Bedmaking and Unit Care

67 10 Bedmaking and Unit Care 1. Define important words in this chapter 2. Discuss the importance of sleep 3. Describe types of sleep disorders 4. Identify factors affecting sleep 5. Describe a standard resident unit and equipment 6. Explain how to clean a resident unit and equipment 7. Discuss types of beds and demonstrate proper bedmaking Supplemental Tool chapter 10: exam Assignments textbook reading, pp. 151-165 workbook exercises, pp. 59-61 Overview of Teaching Strategies The focus of this chapter is the resident s home, or unit. It should be emphasized that the resident has the right to privacy in her room as well as security of personal possessions. The students will learn about the importance of sleep and the factors that may cause residents to have problems sleeping. It is a good idea to remind students again to empathize with residents. Residents might be sharing a room for the first time with another person and not just a room, but also an entire living space, i.e., the care facility. A standard unit is described; if applicable, this is a good time to show the students how units in your facility are set up. Students will learn how to clean a resident s unit and equipment, with emphasis placed on proper infection prevention methods and body mechanics. They will also learn about the different kinds of beds found in a facility and how to make beds properly. 1. Define important words in this chapter textbook p. 151 Pronounce and define each of the key terms listed in the Learning Objective on page 151. 2. Discuss the importance of sleep textbook pp. 151-152 Sleep Biorhythms Circadian rhythm Review the following important points about sleep: The human body cannot survive for long without sleep. Sleep is needed to replace old cells with new ones and provide energy to organs. Sleep is vital to proper physical and mental development. 3. Describe types of sleep disorders textbook p. 152 Insomnia Parasomnias

68 Review some of the reasons that people develop sleep disorders: Illness Fear Stress Medications Trouble breathing Noise Hunger Thirst Discuss the following sleep disorders: Somnambulism Sleeptalking Bruxism REM sleep behavior disorder 4. Identify factors affecting sleep textbook pp. 152-155 workbook pp. 59-60 and Discussion Incontinent Depressant Stimulant Review some factors that may affect residents sleep: Environment Noise level and lighting Problems with odors and inadequate ventilation Temperature problems Illness Aging changes Dietary habits Medications, alcohol, and cigarettes Review some of the problems that can be caused by not sleeping well: Decreased mental function Reduced reaction time Decreased immune system function Irritability Ask the students to remember a time when they were adversely affected by not sleeping well. Ask them if they have had problems sleeping and whether they have any special methods to help them sleep. 5. Describe a standard resident unit and equipment textbook pp. 155-156 workbook p. 60 Remind students that residents units are their homes. Stress that residents have a right to privacy, and that a nursing assistant must always knock and wait for permission before entering a resident s room. Emphasize that residents personal items should always be respected and handled carefully. Review some of the standard equipment that is found in residents rooms: Bed Bedside stand Overbed table Chair Bath basin Emesis basin Bedpan Urinal for males Water pitcher and cup Privacy screen or curtain Call light Review the items that are usually stored in the bedside stand: Emesis basins Bath basins Urinals Bedpans Soap Toothbrushes and toothpaste Combs and brushes

69 Explain that personal articles are usually kept in the top drawer, and that they must be kept separately from basins, urinals, and bedpans. Discuss the use of the overbed table for meals and personal care, emphasizing that it must be kept clean. Bedpans, urinals, and soiled linen should never be placed on it. It should be kept free of clutter. 6. Explain how to clean a resident unit and equipment textbook pp. 156-157 workbook pp. 60-61 Pronounce and define the following key term: Disposable Explain that disposable equipment is used to prevent the spread of microorganisms. Review common disposable equipment found in facilities: Cups Tissues Gloves Paper gowns Masks Disposable razors Pads Review the guidelines for residents units: Keep residents units neat and clean. Keep call lights within resident s reach. Straighten bed linens and remove crumbs before leaving the room. Re-stock resident supplies daily. Notify housekeeping department if bathroom needs cleaning. Check equipment to make sure it is working and not damaged. Refill water pitchers regularly. Remove anything that might cause odor or safety hazards. Report signs of insects or pests immediately. Leave residents personal items where you found them. Review the guidelines for cleaning a unit after a transfer, discharge, or death: Wash hands. Wear gloves and proper PPE. Remove and dispose of equipment and supplies carefully. Raise bed to safe working level and remove soiled linen. Make sure area is well-ventilated when using strong cleaning solutions. Write repair orders for damaged or broken furniture. Remove PPE and wash hands. Place new equipment and supplies in room for new resident. 7. Discuss types of beds and demonstrate proper bedmaking textbook pp. 157-165 workbook p. 61 Review some of the reasons that proper bedmaking is important: The resident will spend a great deal of time in bed. Neat, well-made beds help the resident sleep better. Careful bedmaking prevents infection. A clean, neat, and dry bed helps prevent skin breakdown and odors and promotes good health. Discuss the different kinds of beds and features that may be found in a facility: Electric beds Beds with built-in weight scales Alternating pressure mattresses Bariatric beds Emphasize that beds should remain locked in their lowest positions whenever residents are in the beds. If applicable, tell the students about the different kinds of beds that are used in your facility.

