When making an occupied of bed ridden patient, the nurse should prioritize safety, privacy, and comfort

According to healthcare guidelines, maintaining a clean and comfortable environment is crucial for bedridden patients, impacting both physical health and psychological well-being. Knowing the correct procedure for When making an occupied of bed ridden patient, the nurse should follow specific steps to ensure safety, privacy, and hygiene.

Quick Summary

The process for making an occupied bed focuses on systematic, one-sided movement to minimize patient disruption while maintaining a high standard of hygiene. Key steps include gathering supplies, ensuring privacy, rolling the patient safely, and smoothing linens meticulously to prevent friction and promote comfort.

Key Points

• Prioritize Safety: The nurse should always begin by raising the bed to a working height, ensuring the opposite side rail is up, and lowering the bed's head to a safe level.

• Communicate Constantly: Explaining each step to the patient and ensuring their privacy is maintained throughout the process is critical for building trust and reducing anxiety.

• Work One Side at a Time: The correct technique involves rolling the patient to one side to change half the linens before repeating the process on the other side, minimizing disturbance and effort.

• Keep Linens Smooth and Wrinkle-Free: After rolling the clean sheet, the nurse must pull it taut and smooth out all wrinkles to prevent friction, which is a leading cause of bedsores.

• Utilize Proper Body Mechanics: Nurses should use draw sheets to assist in repositioning the patient, lifting rather than dragging them to protect both the patient's skin and the caregiver's back.

• Finish with Patient Comfort in Mind: Once complete, the bed should be lowered to its safest position, with the call light and personal items placed within easy reach.

Preparation for Making an Occupied Bed

Proper preparation is the first and most critical step in ensuring the procedure is efficient and comfortable for the patient. A nurse must gather all necessary supplies and prepare both the environment and the patient effectively before beginning.

Gathering Equipment and Supplies

Before starting, the nurse should assemble all required materials. This saves time and prevents the need to leave the patient unattended. Essential items include:

• Clean linens (bottom sheet, top sheet, pillowcases, and a draw sheet)
• Waterproof pad or absorbent sheet if necessary
• Laundry hamper or bag for soiled linens
• Disposable gloves
• Additional comfort items, such as extra pillows

Pre-Procedure Communication and Privacy

Upon entering the room, the nurse should introduce themselves, explain the procedure to the patient, and ensure a private environment by closing the door or curtains. This shows respect for the patient's dignity and helps them feel more secure. Communication throughout the process is key, as it keeps the patient informed and can alleviate anxiety.

The Step-by-Step Procedure for Making an Occupied Bed

Making an occupied bed is a methodical process that prioritizes patient safety and comfort. It involves working on one side of the bed at a time to minimize the patient's movement and risk of injury.

Step 1: Adjusting the Bed and Positioning the Patient

First, raise the bed to a comfortable working height for the nurse to prevent back strain. Ensure the side rail is up on the side opposite from where you are working to prevent the patient from rolling out. The head of the bed should be lowered as much as is tolerable for the patient. Gently help the patient turn onto their side, facing away from you, and have them hold the far side rail for support if they are able.

Step 2: Removing Soiled Linens from One Side

After positioning the patient, the nurse should loosen the soiled bottom sheet and mattress pad on their working side. Roll or fanfold the soiled linen inward towards the patient's back, tucking it snugly against them. This creates a barrier between the patient and the soiled linens. Never shake the linens, as this can spread microorganisms.

Step 3: Placing Clean Linens on the Exposed Side

Take the clean bottom sheet and fanfold a portion of it towards the center of the bed. Tuck the clean sheet's edge smoothly under the mattress, ensuring there are no wrinkles. Place a clean draw sheet or waterproof pad over the new bottom sheet, also tucking it tightly under the mattress. Position the clean, fanfolded linens next to the patient, replacing the soiled linens that were tucked underneath them.

Step 4: Repositioning the Patient and Making the Other Side

With the far side rail still raised for safety, the nurse should move to the opposite side of the bed. Lower the side rail on the new working side. Help the patient gently roll over the pile of soiled linens and onto the clean side of the bed. The patient is now positioned safely and can hold the newly-placed side rail for stability.

Step 5: Completing the Bedding Change

Remove the remaining soiled linens, rolling them away from the nurse's uniform, and place them in the designated laundry hamper. Pull the clean, fanfolded bottom sheet and draw sheet through from the other side, smoothing out all wrinkles. Miter the top and bottom corners neatly. Assist the patient back to a supine (on their back) position and center them in the bed. Finally, place the new top sheet, blanket, and bedspread, making a toe pleat to ensure adequate space for the patient's feet to prevent pressure.

