicator if needed.
14. Apply sterile dressing (OS) pad one at a time over the wound.
15. Secure the dressing with plaster correctly.
Post Procedure:
16. Remove the equipment and the bag containing soiled dressing and dispose it properly.
17. Wash hands
18. Observe proper body mechanics all throughout the procedure.
19. Report unusual problems to the nurse in-charge / physician.
20. Record pertinent data correctly on the patient’s chart.

BED BATH

Classifications:
1. Cleaning Bath - Is a bath taken basically for deodorizing the skin by removing accumulated
sebum, perspiration, dead skin cells and bacteria
2. Therapeutic Bath - Is a bath taken for specific physical effect such as to sooth irritated skin
or to treat an area of a body.
- Ordered by physician
TYPES:
1. Complete Bed Bath - Washes the whole body of a dependent patient.
2. Partial or Abbreviated bath - Washes only parts of the patient’s body that causes discomfort
or odor
3. Self-help Bath - A patient confined to bed is able to bathe with some assistance from the
caregiver
4. Tub Bath and Shower Bath - Maybe partial or complete bath
 - Patient is able to take a bath inside the bathroom with the guidance
and assistance of a caregiver
PURPOSES / OBJECTIVES:
1. To clean and deodorize the skin
2. To produce a sense of well being
3. To stimulate circulation to the skin
4. To determine aspects of the patient’s overall physical & mental health such as mobility,
fatigue, strengths, hygiene practices and learning needs.
5. To provide opportunity for the caregiver to assess condition of patient’s skin

MATERIALS NEEDED:
1. Bath Blanket
2. 2 Bath towels
3. 2 wash cloths
4. Soap in a soap dish
5. Basin filled with warm water
6. Hygiene aids
7. Laundry Bag
8. Bed pan / urinals
9. Clean set of bed linens
10. Clean Gloves
11. Clean set of clothing

PERINEAL CARE:
• Also referred as Pericare
• Involves cleaning or washing the genital and anal areas
• Commonly done following bed bath or anything as requested by patient.
• Done by patient him/herself with some assistance from nurse / caregiver.
• If unable to do so, the health care provider do the washing or cleaning.
PURPOSES:
1. To remove normal secretions and odors.
2. To prevent infection.
3. To irrigate the perineum following childbirth or an infection process
MATERIALS NEEDED:
1. Bath Blanket
2. 4 wash cloths / gauze / cotton balls
3. Soap in a soap dish
4. Basin filled with warm water
5. Waterproof pad ( Kelly pad)
6. Bed pan (optional)
7. Disposable gloves
8. Tissue or wipes

Prepared By: Rosalind F. Estrada, RN

MNHS - Teacher III