When making an occupied bed, which of the following should you consider?

Maintaining a clean, wrinkle-free bed is essential for preventing skin breakdown and enhancing patient comfort. When making an occupied bed, which of the following should you consider to ensure the process is safe, respectful, and efficient for everyone involved?

Quick Summary

Prioritize patient safety and dignity by clearly explaining the procedure, maintaining privacy, and using correct body mechanics and bed adjustments. Key considerations include effective infection control, preventing injury for both the patient and caregiver, and minimizing disruption to the patient's rest.

Key Points

• Patient Safety and Comfort: Always ensure bed wheels are locked, use side rails for support, and keep the patient covered with a bath blanket for privacy and warmth.

• Clear Communication: Explain every step of the process to the patient to reduce anxiety and build trust.

• Infection Control: Practice meticulous hand hygiene, wear gloves if needed, and never shake soiled linens to prevent spreading microorganisms.

• Caregiver Ergonomics: Protect your back by raising the bed to a comfortable working height and using a draw sheet to assist with patient movement.

• Wrinkle Prevention: Ensure linens are pulled taut and wrinkle-free to prevent pressure injuries and skin breakdown.

• Medical Device Awareness: Carefully check for and protect any medical tubes or drains to prevent dislodgement during the process.

Prioritizing Patient Safety and Dignity

Making an occupied bed is a fundamental caregiving skill that requires a focus on both safety and respecting the patient's dignity. The process can be unsettling for someone who is bedridden, so clear communication is key. Always knock before entering, introduce yourself, and explain every step of the process in a calm, reassuring tone. This helps the person feel informed and in control, rather than feeling like a passive object.

Furthermore, providing privacy is critical. Close the door or pull the privacy curtain, and use a bath blanket to keep the patient covered during the linen change. This not only maintains their dignity but also helps them feel warm and secure throughout the process.

Protecting the Patient from Injury

Patient safety is non-negotiable. Before beginning, always ensure the bed wheels are locked to prevent movement. When rolling the patient from one side to the other, the side rail on the side they are turning toward must be securely raised to prevent falls. Additionally, keep a close watch for any tubes, drains, or medical devices to ensure they do not become entangled or disconnected during the maneuver. After the task is complete, return the bed to the lowest possible position to minimize the risk of falls when the patient eventually gets up.

Upholding Infection Control Standards

Infection control is a critical aspect of caregiving, especially when handling soiled linens. Failing to follow proper procedures can spread harmful pathogens.

Key Infection Control Rules

• Hand Hygiene: Wash hands thoroughly before and after the procedure.
• Wear Gloves: Don gloves if there is any chance of contact with bodily fluids.
• No Shaking: Never shake linens, as this can release microorganisms into the air.
• Separate Linens: Keep soiled linens away from your uniform and place them directly into a designated hamper or bag.
• Keep Clean Linens Clean: Do not place clean linens on the floor or on another patient's bed. If a clean item touches the floor, it must be discarded into the soiled laundry.

Ensuring Caregiver Ergonomics

Caregiving can be physically demanding, and changing an occupied bed is no exception. Proper technique protects the caregiver from back strain and other musculoskeletal injuries.

Best Practices for Caregiver Safety

• Adjust Bed Height: Raise the bed to a comfortable working height, typically around your waist level, to avoid unnecessary bending and reaching.
• Good Body Mechanics: Use your legs to lift and lower, keeping your back straight. Work as close to the bed as possible to avoid overreaching.
• Use Assistive Devices: Utilize draw sheets or friction-reducing sheets to help move and reposition the patient more easily, reducing the physical strain on your back and arms.
• Teamwork: If the patient is large or immobile, ask for assistance from another person to safely and efficiently complete the task.

