The Resident’s Environment

Make your patient’s comfortable!

A little funny…

Resident Comfort

Affected by age, illness, and degree of activity Watch for symptoms of sleep deprivation Important to control lighting, ventilation, odors,

noise based on resident’s needs– How can we do this???

Temps controlled between 71o and 81o per OBRA– Protect from drafts-blankets, clothing, wraps

Resident Comfort

Lighting – light control in reach of resident so residents can

choose how much light they want Noise Control

– keep noise to a minimum because some are very sensitive to noise

Odor Control– Remove soiled items, clean bedpans and urinals,

use deodorizers as needed

Bedmaking

What does a well made bed offer your patient? – Comfort– Safety

This is part of their home while they are in the hospital or health care facility

Types of Beds

Gatch bed– Bed height and

head/foot can be adjusted by turning crank.

Electric bed– Bed height and

head/foot can be adjusted by electric controls.

Types of Beds

Low bed– Used for patients with fall

risks and those for whom use of side rails are not advised

Air-Loss bed– Used for those who have

pressure ulcers or are at risk

– Turning of patients using a low air loss bed still must be turned every 2 hours

– CPR is not effective in this type of bed unless the air pillow switch is activated

Types of Beds

CircOlectric Bed– Spinal injury patients and

those with severe burns use these beds

– After rotation, the patient is on the abdomen

Stryker Frame– Similar in function to the

CircOlectric bed but is manually operated

– Used for patients with severe burns or spinal injuries

Safety Alert

You must be trained in order to use specialty beds Always find out the proper operating procedure

before attempting to operate any bed Two or more staff members must be present when

these beds are used Patients must be turned in the direction of the narrow

wedge to reduce the risk of falls Make sure all straps are secure and the frame is

locked Sections may be removed for patient elimination but

remember to always replace them

Bedmaking and Bed Linens

Bed linen is routinely changed when soiled but also– Daily in an acute care facility (hospital)– Two or three times a week (or every other day) in

LTCF’s

Guidelines for handling linens and making the bed…

Always wash hands and use gloves if linen is soiled

Linen carts must be covered Take only the linens you need to change the

bed– Unused linen is never returned to the linen cart

Avoid contact between the linens and your uniform

Fold or roll soiled linen toward the center when removing it from the bed

Guidelines for handling linens and making the bed…

Soiled linen may be placed into a plastic bag or pillowcase and then placed into the soiled linen hamper

Never shake bed linens, microbes may be released into the air

Never place soiled linen on environmental surfaces is in the room– Overbed tables, floors, chairs, etc

Guidelines for handling linens and making the bed…

Use proper body mechanics when making the bed to prevent back injury

Work on one side of the bed at a time to save time

Make sure bottom linen are wrinkle free to prevent skin breakdown

Follow the patient’s care plan regarding positioning of the head and foot of the bed, the number of pillows used and the use of pillows for positioning

OSHA and Safety Alerts

Preventing back injuries is one of the most important things you can do.

Raise the bed to a working height Watch for sharp items or resident belongings

in linen Never turn your back on the patient or leave

the bedside when the bed is in the high position and the side rail is down

Infection Control Alert

Always wear gloves when handling wet or soiled linen

Soiled linen must be placed in a linen hamper or plastic bag

Avoid contaminating environmental surfaces with soiled gloves

Disinfect the mattress if needed Discard gloves and wash hands Report any cracks in mattresses at once It is not necessary to wear gloves when handling

clean linen

Types of Bedmaking Styles

Occupied Bed– Made with the

patient in the bed– Bedbound patients

receive their baths in the bed and this bedbath is done before the bed change

Unoccupied bed– Made with the

patient out of the bed

– Is fanfolded halfway down for ease of entry

Types of Bedmaking Styles

Open bed– “Welcoming” bed

style– For the new patient– In LTCF’s the bed is

not made “open” unless the resident is going to bed soon

Closed bed– Made following

discharge of a patient and after the room has been cleaned

– Remains closed until a new patient is admitted

Types of Bedmaking Styles

Surgical bed– Used for patient returning from surgery or to be

admitted from stretcher– Linen is fanfolded to the side of the bed– Raise bed to stretcher height– Place all needed equipment (vitals equip, emesis

basin, tissues) next to the bed

Procedures

Occupied Bed Unoccupied Bed

If you can make an occupied bed, an unoccupied bed change will be easy

Opening a Closed Bed Making a Surgical Bed

Admission

“Open” the bed Determine how your patient will arrive Determine what you will need Greet resident and family (family may be

asked to go to waiting room while you prepare resident

Provide privacy

Admission

Assist patient to change clothes if needed Obtain assessments:

– Vital Signs, Ht and Wt– Skin assessments– Belongings inventory

Orient to unit– Call bell, bed controls, bathroom features, TV, visiting

hours, mealtime routines Assist in unpacking/storing items if needed

Transfers

Check with the nurse for instructions Verify that the receiving unit is ready for the

resident Gather all personal belongings and

equipment that is to be transferred with the resident

Follow facility procedure for handling valuables

Transfers

Transfer resident via ______ according to instructions from the nurse, ensure resident safety

Ensure resident knows how to use call bell, bed before leaving in new location

Document according to facility protocol, Make sure all personal belongings and valuables

are transferred– Check inventory with receiving healthcare worker

Discharge

Check with the nurse for instructions Gather all personal belongings and equipment that is

to be sent home with the patient– Follow facility procedure for handling valuables– Make sure all belongings and valuables are sent with

patient upon discharge and not left in room

Transfer patient via ______ according to instructions from the nurse, ensure resident safety

Document according to facility protocol