70 Review guidelines for bedmaking: Change bed linens when they are wet, soiled, or wrinkled. Wash hands and use proper infection prevention methods. Wear gloves when removing soiled linens. Gather linen in order of placement on the bed. Carry clean linen away from uniform. Bring linen into one resident s room at a time. Never transfer linen from one room to another. Place clean linen on a facility-approved spot. Use proper body mechanics. Look for personal items. Roll dirty linen away from you. Do not shake linen. Place used linen in proper container. Make one side of bed first to save energy. Keep beds free of wrinkles and crumbs. Wash hands after handling linens. Closed bed Open bed Draw sheet Occupied bed Unoccupied bed Surgical bed Demonstration Demonstrate each of the following procedures, including all of the numbered steps in your demonstration: Making a closed bed Making an open bed Making an occupied bed Making a surgical bed Have the students return each demonstration. Procedure checklists are located at the end of the Student Workbook. Chapter Review Exam distribute chapter 10: exam (appendix c, pp. 309-310) Allow students enough time to finish the test. See Appendix D for answers to the chapter exams. Answers to Chapter Review in Textbook 1. Answers include: Sleep is a natural period of rest for the mind and body. Energy is restored. Sleep helps to replace old cells with new ones and provides new energy to organs. 2. Answers include: illness, anxiety, fear, stress, medications, trouble breathing, noise, hunger, and thirst. 3. Answers include: Environment Listen to residents if they wish to talk. Be compassionate and reassuring. Have enough pillows and blankets. Make sure mattresses fit properly and are not damaged or lumpy. Noise level and/or lighting Keep the noise level low. Closing doors at night may help. Keep your voice low. Do not bang equipment or metal trays. Use blinds or shades to help darken a room for sleep. Keep light controls within residents reach. Problems with odors and inadequate ventilation Change incontinent briefs often. Keep equipment and supplies clean. Give personal care often to help avoid breath and body odors. Change soiled bed linens and clothing as soon as possible. Open a window to help eliminate odors. Temperature problems Help find a comfortable temperature for residents. Report to the nurse if the temperature is a problem. Layer clothing and bed covers. Anxiety Sit with residents and listen if they want to talk. Use touch and soothing words. Offer to give a back rub. Report to the nurse if a resident is anxious. Illness Make sure residents are clean and comfortable before bed. Observe and report signs of pain promptly to the nurse. You may be asked to help by giving a back rub or a bath.

71 Aging changes Assist residents to the bathroom just before bedtime. Honor fluid restrictions in the evening if they are ordered. Use music or reading to help the resident to fall asleep. Provide naps as needed throughout the day. Encourage residents to exercise if it is in their care plan. Encourage residents to wear day wear instead of night clothes during the day. Dietary habits Limit caffeine intake. Avoid serving heavy meals. Serve meals earlier in the evening, not late at night. pillows in place. A closed bed is turned into an open bed by folding the linen down to the foot of the bed. 13. The NA should observe the resident s skin for signs of breakdown. 14. A surgical bed is made to accept residents returning to bed on stretchers, after they have had treatments or a hospital visit. Medications, alcohol, and cigarettes Report if residents are not taking medications ordered for sleep. Report any evidence of unusual sleepiness or sudden inability to fall asleep. Discourage smoking and drinking alcohol before bedtime. 4. Answers include: emesis basins, bath basins, urinals and bedpans; soap, toothbrushes, toothpaste, combs and brushes; a telephone and/or radio, along with other personal items 5. The overbed table may be used for residents meals or personal care. Bedpans, urinals, and soiled linen should not be placed on overbed tables because these tables are used for food. 6. Within the resident s reach 7. Disposable equipment will be used one time and then discarded. 8. Answers include: Neat, well-made beds can help the resident sleep better each night. Careful bedmaking prevents infection. A clean, neat, dry bed helps prevent skin breakdown and odors, and promotes good health and overall comfort. 9. Residents can develop pressure ulcers when left in wet, wrinkled, or soiled linens. 10. If clean linen touches the nursing assistant s uniform, it becomes contaminated. 11. Shaking linen may spread airborne contaminants. 12. A closed bed is usually made for a resident who will be out of bed all day. It is a completely made bed with the bedspread, blankets and