How to put a bed pad under a patient?

According to a study on elderly care, managing incontinence effectively is a critical aspect of patient dignity and hygiene. Learning how to put a bed pad under a patient correctly is a fundamental skill that every caregiver needs to master to ensure both patient comfort and safety.

Quick Summary

Placing a bed pad under a patient involves gently rolling the patient to one side, tucking the pad underneath them, and then rolling them back over to flatten the pad completely. This method ensures hygiene and comfort while preventing caregiver back strain. Proper communication and preparation are key to a smooth and respectful process.

Key Points

• Roll Patient Safely: Use the 'log roll' method to gently turn the patient onto their side, minimizing friction and discomfort.

• Prepare Your Supplies: Gather gloves, a clean pad, wipes, and other essentials beforehand to make the process quick and seamless.

• Prioritize Hygiene and Skin Care: Always clean the patient's skin and apply a barrier cream if necessary to prevent irritation and infection.

• Use Proper Body Mechanics: Raise the bed to a comfortable height and lift with your legs, not your back, to avoid injury.

• Consider a Draw Sheet: For heavier or less mobile patients, a draw sheet can significantly aid in repositioning and protect the patient's skin from shearing.

• Ensure Patient Comfort: After the pad is in place, check for wrinkles and adjust pillows to ensure the patient is comfortable and properly positioned.

Essential Preparations for Changing a Bed Pad

Before you begin the process of learning how to put a bed pad under a patient, proper preparation is essential. Gathering your supplies beforehand not only streamlines the task but also minimizes disruptions for the patient. A well-organized approach demonstrates respect and competence.

Gather Your Supplies

• Bed Pads: Have a clean, fresh pad ready. Choose between disposable underpads (chucks) or reusable, washable options based on your needs.
• Gloves: Wear a fresh pair of non-sterile gloves to maintain hygiene for both yourself and the patient.
• Cleaning Supplies: Gather pre-moistened wipes or a basin with warm water and a mild soap to clean the patient's skin.
• Disposal Bag: A separate bag for soiled linens or disposable pads is crucial for infection control.
• Barrier Cream: Applying a barrier cream can help protect the skin from moisture and prevent irritation.
• Pillows or Wedges: These can be used to provide support for the patient while they are on their side.

Preparing the Environment and Patient

• Adjust Bed Height: Raise the bed to a comfortable working height for yourself to prevent back strain.
• Flatten Bed: Lower the head of the bed to a flat position if the patient can tolerate it. This makes rolling easier and safer.
• Ensure Privacy: Pull the curtains or close the door to provide privacy for the patient. Explain each step clearly and calmly to reduce any anxiety.
• Wash Hands: Always wash your hands thoroughly before putting on gloves.

The Step-by-Step Guide for Changing a Bed Pad

The most common and safest technique for how to put a bed pad under a patient involves the 'log roll' method. This minimizes friction and shear forces on the skin, which helps prevent pressure ulcers.

Step 1: Position the Patient

1. Bend Limbs: With the patient lying on their back, bend the knee of the leg that is closest to you. Place the patient's opposite arm across their chest.
2. Roll Patient: Place one hand on the patient's shoulder and the other on their hip. Gently and steadily roll them towards you onto their side, away from the soiled pad.
3. Use Support: If necessary, place pillows or a wedge behind the patient's back to keep them stable and prevent them from rolling back.

Step 2: Prepare and Position the New Pad

1. Manage Soiled Pad: Roll the soiled pad tightly towards the patient's back, tucking it as far under them as possible. Contain any waste carefully within the folds.
2. Clean Patient: Gently clean the patient's skin with wipes or a washcloth, ensuring the area is completely dry before proceeding. Apply barrier cream if needed.
3. Place New Pad: Take the clean pad and fold or roll it lengthwise. Tuck the folded portion under the clean side of the patient, ensuring it reaches their back. Spread the rest of the new pad out smoothly on the exposed side of the bed.

Step 3: Complete the Roll and Finalize Placement

1. Raise Side Rail: If the bed has rails, raise the rail on the side where you just placed the new pad.
2. Move to Other Side: Go to the opposite side of the bed and lower the side rail. Roll the patient gently over the tucked-in portion of the new pad and onto their back.
3. Remove Soiled Pad: With the patient now centered on the bed, you can easily pull the soiled pad out from underneath them.
4. Finish: Unroll and smooth out the new pad completely. Adjust the pillows and covers to make sure the patient is comfortable and the pad is wrinkle-free. Wrinkles can cause skin irritation.

