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Bed Making Procedure: Definition, Principles, Types of Bed Making

Bed making is an essential procedure in nursing in which nurses prepare and arrange different types of beds for the client's comfort in the hospital or other healthcare institutions. Bed making procedure ensures the patient's comfort according to the situation. It may vary on the client's conditions, purposes and procedures such as open bed, closed bed, occupied bed, cardiac bed, fracture bed, blanket bed etc .

Nurses have a major role in bed making procedures in hospitals . So, a nurse should learn and follow the proper and standard techniques of bed making procedures.

Bed Making Procedure

Definition of bed making -.

Bed making is a technique in which different types of beds are prepared to make a client or patient comfortable according to the situations and procedures.

Purposes of Bed Making -

1. To provide a safe and comfortable bed to the clients or patients. 2. To organize a specific ward. 3. To be prepared for any critical or emergency condition. 4. To prevent bedsores . 5. To promote neat appearance and cleanliness . 6. To teach the relatives to take care of the sick at home.

Principles of Bed Making at Nursing -

1. Micro-organisms are present everywhere on the used articles, skin, clothing and environment. Prevent the spreading of micro-organisms from the contaminated source to the new host by taking precautions and preventing the multiplication of the micro-organisms.

• The nurse should wash her/his hands before and after the bed making procedure to prevent cross-infection . • Bed linen and clothes must be changed frequently to ensure cleanliness. • Do not drop the removed bed linen on the floor. • Gently shake the linen to remove dust. Do not flap the bed clothing because it transfers dust and bacteria easily. • Linen should be folded and held away from the nurses to prevent direct contact with dust and micro-organisms. • Daily cleaning and dusting of beds and units will keep them free from dust and micro-organisms. Soap, water, air and sunshine will help them to be clean. • Damp dusting is recommended because dry dusting raises dust. • Nurses should maintain a necessary distance from patients to prevent droplet infection. • Clean the less contaminated area first and then the clean high contaminated area to minimize the spreading of micro-organisms to the clean area. • Linens should be disinfected before sending them to the laundry. • Nurses who have respiratory infections should not attend to the clients.

2. A protected and comfortable bed will provide rest, and sleep and avoid many complications for bedridden clients e.g. bedsores, foot drops etc.

• The nurse should make a smooth and unwrinkled bed because a wrinkled bed exerts pressure on bony prominence and lumps. The wrinkles cause bedsores due to friction between the skin and wrinkled sheets. • Pull the bottom sheet tightly to avoid wrinkles. • Tuck the linen far enough and tightly to keep it fixed. • Smooth the mattress, if there is a collection of cotton in one place before making a bed. • Do not keep any wet linen on the bed. • Daily dusting should be done to remove any peeling or seeds that are adhered to the bed linen of a bedridden client. • A bed should have enough space to move from side to side. The movements prevent bedsores, stimulate blood circulation and maintain muscle tone. • Use comfort devices to provide additional comfort to the client.

3. Good body mechanisms maintain body alignment and prevent fatigue.

• The stability of the body is assured by keeping the centre of gravity over its base. In the standing position, the nurse can have a wide base by separating his/her feet. • The nearer to the centre of gravity a weight is held, the less strain is produced. E.g. it is more suitable to place the linen on the edge of the bed instead of holding it above shoulder level. • Flex the knees and hips when tucking the sheet under the mattress. This position shifts the work to the long and strong muscle of the thigh and keeps the back in good alignment. • When placing and tucking the linen, face the direction of the work and move with the work rather than twisting the body and overreaching.

4. Planned and organized  ways of working save energy, time and equipment.

• Collect and arrange all the articles before starting the bed making procedure. • At the first finish on one side of the bed making and then go to the opposite side. • Remove the bed linen one by one holding the open end towards the floor when stripping the bed so that the client's possessions and the hospital articles are not sent to the laundry. • The bed sheets are folded in such a way that they can be replaced easily.

General Instructions for Bed Making in Hospital -

• Wash hands properly before and after the procedure. • Do not expose the client unnecessarily. • Do not keep clean linen with soiled linen. • Do not place the woollen blanket directly on the client's body without the bath blanket. • Always ensure that the client does not lie down on the Macintosh without lining. • Shake the linen gently. • Maintain a distance so that the linen should not touch your body or uniform. • Always maintain good body mechanics to prevent extra workload. • Make the bed comfortable, smooth and unwrinkled. • To prevent cross-infection maintain reasonable distance with the patient.

Bed Making Procedure -

• preparation of the articles for bed making procedure -.

