Nursing Assistant

1. Nursing Assistant Bedmaking

2. Comfort due to bedmaking • Bed should be clean, neat, & dry • Body exerts pressure unevenly over bony prominences when against mattress for extended periods – always use mattress pad • Bed linen MUST be wrinkle-FREE! • State of mind affected by bed condition- keep bed in good repair, clean, well-made, wrinkle-free, & attractive with bedspread • Keep call light in place, clipped to linen • Keep resident reality-oriented by using personal pillows, afghans, familiar objects

3. Bed linen as an irritant • Use sheets to separate blanket from skin, preventing fibers from irritating • Keep bottom linens tucked in & wrinkle free • Cover plastic with cotton drawsheet • Straighten & tighten loose sheets, blankets, & bedspreads as necessary • Strong laundry soaps may cause skin irritation, watch for problems & report

4. Aseptic technique with bed making • Wash hands, germs spread by cross-contamination • Hold & carry linen away from uniform • Dirty linen makes you dirty • Clean linen gets dirty • Shaking linens or fluffing in air spreads dust & germs • Keep linen off floor or bedside table as to not spread germs. Soiled linen should be placed in a linen hamper or rolled tightly & tucked at foot of bed • Cover dirty linen hampers

5. Hospital beds • Manually operated – hand cranks at foot of bed to raise or lower head, foot, or total bed. Keep cranks down when not in use • Electric beds – controls at side for resident & NA use or at foot of bed for NA use

6. Hospital beds • Side rails • Uses • Prevent resident from falling out of bed • Provide security • Give resident support to hold or grasp when moving or turning • Regulations regarding use • Considered restraints • Must have consent to use • Need for use must be noted in resident’s record & care plan • Resident must be checked frequently if side rails are ordered

7. Bed positions • High position – encourages staff to use good body mechanics • Low position – encourages ambulatory resident to get in & out of bed safely • Fowler’s position – used for resident comfort in eating & breathing easily • Semi-Fowler’s position – used for comfort, raise knees 15 degrees to keep from sliding down in bed • Trendelenberg’s position – HOB lowered, FOB raised. Requires doctor’s order • Reverse trendelenberg – FOB lowered, HOB raised. Requires doctor’s order

8. Body Mechanics in bed making • Know limitations. Don’t lift, turn, or move resident alone if in doubt • Get close to side of bed, don’t make from the top or bottom of the bed • Back straight, knees bent, feet apart • Move feet to turn in direction wanted & avoid twisting back • Raise bed to comfortable height • Make one side of bed before beginning other side

9. Unoccupied bed making • Place linen on clean surface • Stack linen in order to be used with first thing on top & last thing on bottom • Place bed in flat position • If removing soiled linen, untuck linen & roll towards center with soiled side inside • Place soiled linen in hamper

10. Unoccupied bed making • Remove pillowcase, place in hamper & place pillow on clean surface • Wash hands • Mattress pad • Bottom sheet, small hem at bottom, tuck in at top • Miter corners • Draw sheet • Top sheet, large hem at top, tucked at bottom • Blanket, bedspread, tuck all top linen together, mitering corners • Pillow & pillowcase