Comparison of Bed Pad Types

Feature	Disposable Underpads (Chucks)	Reusable Bed Pads	Draw Sheets (Transfer Sheets)
Cost	Lower initial cost, higher long-term cost	Higher initial cost, lower long-term cost	Moderate cost, highly durable
Absorbency	Good, single-use absorption	Excellent, multi-layer design	Minimal absorbency, primary function is repositioning
Hygiene	Highly hygienic, disposed of after use	Washable, must be laundered frequently	Washable, less focused on fluid absorption
Convenience	Easy cleanup, no laundry required	Requires regular laundering	Excellent for repositioning, requires separate absorbent pad
Durability	Single-use	Long-lasting, multiple washes	Very durable, reinforced handles
Purpose	Fluid absorption, mattress protection	Fluid absorption, mattress protection, comfort	Patient mobility, transferring, repositioning

Safety Precautions and Best Practices

• Use Proper Body Mechanics: Always lift with your legs, not your back, and avoid twisting your body. Get help if the patient is too heavy or uncooperative.
• Communicate with the Patient: Explain what you are doing throughout the process. This builds trust and cooperation.
• Monitor Skin Health: After changing the pad, take a moment to check the patient's skin for any redness or signs of irritation, especially around bony prominences. Address any concerns promptly to prevent bedsores.
• Maintain Dignity: Treat the patient with respect and preserve their dignity by ensuring they are covered as much as possible and speaking in a kind, reassuring tone.
• Consider Assisted Devices: For heavier or more immobile patients, using a draw sheet with handles can make repositioning and pad changes much easier and safer for both parties.

Advanced Techniques for Difficult Situations

For patients with limited mobility, advanced techniques may be necessary to minimize discomfort and ensure safety. A draw sheet can be an invaluable tool in this situation, acting as a lift to reduce dragging and friction on the skin.

Using a Draw Sheet with a Bed Pad

1. Place Draw Sheet First: After cleaning the patient's skin, place a folded draw sheet across the bed, covering the area from the patient's shoulders to their hips.
2. Position Bed Pad: Place the absorbent bed pad on top of the draw sheet, ensuring it is centered properly.
3. Log Roll with Two People: For a two-person change, one person stands on each side of the bed. Roll the patient onto their side, away from the soiled area, with one caregiver on each side. The caregivers use the draw sheet to assist in the movement.
4. Centralize Patient: With the soiled pad removed, both caregivers use the draw sheet to lift and shift the patient back to the center of the bed, ensuring they are positioned smoothly on the new pad.

Conclusion

Mastering how to put a bed pad under a patient is a vital skill that enhances patient comfort, promotes hygiene, and reduces the risk of skin complications like bedsores. By following a clear, step-by-step process, preparing all necessary supplies in advance, and prioritizing patient safety and dignity, caregivers can perform this task efficiently and with confidence. Whether using disposable or reusable pads, the core technique of gentle rolling and proper positioning remains the same. Consistent, careful practice ensures a smoother experience for everyone involved in senior care. For more information on patient care best practices, visit reputable health resources like the MedlinePlus website.

Frequently Asked Questions

What is the safest way to turn a patient to change a bed pad?

The safest method is the 'log roll' technique. Roll the patient gently onto their side as if they were a single unit, avoiding twisting their spine. Using a draw sheet can make this process even smoother and safer.

How often should a bed pad be changed?

The frequency depends on the level of incontinence. Disposable pads should be changed immediately after being soiled. For reusable pads, check regularly and change as soon as they are wet to prevent skin irritation and infection.

Can I change a bed pad by myself, or do I need help?

For most patients, one person can manage the change using the proper rolling technique. However, if the patient is heavy or has very limited mobility, having a second person assist is highly recommended for safety and to prevent back strain.

What type of bed pad is best for an elderly patient?

The best type depends on the patient's needs. Disposable underpads (chucks) are convenient for single use, while reusable, washable bed pads are more cost-effective long-term and often have higher absorbency and more comfortable materials.

How can bed pads help prevent bedsores?

Bed pads prevent bedsores by keeping the patient's skin dry and wicking away moisture, which is a major contributing factor to skin breakdown. Using a breathable pad and ensuring there are no wrinkles or creases under the patient also reduces pressure and friction.

What should I do if the patient becomes agitated during the change?

If a patient becomes agitated, stop and reassure them calmly. Explain the process again in simple terms. If they remain distressed, take a break and try again later, or have another caregiver assist if possible. Prioritizing their comfort and emotional state is key.

How do I ensure the new pad is positioned correctly under the patient?

To ensure correct placement, roll the new pad lengthwise and tuck the folded side under the patient's back as far as possible. After rolling the patient back, unfold and flatten the pad. Check that it is wrinkle-free and centered to provide maximum protection and comfort.