1. Cot 2. Mattress and pillow 3. Chair or stool 4. Bedside table 5. Mackintosh 6. Blanket 7. Mattress cover 8. Top sheet and bottom sheet 9. Draw sheet 10. Pillowcase 11. Counterpane 12. Laundry bag 13. Dusters

• Steps of bed making procedure -

1. Wash hands. 2. Remove the pillow and place it on the chair. 3. Remove the top linen. 4. Fold the draw sheet. Bring the opposite end to the middle of the bed and fold them into three. Place it over the chair. 5. Roll the mackintosh and place it on the chair. 6. Remove the bottom sheet and the soiled mattress cover. 7. Dust the mattress with a dry duster. 8. Place the bottom sheet on the mattress and tuck it securely at the top on the near side. 9. Make a mitred corner and tuck at the foot end. Tuck the sheet along the sides. 10. Place the mackintosh nearly 37 cm from the head and tuck it along the sides. 11. Place the top sheet. 12. Place the blanket over the top sheet 15 to 20 cm below the top of the mattress. 13. Put the pillowcase on the pillow and place the pillow at the head end.

Types of Bed Making -

1. Closed bed 2. Open bed 3. Admission bed 4. Occupied bed 5. Operation bed or post-anaesthetic bed or recovery bed 6. Cardiac bed 7. Fracture bed 8. Amputation bed or stump bed or divided bed 9. Blanket bed

Closed Bed -

The closed bed is an empty bed, which is covered with the top linen so that all linen beneath the linen is fully protected from dust and dirt while waiting for the patient's admission.

The closed bed is uncovered when the client is admitted.

The term open bed is used to describe the hospital bed when it is about to be occupied by a client. It is made either for a new client or an ambulatory client.

Admission Bed -

The admission bed is made as an open bed. The client gets into bed after a bath and changes into a hospital dress if it is a custom in the hospital.

Occupied Bed -

This is to make a bed with the client in. This is made for a client who cannot get out of bed. The preparation and the aftercare of the client will be the same as in an open bed.

Operation Bed or Post-anaesthetic Bed or Recovery Bed -

It is prepared for a client who is recovering from the effects of anaesthesia following a surgical operation.

Cardiac Bed -

A cardiac bed is used to help the client assume a sitting position that can afford him the greatest amount of comfort with the least strain. The main purpose of the cardiac bed is to relieve dyspnoea caused by cardiac disease.

Necessary requirements of cardiac bed:

• Items for an open bed. 
• Extra pillows. 
• Backrests and cardiac tables. 
• Air cushion, knee pillow, and footrest.

Fracture Bed -

It is used for a client with a fracture of the trunk or extremities to provide firm support by the use of a firm mattress that rests on a fracture board or bed board.

Amputation Bed or Stump Bed or Divided Bed -

An amputation bed is used after the amputation of the leg to take the weight of the bedclothes off the site of the operation.

Purpose of amputation bed or stump bed or divided bed:

• After the amputation of the leg, an amputation bed is used to remove the weight of the bedclothes from the operation site. 
• To maintain the stump's position. 
• To be able to check the stump for bleeding and apply a tourniquet as soon as possible if necessary.

Blanket Bed -

The blanket bed is made for a client who is suffering from renal disease to promote elimination through the skin.

Purpose of blanket bed:

• To lift the weight of the bedclothes away from the painful joints. 
• To maintain the client's warmth. 
• To encourage elimination via the skin.

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Session 06 BED MAKING PROCEDURE Fundamentals of Nursing

2020, Any one

This is a lecture note for the students 1st year students of Diploma in Nursing Science and Midwifery Course in Bangladesh.

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Bed Making in Hospital Procedure, Definition, Principles, Types

Bed Making in Hospital Procedure, Definition, Principles, Types – The art of bed making is not merely a chore but a crucial procedure. Bed-making is the process through which nurses prepare and arrange various types of beds to ensure the utmost comfort of patients in healthcare facilities, be it a hospital or any other medical institution. This task is no simple feat; it is a meticulous process that varies according to the patient’s condition, the purpose of the bed, and the specific medical procedure. Let’s delve deeper into the world of bed making, exploring its definition, principles, and the various types that cater to diverse patient needs.

Table of Contents

Definition Of Bed Making

At its core, bed-making is a precise technique employed to create an environment where patients can rest and recover comfortably. Different types of beds are prepared with a singular goal in mind: to cater to the specific needs of the patient based on their condition and the procedures that they may undergo.

