Wednesday , September 19 2018
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unit preparation admission preparation

UNIT PREPARATION FOR PATIENT

Purpose

  • To welcome the patient and establish a positive relationship with patient and close relative.
  • To offer immediate management and care in acute conditions.

Scope

In-Patient Department

Definition

A unit is kept ready with beds along with the surroundings to receive the patient.

Applicable areas

All Departments

Responsible person

Staff Nurse, Ward Clerk, Head Nurse and Housekeeping Staff

Procedure

Follow the basic principles for bed making such as 

  • Use clean and untorn linen.
  • Avoid linen from touching uniform or floor.
  • Use principles of body mechanics to conserve energy and time for the nurse.
  • Take help in making the bed, if required.
  • Check that the mattresses and pillows have plastic covers.

Keep the following articles ready 

  • Chair / Over bed table.
  • Dirty linen hamper.
  • Cleaning agent for terminal disinfection of bed.
  • Damp duster.
  • Mattress with plastic cover.
  • Pillows and Bed sheets – 2
  • Draw mackintosh as required.
  • Draw sheet.
  • Blanket(s)

Prepare bed for an Ambulatory patient (Open Bed) as described

  • Collect all needed articles on a chair / over bed table.
  • Explain to the patient and communicate with the patient throughout the procedure.
  • Take off bed-clothes by folding one by one and place them in the dirty linen hamper.
  • Take pillows and change cover(s) (put dirty covers into the hamper).
  • Discard dirty bed sheet into the hamper.
  • Place mattress in position, fix the mattress cover without wrinkles.
  • Spread bed sheet and make box (mitered) corners on your side of the bed.
  • Spread draw mackintosh and draw sheet and tuck them.
  • Go to the other side of the bed.
  • Make box corners of the sheet at the head and foot end of the bed. Tuck draw mackintosh and draw sheet neatly without wrinkles on the side.
  • Spread top sheet to the full length of the mattress.
  • If patient is not in the bed, fan fold top sheet to the foot end of the bed.

Provide After Care (applicable for any type of bed making procedure) as mentioned

  • Place the bed in the alignment with other beds.
  • Lock bed wheel.
  • Keep locker on working side of the patient.
  • Place chair at the foot end of the bed and remove extra equipment from bedside.
  • Wheel hamper bag to the dirty utility room.
  • Wash and dry duster and basin.
  • Wash hands.

Make bed for an occupied patient as described 

  • Collect all the articles and bring to bedside.
  • Talk to the patient and explain how he could be involved in the procedure.
  • Wash hands.
  • Arrange linen in order of use on the over-bed table after cleaning the surface of the table.
  • Pull curtain closed.
  • Adjust the bed to a comfortable working height.
  • Lower side rail on open side of the bed, but make sure side rail on the opposite is in the up position.
  • Loosen top linen.
  • Remove all top linen and place in hamper bag and leave patient covered with one sheet. If they are to be reused, fold them and place them on the chair.
  • Push mattress to head of bed. Center the mattress, if necessary (Take help, if required).
  • Assist patient to the side of the bed, place in side lying position facing away from you, as near as the far side rail as possible.
  • Loosen used bottom linens and gather under or as close to the patient as possible.
  • Clean the exposed surface of the draw mackintosh and roll it towards the patients back.
  • Clean the mattress cover.
  • Place clean bottom sheet on mattress and centerfold of the sheet should be in the middle of the mattress. Leave enough length of linen at the top and bottom end of the mattress.
  • Open the bottom sheet on your side and cover the mattress. Gather the remaining part of the clean bottom sheet towards the patient back and over the used linen. Tuck the top of the remaining bottom sheet under the head of the bed making the mitered corner.  Tuck the top of the remaining bottom sheet under the mattress at the foot end of your side of the bed.
  • Unfold the cleaned draw mackintosh (if used) smooth out wrinkles.
  • Place draw sheet folded in quarters lengthwise over the draw mackintosh. Open out one quarter; gather the remaining towards the patient after spreading new mackintosh sufficiently to cover the exposed draw mackintosh on your side.
  • Tuck the draw sheet along with the draw mackintosh on your side.
  • Help patient roll over to your side of the bed. Make the patient comfortable.  Fix side rails in up position.
  • Move to the other side.
  • Loosen the bottom linen and gently remove the used bottom sheet and draw sheet. Discard into linen hamper bag.
  • Do not place dirty linen on the floor.
  • Repeat cleaning of the mattress cover and of the mackintosh as on the other side.
  • Pull clean bottom linen across the mattress and tuck in as done on the other side.
  • Help patient into a supine position. Place the bed rails in up position, if required.
  • Place the clean top sheet across the patient at the bottom end of the bed; draw it up to the level of the chest of the patient.
  • Remove the used top-sheet from up to down under cover of the clean top-sheet.
  • Leave a 6 inches cuff of top sheet at the head of the bed (below the level of the patient’s chest).
  • Miter the corner of the top sheet at foot end of bed, but do not tuck. Use blanket over the top sheet, if necessary.
  • Cover head end of blanket with the cuff of the top sheet. Make sure that the top linen forms a cuff at the level of the patient’s chest.
  • Pull up all layers of linen over patient’s toes. Make a small toe pleat.
  • Return bed to the position desired. Check if patient is comfortable. Dispose off soiled linen and wash hands
  • Remove pillow from bed and change pillowcase. Keep open end of the pillowcase away from the entrance to the patient’s unit.
  • Prepare operation bed as described.
  • Prepare an unoccupied bed.
  • The top sheet and blanket should not be tucked at the bottom end, but should be tucked from one side away from the entry to the bed and kept rolled.
  • The pillow should not be placed on the bed.
  • Keep bed blocks at the bedside.
  • Keep I.V. stand, Kidney tray, sputum mug as well as napkin or tissue paper at the bedside.
  • Ensure that the source of oxygen and suction is kept ready.
  • Ensure that the bedside locker and the over bed table is kept clean and tidy at all times.
  • Instruct relatives / patients to keep the toilet articles inside the locker after use.
  • Encourage relative to take away old newspaper and extra articles from the patient’s bedside.
  • Ensure that the unit is tided up at all times and minimum in each shift, as well as when the patient is shifted to other department for procedure.
  • Ensure that the unoccupied bed is kept covered with a counter pane at all times.

Note

In case of terminal disinfection of the unit all the articles inclusive of bed railing mattress, pillow, etc. should be wiped / cleaned with a disinfectant solution.

Reference

Documentation