When making the bed for a bedridden patient, which of the following steps should be done first?

According to the U.S. Census Bureau, approximately 5.8% of the population over 65 needs assistance with everyday care, including bed-making. Knowing the correct procedure is crucial for both the patient's safety and the caregiver's well-being. So, when making the bed for a bedridden patient, which of the following steps should be done first? The initial step is not about the linens, but about preparation and communication.

Quick Summary

The process for changing linens on an occupied bed begins with gathering supplies and ensuring safety. This includes explaining the procedure to the patient, securing privacy, washing hands, applying gloves, and raising the bed to a comfortable working height. The patient is then gently rolled to one side, allowing for the partial removal of soiled sheets and placement of clean ones.

Key Points

• Start with Preparation: The first step is to prepare the environment and communicate with the patient before touching the bed.

• Prioritize Safety First: Always lock the bed wheels, adjust the bed to a comfortable height, and ensure side rails are used appropriately to prevent falls.

• Work One Side at a Time: To change the sheets, gently roll the patient to one side, change the linens on the exposed half, and then roll them to the clean side to finish.

• Ensure a Wrinkle-Free Surface: Meticulously smooth out all wrinkles from the sheets to prevent skin irritation and pressure sores for the patient.

• Communicate Throughout: Continually explain your actions to the patient to reduce anxiety and increase their comfort during the process.

• Contain Soiled Linens: Immediately roll soiled linens inward and place them in a proper receptacle to prevent contamination.

• Use a Draw Sheet: A draw sheet (lift sheet) can significantly assist in repositioning the patient safely and with less strain on the caregiver.

A successful and safe occupied bed change begins with a clear, sequential process that protects both the patient and the caregiver. The first step involves careful preparation, which is essential to prevent injury, manage infection, and maintain patient dignity throughout the task.

The Critical First Step: Preparation and Communication

Before interacting with the patient or the bed, the caregiver must prepare the environment and communicate with the patient. This initial phase involves gathering supplies, explaining the procedure to the patient, ensuring privacy, washing hands, applying gloves, and adjusting the bed to a comfortable working height while locking the wheels.

Safely Maneuvering the Patient and Changing Linens

Once prepared, the process focuses on safely changing linens on one side of the bed at a time. This involves rolling the patient to one side, raising the side rail on that side, untucking and rolling soiled linens inward towards the patient, and placing a clean sheet on the exposed mattress. The caregiver then moves to the other side, lowers the rail, rolls the patient over the linens, and removes the soiled linens, placing them in a laundry bag. The clean sheets are then pulled through and smoothed.

Completing the Bed Change and Ensuring Comfort

Finish by adding the remaining linens and prioritizing patient comfort, including placing a clean top sheet, changing the pillowcase, and creating a toe pleat. The bed should then be lowered to a safe position, the call light made accessible, and the patient's comfort confirmed. Remove gloves and wash hands.

Proper Bedding Materials vs. Caregiver Technique

Aspect	Best Practice for Bedridden Patients	Standard Bed Making Technique
Primary Goal	Patient comfort, safety, and skin integrity. Preventing bedsores is paramount, requiring wrinkle-free sheets.	Achieving a neat, tidy appearance.
Rolling the Patient	Requires careful, gentle rolling, often with assistance, and using a side rail for safety. Communication is constant.	Not applicable, as the bed is empty.
Linen Material	Consider using a draw sheet (also called a lift sheet) and an incontinence pad for easier repositioning and protection.	Standard fitted and flat sheets are sufficient.
Wrinkle Prevention	Meticulous attention to smoothing all wrinkles is crucial to prevent pressure points and skin breakdown.	Smoothing wrinkles is for aesthetics and comfort, not a critical health measure.
Bottom Sheet	Changed one side at a time, rolling the dirty portion under the patient.	Removed completely before the new sheet is put on.
Final Bed Position	The bed is lowered to a safe height, and side rails are adjusted according to facility policy or patient needs.	The bed height is not a concern; the focus is on appearance.

Conclusion

The essential first step in changing the bed for a bedridden patient is comprehensive preparation and clear communication. This involves gathering supplies, prioritizing safety and dignity, and explaining the process. Following these steps ensures a clean and secure bed, minimizing risks for both patient and caregiver. Preventing wrinkles is critical for preventing pressure sores in bedridden individuals. For more information on safe patient handling, refer to guidelines from the Occupational Safety and Health Administration (OSHA).

Frequently Asked Questions

What is the very first thing a caregiver should do?

The very first thing a caregiver should do is gather all necessary supplies, wash their hands, put on gloves, and explain the procedure to the patient.

How do you roll a bedridden patient to change the sheets?

To roll a bedridden patient, gently assist them to turn onto their side, using a side rail for them to hold onto if possible. Roll them away from you to allow access to the bed.

Why is it important to smooth out wrinkles in the sheets?

It is crucial to smooth out all wrinkles because they can cause pressure points on the patient's skin, which can lead to the development of painful and dangerous bedsores.

Can I change the sheets by myself?

While it is possible to change an occupied bed alone, it is significantly safer and easier with assistance from another person, especially with heavier or less mobile patients.

What is the purpose of a draw sheet?

A draw sheet, or lift sheet, is a smaller sheet placed under the patient's midsection that helps with repositioning and moving the patient in bed with less friction and strain.

How often should bed linens be changed for a bedridden patient?

Linens should be changed at least weekly, but more frequently if they become soiled or wet, as this helps prevent infection and skin breakdown.

What are 'hospital corners' and are they necessary?

Hospital corners are a method of neatly tucking sheets under the mattress. They are not strictly necessary but are used to create a tight fit to reduce wrinkles and keep the sheets securely in place.