Beds and Bed Making in Healthcare

Occupied Beds

An occupied bed is made while the client remains in it. This procedure is necessary for clients who are totally or partially confined to bed due to illness, injury, or weakness.

Postoperative (Surgical) Beds

A postoperative bed is a specialized setup designed to receive a client returning from surgery on a stretcher. To facilitate a safe and easy transfer, the bed is typically kept in a high position, and the top linens are fan-folded to the side of the bed rather than the foot.

Specialized Equipment and Devices

Modern healthcare often utilizes the Gatch bed, an electric or manual adjustable bed that allows caregivers to change the height and the angle of the head and foot sections. This adjustability is crucial for facilitating care and ensuring client comfort.

To further support specialized needs, several devices may be used:

• Bed Cradle: A metal frame placed under the covers to keep top linens from touching the client's body, which is useful for clients with severe skin sensitivity or burns.
• Trapeze: An overhead device that allows clients to use their upper body strength to assist in moving or repositioning themselves in bed.
• Specialized Mattresses: To prevent pressure injuries, facilities use egg crate mattresses or flotation mattresses to distribute weight more evenly.
• Footboard: This is used to keep the feet in a neutral position and prevent footdrop.
• Side Rails: These are used to assist in positioning or to provide safety, though their use must be monitored according to facility policy to prevent entrapment.

Clinical Best Practices and Procedures

To ensure high-quality care, healthcare providers must follow specific clinical standards during bed making.

Linens and Skin Protection

Linens should be changed whenever they become soiled or according to the facility's specific policy, often following morning care. When applying linens, caregivers should use a draw sheet (a smaller sheet placed across the middle of the bed to assist with moving the client) and incontinence pads to protect the mattress from moisture.

To maintain skin integrity, it is essential that linens are:

• Smooth and wrinkle-free: Wrinkles are a primary cause of skin irritation.
• Mitered: Corners should be mitered (tucked tightly at specific angles) to ensure the linens stay secure and remain smooth.

Caregiver Safety: Body Mechanics

Making beds can be physically demanding. Caregivers must utilize proper body mechanics to prevent injury. This includes:

• Adjusting the bed to a comfortable working height during the procedure to prevent back strain.
• Lowering the bed to its lowest position when finished to ensure client safety.

Exam Tip: Prioritization When assessing a client in bed, always prioritize the "ABCs" (Airway, Breathing, and Circulation). For example, if a client in bed suddenly reports difficulty breathing, this is a higher priority than addressing wrinkled linens or skin care.

Summary Table: Bed Types at a Glance