Bedmaking
Making a Surgical Bed
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Safety
- Use Standard Precautions when making a surgical bed.
- Be sure to wear clean gloves to remove soiled linen. Hold soiled linen away from your uniform, and avoid shaking or fanning it.
- Assess the environment for safety, such as checking the room for spills and making sure equipment is working properly.
- Use proper body mechanics when making a surgical bed.
- Be sure to lock the wheels on the bed to prevent accidental movement while making the bed.
- Remember to lower the side rails when preparing to make the bed.
Equipment
(Roll cursor over items to see labels)
Bottom Sheet (flat or fitted) and Drawsheet (optional)
Large, quilted waterproof pad (optional)
Top sheet
Bath blanket
Bedspread
Pillowcases
Clean gloves
Antiseptic cleanser or wipes
Towels or washcloth
Linen bag
PrintableDelegation
The skill of making a surgical bed can be delegated to nursing assistive personnel (NAP). Be sure to inform NAP of the following:
- Specify that Standard Precautions are to be used when making a surgical bed.
- Specify any position or activity restrictions that can be expected when the patient returns.
- Specify any special linen instructions, such as when the patient is on an airflow mattress.
Preparation
- Perform hand hygiene
- Use Standard Precautions when making a surgical bed. Wear gloves when removing soiled linen. Assess the environment for safety, such as checking the room for spills and making sure equipment is working properly.
- Assemble all equipment on the clean and dry bedside table.
- Use body mechanics principles when making the bed.
- Adjust the bed to working height. Lower the side rails.
Follow-up
- Transfer the patient into bed.
- Ask if the patient is comfortable.
- Ensure that the call light is within the patient's reach.
- Periodically check the linen for cleanliness and tightness.
Documentation
The making of a surgical bed is not documented in the medical record.
Review Questions
1. When making a surgical bed with no patient present, at which time is it unnecessary to perform hand hygiene?
Before making the bed- After gloving, washing the mattress with an antiseptic solution, and ungloving
After disposing of soiled linen that is not visibly soiled- After fanfolding the sheets to complete the open bed
INCORRECT. The nurse would perform hand hygiene before beginning the process of bedmaking.
INCORRECT. The nurse would apply gloves to wash the mattress with an antiseptic solution, and perform hand hygiene after removing and discarding the gloves.
CORRECT. The nurse need not perform hand hygiene after disposing of linen that is not visibly soiled.
INCORRECT. The nurse would perform hand hygiene after making the bed.
2. A new nursing assistive personnel (NAP) is making a surgical bed for a patient who is having abdominal surgery. Where will you instruct the NAP to place the waterproof pad on this bed?
- Over the mattress
- Over the bottom sheet
- Over the top sheet
- A waterproof pad should not be used for this patient.
INCORRECT. If a waterproof pad is used, it is placed over the bottom sheet, where it can draw away any wound drainage or other body fluids from the patient’s skin.
CORRECT. If a waterproof pad is used, it is placed over the bottom sheet, where it can draw away any wound drainage or other body fluids from the patient’s skin.
INCORRECT. If a waterproof pad is used, it is placed over the bottom sheet, where it can draw away any wound drainage or other body fluids from the patient’s skin.
INCORRECT. A waterproof pad can be used for any patient for whom the nurse or NAP deems the intervention necessary.
3. For a surgical bed, why is the linen formed into a triangle and fanfolded away from the side on which the patient will be transferred?
- To protect the linen from soiling
- To ensure that the toe pleat is not pulled out
- To keep the linen out of the way during the transfer
- To keep the flat sheet taut during the transfer
INCORRECT. The linen is formed into a triangle and fanfolded in order to keep the linen out of the way as the patient is transferred from the stretcher. Patient safety, not hygiene, is of paramount concern during the transfer.
INCORRECT. The linen is formed into a triangle and fanfolded in order to keep the linen out of the way as the patient is transferred from the stretcher. A surgical bed does not have a toe pleat.
CORRECT. The linen is formed into a triangle and fanfolded in order to keep the linen out of the way as the patient is transferred from the stretcher.
INCORRECT. The linen is formed into a triangle and fanfolded in order to keep the linen out of the way as the patient is transferred from the stretcher. Fanfolding the linen has no effect on the flat sheet.
4. A nursing assistive personnel (NAP) has finished making a surgical bed for a patient in surgery. How would the nurse instruct the NAP to leave the bed to transfer the surgical patient safely?
- Raise the head of the bed to a 30-degree angle.
- Raise the top two side rails.
- Raise the height of the bed.
- Release the bed wheels.
INCORRECT. A surgical bed is placed in the high position, with side rails down and wheels locked. The head of the bed must be flat to facilitate safe transfer of the patient from the stretcher to the bed.
INCORRECT. A surgical bed is placed in the high position, with the head of the bed flat and the wheels locked. The side rails must be down to facilitate safe transfer of the patient from the stretcher to the bed.
CORRECT. A surgical bed is placed in the high position, at the level of the stretcher, with side rails down, wheels locked, and the head of the bed flat. This position facilitates safe transfer of the patient from the stretcher to the bed.
INCORRECT. A surgical bed is placed in the high position, with the head of the bed flat and the side rails down. The wheels must be locked to keep the bed stationary as the surgical patient is transferred from the stretcher to the bed.
5. When making a surgical bed, why does the nurse avoid shaking the linen being removed from the bed?
- To keep the linen folded correctly
- To prevent contamination to the environment and the nurse’s uniform
- To keep it separate from the towels and washcloths in the linen bag
- To reduce the amount of time needed to make the bed
INCORRECT. The nurse avoids shaking the used linen in order to prevent contamination to the environment and the nurse’s uniform with microorganisms. Linen is not folded before it is laundered.
CORRECT. The nurse avoids shaking the used linen in order to prevent contamination to the environment and the nurse’s uniform with microorganisms.
INCORRECT. When making a surgical bed, the nurse will avoid shaking the used linen in order to prevent contamination to the environment and the nurse's uniform with microorganisms. Sheets and towels need not be kept separate before they are laundered.
INCORRECT. When making a surgical bed, the nurse will avoid shaking the used linen in order to prevent contamination to the environment and the nurse’s uniform with microorganisms. This action does not pertain to time or efficiency.
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