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

Executing the procedure methodically ensures efficiency and reduces discomfort for the patient. While specific steps may vary, the general process is as follows:

1. Gather all supplies: Bring clean linens (fitted sheet, flat sheet, draw sheet, pillowcase, bath blanket, etc.), a soiled linen hamper, and gloves to the bedside.
2. Prepare the patient and bed: Introduce yourself, explain the procedure, and provide privacy. Lock the bed wheels and raise the bed to a comfortable working height.
3. Position the patient: Gently assist the patient in rolling onto their side, facing away from you. Ensure the side rail on that side is up for safety.
4. Remove and replace linens (first side): Loosen the soiled bottom linens. Roll them inward toward the patient, tucking the bundle snugly against their back. Place the clean, rolled-up fitted sheet and any draw sheets on the exposed side of the mattress.
5. Roll the patient over the hump: With the far side rail raised, help the patient roll over the bundle of linens toward you, onto the clean sheets.
6. Remove and replace linens (second side): Go to the other side of the bed. Lower the side rail. Remove the soiled linens by pulling them out from under the patient and placing them in the hamper. Pull the clean sheets smooth and tuck them tightly under the mattress.
7. Finalize the bedding: Help the patient roll back to the center of the bed. Place a clean top sheet and blanket, making a cuff at the top and a toe pleat at the foot for comfort. Change the pillowcase.
8. Complete post-procedure checks: Ensure linens are wrinkle-free, lower the bed, raise side rails as needed, and place the call light within reach.

Comparison: Occupied vs. Unoccupied Bed Making

Feature	Occupied Bed Making	Unoccupied Bed Making
Patient Presence	The patient remains in bed throughout the process.	The patient is out of bed, either in a chair or out of the room.
Procedure Technique	Involves rolling the patient from side to side to change linens in two stages.	Involves stripping and making the entire bed at once.
Primary Goal	To maintain patient hygiene, comfort, and dignity with minimal disruption.	To prepare a clean, comfortable bed for a new or returning patient.
Risk of Injury	Higher risk for both patient and caregiver, requiring strict safety protocols.	Lower risk, as patient is not in the bed during the procedure.
Ergonomics	Requires careful body mechanics to prevent caregiver back strain.	Can be performed with less direct patient contact, reducing some ergonomic risks.

Conclusion

Making an occupied bed is a delicate task that is fundamental to providing quality care. By considering the crucial aspects of patient safety, maintaining dignity and comfort, following strict infection control protocols, and employing proper ergonomic techniques, caregivers can perform this task with confidence and competence. The most important tool is a methodical approach combined with clear communication to ensure a clean, safe, and comfortable experience for the patient. For further guidelines on caregiver safety, refer to the Occupational Safety and Health Administration (OSHA) Ergonomics Guidelines.

Frequently Asked Questions

What is the very first step when making an occupied bed?

The very first step is to perform hand hygiene and gather all necessary clean linens and supplies to ensure efficiency and infection control. After this, you should introduce yourself and explain the procedure to the patient.

How do you ensure the patient's privacy when changing linens?

To ensure privacy, close the door and pull the privacy curtain. You should also cover the patient with a bath blanket or top sheet before removing the top linens.

What are hospital corners, and how do they relate to occupied bed making?

Hospital corners are a neat, tight fold technique used to secure top sheets and blankets under the mattress. When making an occupied bed, this is done at the foot of the bed while ensuring a small toe pleat is created to allow foot movement for patient comfort.

Why is it important to prevent wrinkles in the bottom sheet?

Wrinkles can cause friction and pressure on the patient's skin, which increases the risk of skin breakdown and the development of painful pressure ulcers or bedsores, especially for those confined to bed for long periods.

How can a caregiver protect their back during this process?

A caregiver can protect their back by raising the bed to a comfortable working height (around waist level), using good body mechanics by bending the knees instead of the back, and using a draw sheet to help roll the patient.

When should you get assistance for making an occupied bed?

It is advisable to get assistance from another person if the patient is particularly heavy, unable to assist at all, or uncooperative. This improves safety for both the patient and the caregivers involved.

What should be done after the bed is made and the procedure is complete?

After completing the bed change, ensure the linens are smooth and wrinkle-free, and that the patient is in a comfortable and safe position. Lower the bed to its lowest position, raise the side rails as needed, and place the call light within the patient's reach.