Purposes Of Bed Making in Hospital

Bed making in Hospital serves several essential purposes:

• Ensuring Patient Comfort: The primary objective is to provide a safe and comfortable bed for the patient, facilitating their recovery journey.
• Organizing the Ward: Bed-making helps in maintaining the organization within the healthcare facility, ensuring that patients are allocated to the appropriate beds.
• Preparedness for Emergencies: An efficiently made bed can be crucial in critical or emergency situations, where every second counts.
• Preventing Bedsores: By employing correct bed-making techniques, nurses can significantly reduce the risk of bedsores, a common concern for immobile patients.
• Promoting Neatness and Cleanliness: Cleanliness is paramount in a medical setting, and well-made beds contribute to maintaining a hygienic environment.
• Patient Education: It is also an opportunity for nurses to educate the patient’s relatives on how to care for the sick at home, as they may have to deal with similar situations.

Principles Of Bed Making In Nursing

Effective bedmaking involves adhering to several principles to ensure the patient’s well-being and the maintenance of a sterile environment.

• Preventing the Spread of Microorganisms: Microorganisms can be found everywhere, but their spread can be controlled through various actions, such as frequent handwashing by the nurse, changing bed linen and clothes regularly to maintain cleanliness, and avoiding dropping removed bed linen on the floor.
• Creating a Comfortable Bed: A comfortable bed can significantly impact a patient’s recovery. Steps taken to achieve this include ensuring the bed is smooth and free of wrinkles to avoid pressure on bony prominences and the development of bedsores.
• Maintaining Good Body Mechanics: Proper body mechanics are crucial to preventing strain and fatigue among nurses. This involves keeping the center of gravity over a wide base, flexing knees and hips when tucking sheets, and facing the direction of work to avoid unnecessary twisting and overreaching.
• Planned and Organized Work: Efficiency is key. Nurses should organize their work, collect and arrange all necessary items before starting the bed-making procedure, and follow a systematic approach to minimize energy expenditure and save time and equipment.

Importance of Proper Bed-Making

Proper bed-making is essential for several reasons:

• Preventing Pressure Ulcers : Well-made beds help distribute the patient’s weight evenly, reducing the risk of pressure ulcers.
• Reducing the Risk of Infection : Proper infection control during bedmaking can prevent the spread of infections within the hospital.
• Enhancing the Patient’s Experience : A well-made bed contributes to a more comfortable and pleasant stay for the patient.

General Instructions For Bed Making In Hospitals

To maintain a standard of excellence in bed making within hospitals, several general instructions are followed:

• Proper Hand Hygiene: Nurses must wash their hands thoroughly before and after the bed-making procedure to prevent cross-infections.
• Patient Privacy: It is imperative to avoid unnecessary exposure of the patient.
• Separating Clean and Soiled Linen: Clean and soiled linen should be kept separate at all times.
• Avoiding Direct Contact with Woollen Blankets: Woollen blankets should not be placed directly on the patient’s body without a bath blanket in between.
• Gentle Linen Handling: Linen should be handled with care to prevent the transfer of dust and microorganisms.
• Maintaining Safe Distances: Nurses should maintain a reasonable distance from the patient to prevent the risk of infection.

The Step-by-Step Bed Making in Hospital Procedure

Now that we understand the importance of bed making in hospital setting, let’s walk through the procedure.

Step 1: Gather Your Supplies

Before you begin, gather all the necessary supplies, which typically include fresh linens, a mattress pad, a bedspread, pillowcases, and any additional items such as waterproof covers if needed.

Step 2: Prepare the Bed

Start by ensuring the bed is at a comfortable working height. Lower the side rails if applicable, and wash your hands thoroughly to maintain asepsis .

Step 3: Remove Old Linens

Remove the old linens carefully to avoid any contamination. Dispose of them appropriately and place them in a laundry bag.

Step 4: Prepare the Mattress

If the patient requires a waterproof cover, ensure it’s in place. Add a clean mattress pad and fitted sheet.

Step 5: Create Hospital Corners

Hospital corners are the hallmark of a well-made bed. Tuck in the bottom sheet at the foot of the bed, and then lift the edge of the mattress to create a triangular fold. Tuck the excess fabric beneath the mattress, ensuring it is tight and wrinkle-free.

Step 6: Add the Top Sheet

Place the top sheet, ensuring it aligns evenly with the head of the mattress. Tuck it in at the foot end and along the sides.

Step 7: Arrange the Blanket or Bedspread

Now, add a blanket or bedspread, tucking it in at the foot and along the sides. Ensure it’s straight and wrinkle-free.

