Special Bed Making

Introduction and Principles of Special Bed Making

Special bed making involves arranging hospital beds in specific ways to meet the therapeutic, diagnostic, or comfort needs of patients. Unlike standard unoccupied beds, these variations require careful planning based on the patient's medical condition. Several core principles guide this practice across Nigerian healthcare facilities:

• Infection control: Prevent the spread of microorganisms by avoiding the shaking of soiled linen and keeping dirty linen away from the uniform.
• Patient comfort: Ensure wrinkle-free sheets to prevent pressure sores and skin breakdown, especially for immobile patients.
• Body mechanics: Maintain a wide base of support and adjust the bed height to protect the nurse's back during the procedure.
• Efficiency: Gather all necessary equipment before starting to minimize trips and reduce patient exposure.

General Equipment and Infection Control in Bed Making

Preparing a special bed requires a standard set of linen and protective supplies assembled on a clean trolley or chair. Standard items include a mattress cover, bottom sheet, draw sheet, waterproof sheet, top sheet, blanket, and pillowcase. Additional equipment depends on the specific bed type, such as extra pillows for a cardiac bed or an IV pole for an operation bed.

Infection control remains paramount throughout the process. Nurses must wear a plastic apron to protect their uniforms from patient flora or bodily fluids. Soiled linen must be rolled tightly inward, placed directly into a designated laundry hamper, and never held against the nurse's body. Hand hygiene must be performed before handling clean linen and immediately after discarding used materials.

Admission Bed

An admission bed, also known as an unoccupied or open bed, is prepared to receive a new ambulatory or semi-ambulatory patient from the clinic or emergency department. The top covers are fan-folded either to the side, to the foot of the bed, or diagonally to make getting into bed as easy as possible for the arriving patient.

The bed should look welcoming and neat. Essential diagnostic or admission equipment, such as a thermometer, sphygmomanometer, and admission chart, should be readily available on the bedside locker. If an emergency admission is expected, extra equipment like an oxygen mask or suction catheter should be placed nearby out of sight but within immediate reach.

Operation Bed

An operation bed, or postoperative bed, is designed to receive a patient returning from the theater who is still unconscious or recovering from anesthesia. The primary objective is to facilitate safe transfer from the trolley and maintain a warm, accessible environment.

1. Top linen arrangement: The top sheet, blanket, and counterpane are folded triangularly to one side or rolled to the bottom to allow easy lifting of the patient.
2. Warmth provision: Hot water bottles or warming blankets may be used to keep the bed warm, provided they are covered properly to prevent thermal burns in vulnerable patients.
3. Access and safety: Side rails are kept up, and an IV pole, emesis basin, and suction apparatus are positioned nearby.

Cardiac Bed

A cardiac bed is arranged for patients experiencing severe heart failure, pulmonary edema, or acute respiratory distress. These patients cannot lie flat due to orthopnea. The bed must support an upright or semi-sitting position.

• Backrest and Pillows: A cardiac bed features an elevated backrest supported by multiple arrangement of pillows to keep the patient in a high Fowler's position.
• Overbed Table: A cardiac table with a pillow is placed across the patient's lap, allowing them to lean forward, which relieves pressure on the chest and uses accessory muscles for breathing.
• Foot Support: A footrest or rolled blanket at the bottom prevents the patient from sliding down due to gravity.

Patient Safety, Comfort, and Ergonomics

Bed making directly impacts clinical outcomes through patient safety and nurse wellness. Ergonomics plays a daily role: nurses should adjust the adjustable bed to waist height before starting to prevent lower back strain. Bending over low beds for extended periods causes cumulative musculoskeletal injuries.

For the patient, safety involves ensuring side rails are secured when indicated, wheels are locked before any transfer, and call bells are within reach. Comfort is maintained by checking that no crumbs, wrinkles, or hard plastic equipment remnants press against the patient's skin. Regular repositioning keeps the skin intact and promotes optimal circulation.