What is the most important safety precaution for making an occupied bed?
Beds and Bed Preparation TechniquesDefinitionA hospital bed is the piece of equipment most frequently used by the hospitalized patient. Hospital beds are also found in long-term-care facilities, as well as patients' homes. The ideal hospital bed should be selected for its impact on patients' comfort, safety, medical condition, and ability to change positions. Show PurposeThe purpose of a well-made hospital bed, as well as an appropriately chosen mattress, is to provide a safe, comfortable place for the patient, where repositioning is more easily achieved, and pressure ulcers are prevented. PrecautionsWhen selecting a bed, the nurse should consider the patient's mobility, overall medical condition, and risk for pressure ulcer development. Safety factors should also be considered. Unless a patient is accompanied by a health care professional or other caregiver, the bed should always be placed in its lowest position to reduce the risk of injury from a possible fall. Another precaution to take, especially for weak or bed-bound patients, or for those with altered mental status, is to elevate the side rails. However, health care professionals should be aware of a safety alert issued by the Food and Drug Administration (FDA) in 1995 concerning the use of hospital beds' side rails. Because of a number of injuries and deaths related to side rail entrapment, the FDA recommends the following actions to prevent potential deaths and injuries related to side rail entrapment:
DescriptionThe usual hospital bed consists of a mattress on a metal frame that can be raised or lowered horizontally. The frame is separated into three sections so the head and foot of the bed can be raised and lowered, in addition to inclining the entire bed with the headboard up or down. The majority of hospital beds are powered by electrical motors, but some are run manually (using a crank) or by hydraulic methods. The bed's position is typically changed by using electrical controls that may be located on the side or foot of the bed, in a bedside table, or on a pendant. The electrical controls enable patients to reposition the bed with very little effort. Patients should be instructed how to use the bed controls. They should also be cautioned against raising the bed to a position that may contribute to injuries or falls. At its lowest level, a hospital bed is usually about 26-28 inches (65-70 cm) above the floor. Various safety features are present on hospital beds. These features include:
Most hospital beds have water-repellent mattresses. However, a number of specially designed beds, frames, and mattresses have been created to aid in caring for bed-bound patients. Some of these beds help to turn the immobile patient, and may make it easier for nurses to lift or reposition the patient. The major categories of specialized beds are:
There are also a variety of support surfaces that can be placed on top of the existing mattress, or specialized mattresses that can reduce the risk of pressure ulcer formation. These surfaces and mattresses include:
The rotokinetic bed is used primarily for severely immobilized patients or patients with spinal cord injuries. The bed can rotate a patient up to 270°. Bariatric beds are available for morbidly obese patients. PreparationThe nurse normally makes the bed in the morning after a patient's bath, or when the patient is out of the room for tests. The nurse should straighten the linens throughout the day, making certain they are neither loose nor wrinkled. Any sheets that become wet or soiled should be changed promptly. When changing bed linen, the nurse should keep the soiled linen away from the uniform, and place it in the appropriate linen bag or other designated container. Never fan or shake linens, which can spread microorganisms and, if any of the sheets touch the floor, they should be replaced. The bed can be made in a variety of ways, depending on the particular patient situation. The categories of unoccupied bed making include:
The other method of making a hospital bed is an occupied bed, where the patient is in the bed while the linens are being changed. The nurse should perform the following when making the occupied bed:
The nurse also needs to place the bed into one of the following positions, considering the particular needs of each patient:
AftercareAfter preparing the hospital bed, the patient should be assessed for comfort and safety. Health care team rolesSelecting and preparing a bed for the patient are important responsibilities for the nurse. The nurse or nursing assistant normally makes up the bed, but it is important that all health care professionals be aware of the positive impact an appropriate, well-made bed has on a patient's care, safety, and sense of comfort. KEY TERMSDraw sheet— A sheet placed over the bottom sheet to help lift or move a patient and to protect the bottom sheet from soiling. Fowler's position— A bed position where the head of the bed is raised to an angle of 45° or more; a semisitting position. Trendelenburg— A bed position where the entire frame of the bed is tilted with the head of the bed down. ResourcesBOOKSPotter, Patricia A., and Anne G. Perry. Fundamentals of Nursing, 5th ed.St. Louis, MO: Mosby, 2001. PERIODICALSWarren, Joseph B., et al. "Development of a Decision Tree for Support Surfaces: A Tool for Nursing." Medical Surgical Nursing 8 (August 1999): 239. ORGANIZATIONSThe Hospital Bed Safety Work Group. 〈http://www.fda/gov/cdrh/beds〉. What is the most important safety step when making an occupied bed?Use Standard Precautions to make an occupied bed. Assess the environment for safety before caring for a patient. Check the floor for spills, and make sure all equipment is working properly. Be aware of the positions in which the patient may be turned while making the bed, so that the patient remains safe at all times.
What is the importance of proper bed making?The main purposes of bed-making are to prevent complications by ensuring comfort and security to the patient. To provide rest and sleep. To provide physical and psychological comfort and security to the patient. To give the unit a neat appearance.
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