Step 8: Add Pillowcases

Finally, add clean pillowcases to any pillows required for the patient’s comfort.

Step 9: Final Adjustments

Step back and inspect the bed for any wrinkles, ensuring it’s perfectly made. Adjust any corners or edges as necessary.

By following these steps meticulously, healthcare professionals can create a comfortable and hygienic environment for their patients, promoting a positive healing experience.

Types Of Bed Making in Hospital

Nursing recognizes various types of bed making, each tailored to specific patient needs and situations. These include:

• Closed Bed: Prepared for new patients, a closed bed is covered with top linen to protect against dust and dirt while waiting for patient admission.
• Open Bed: This is made for clients about to be occupied. It is suitable for new clients or those who are ambulatory.
• Admission Bed: Similar to an open bed, the admission bed is made for a client who has had a bath and changed into hospital attire.
• Occupied Bed: This is made with the client in the bed, typically for those who cannot get out of bed.
• Operation Bed (Post-Anaesthetic Bed): This type of bed is prepared for clients recovering from the effects of anesthesia following surgery.
• Cardiac Bed: Designed to help clients assume a sitting position that minimizes strain and discomfort, typically used for those with cardiac conditions.
• Fracture Bed: Designed to provide firm support for clients with fractures in the trunk or extremities, using a firm mattress on a fracture board.
• Amputation Bed (Stump Bed): Used after leg amputations to relieve weight from the operation site and facilitate wound care.
• Blanket Bed: Employed for clients with renal disease to encourage skin elimination, lift the weight of bedclothes from painful joints, and maintain warmth.

Bed Making for Special Cases

Pediatric patients.

When making beds for pediatric patients, extra care must be taken to create a child-friendly and reassuring environment. The choice of bedding and room decor can significantly impact the child’s comfort.

Elderly Patients

Elderly patients may have unique requirements, such as the need for extra pillows or specialized mattresses. Adjusting the bed to accommodate these needs is essential for their well-being.

Patients with Specific Medical Conditions

Patients with specific medical conditions may require specialized beds, such as those with pressure-relief surfaces. Bed making in such cases should adhere to specific guidelines.

In conclusion, hospital bed-making is not just a routine task but a critical aspect of patient care. It directly affects patient comfort, health, and overall experience in the hospital. Healthcare professionals must prioritize proper bed-making to ensure the best possible care for their patients.

FAQ -Bed Making in Hospital

How often should hospital beds be made.

Hospital beds are typically made daily or as needed. If a patient soils the bed or experiences discomfort, the bed may need to be remade more frequently.

Are there any specific guidelines for bed-making in isolation rooms?

Yes, bed-making in isolation rooms follows strict infection control guidelines to prevent the spread of contagious diseases.

How does hospital bed-making contribute to patient recovery?

A well-made bed provides comfort and minimizes the risk of complications, thus aiding in the patient’s recovery process

Why is bed-making important in healthcare?

Bed making is crucial in healthcare to ensure patient comfort, maintain hygiene, and prevent complications like bedsores. It also contributes to the organization of healthcare facilities.

What are the key principles of bed-making in nursing?

The key principles of bed-making in nursing include preventing the spread of microorganisms, creating a comfortable bed, maintaining good body mechanics, and practicing planned and organized work.

Please note that this article is for informational purposes only and should not substitute professional medical advice.

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Bed Assignment and Bed Management

• First Online: 24 November 2011

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• Randolph Hall 2  

Part of the book series: International Series in Operations Research & Management Science ((ISOR,volume 168))

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Beds are a critical resource for serving patients in hospitals, but also provide a place where patients queue for needed care. Bed requirements result from medical needs along with the hospital’s effectiveness at reducing average length of stay and hospitalization rates. Hospitals can reduce the need for beds by reducing the unproductive portion of the patient’s stay (e.g., waiting for a test) and by reducing the portion of time when beds are unoccupied. Hospitals must also synchronize discharges with admissions to minimize time of day and day of week variations in bed occupancy levels. Finally, beds must be managed as part of the overall hospital system so that shortages do not cause delays or cancellations in the emergency department or surgery.

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Acknowledgment

My appreciation goes to David Belson for his contributions to understanding of bed management based on his extensive experience working with California hospitals.

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Randolph Hall

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Hall, R. (2012). Bed Assignment and Bed Management. In: Hall, R. (eds) Handbook of Healthcare System Scheduling. International Series in Operations Research & Management Science, vol 168. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-1734-7_8

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Published : 24 November 2011

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