Step 6: Final Touches and Post-Procedure Checks

After changing the sheets, replace the pillowcase with a fresh one. Adjust the pillows to maximize patient comfort. Lower the bed to its lowest, safest position, and ensure the side rails are up as needed, following the care plan. Make sure the call light and any personal items are within the patient's easy reach. Perform a final hand hygiene wash.

Comparison of Standard vs. Occupied Bed Making

Aspect	Standard (Unoccupied) Bed Making	Occupied Bed Making
Patient Presence	No patient present.	Patient remains in bed throughout.
Focus	Efficiency and neatness.	Patient safety, comfort, and minimal disturbance.
Procedure	Linens changed all at once.	Done one side at a time.
Patient Interaction	Minimal to none.	Continuous verbal communication and physical support.
Risk of Injury	Low risk for patient.	Higher risk; requires careful positioning and handling.
Primary Goal	Prepare a clean bed for a new patient or after discharge.	Maintain hygiene and comfort for a bedridden patient.

Critical Considerations for Patient Safety and Well-Being

Beyond the procedural steps, several key nursing practices are vital for protecting the patient during the bed-making process.

Preventing Skin Breakdown

Friction from wrinkled sheets and constant pressure can lead to pressure ulcers. The nurse must ensure that all linens are pulled taut and smooth, with no wrinkles under the patient. Frequent skin checks during the process are essential, noting any redness, warmth, or other changes that may indicate the start of a sore. Using a draw sheet to lift and reposition the patient, rather than dragging them, significantly reduces shearing forces on the skin.

Maintaining Dignity and Privacy

Patient dignity is a core component of compassionate care. Always provide privacy using screens or curtains and keep the patient covered with a bath blanket or top sheet. This protects the patient from unnecessary exposure and helps them feel more comfortable and respected throughout the procedure.

Ergonomics and Infection Control

Nurses should always use proper body mechanics, adjusting the bed height to prevent injury. Infection control measures, such as hand hygiene and appropriate use of gloves, are mandatory. All soiled linens must be handled carefully, held away from the nurse's uniform, and placed directly into a designated hamper to prevent contamination.

Conclusion

Making an occupied bed is a foundational nursing skill that requires meticulous attention to detail, a focus on patient safety, and compassionate communication. By following a systematic, one-sided approach, ensuring linens are smooth, and prioritizing the patient's dignity, nurses provide a clean and comfortable environment with minimal disruption. This not only promotes physical health, like preventing skin breakdown, but also supports the psychological well-being of the bedridden patient. This procedure is a clear example of how thoughtful nursing practice enhances overall quality of care and patient comfort. For more detailed information on pressure ulcer prevention, visit the National Pressure Ulcer Advisory Panel (NPUAP) website.

Frequently Asked Questions

What is the most important safety measure when making an occupied bed?

The most important safety measure is ensuring the patient never rolls out of bed. This is achieved by raising the side rail on the side the nurse is not working on and communicating with the patient throughout the process.

How do you ensure patient dignity during the procedure?

Ensuring patient dignity involves providing privacy by closing curtains or doors, explaining every step of the procedure, and keeping the patient covered with a bath blanket or clean top sheet during the linen change.

Why is it important to keep the linens wrinkle-free?

Wrinkles in the bed linen can cause increased friction and pressure on the patient's skin, which can lead to the development of painful and serious pressure ulcers, also known as bedsores. A smooth surface is essential for skin integrity.

What is a draw sheet and how is it used when making an occupied bed?

A draw sheet is a smaller sheet placed over the waterproof pad in the middle of the bed. It can be used to lift and move the patient gently, reducing friction and making repositioning easier for both the patient and the caregiver.

When should gloves be worn during the occupied bed making process?

Gloves should be worn when handling soiled linens to prevent the spread of infection. After removing soiled linens and before handling clean ones, a nurse should always perform hand hygiene.

How can the nurse prevent straining their back?

To prevent back strain, the nurse should raise the bed to a comfortable working height (waist level) before beginning the procedure. They should also bend at the knees and hips, not the back, and use the draw sheet to help move the patient.

What should the nurse do with soiled linens?

Soiled linens should be rolled inward, away from the uniform, and immediately placed in a designated laundry hamper or bag. They should never be placed on the floor or shaken out, as this can spread pathogens.