Nursing –Level III

Based on January 2022, Version I Curriculum

Module Title: Prepare and Maintain Beds

Module Code: HLTNUR3 M04 0122
Nominal duration: 99hours
Prepared By: Ministry of Lobar and Skill

August, 2022
Addis Ababa, Ethiopia

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Acknowledgement

Ministry of Labor and Skills and Ministry of Health wish to extend thanks and appreciation to
representatives of, Jimma University, TVET instructors, ENA, Arbaminch, Desie, Shashamene
and Pawie health sciences college instructors and respective industry experts who donated their
time and expertise to the development of this Teaching, Training and Learning Materials
(TTLM).

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 Table of Contents

Acknowledgement........................................................................................Error! Bookmark not defined.

Table of Contents..........................................................................................................................................II

Acronyms.....................................................................................................Error! Bookmark not defined.

List of Figures..............................................................................................Error! Bookmark not defined.

Introduction to Bed making...........................................................................................................................1

Unit one: Preparation for Bed making...........................................................................................................3

1.1. Equipment used for bed making.............................................................................................................3
1.1.1. Organizational policy during bed making..........................................................................................3
1.1.2. Personal protective equipment (PPE)...............................................Error! Bookmark not defined.
1.2. Adjusting the height of the bed..............................................................................................................6
1.3. Cleaning beds and area of other equipment..........................................................................................18
1.3.1. Cleaning a client area........................................................................................................................18
1.4. Check bed linen for displace personal items........................................................................................19

Self-Check -1...............................................................................................................................................20

Unit Two- Make a bed.................................................................................................................................23

2.1. Maintain client’s dignity and privacy..................................................................................................24
2.2. Striping bed linen................................................................................................................................27
2.2.1. Operation sheet -1 Procedures on Stripping of a bed.......................................................................28
2.2.2. Operation sheet-2 Making Unoccupied Bed (Closed bed)...............................................................29
2.2.3. Operation Sheet-3 Open bed.............................................................................................................31
2.2.4. Operation Sheet-4 Making an unoccupied Bed................................................................................33
2.2.5. Operation Sheet-5 Making cardiac bed............................................................................................35
2.2.6. Operation Sheet-6 Post-operative/anesthetic bed making................................................................37

2.2.7. Operation Sheet-7 Making an amputation bed.................................................................................39

2.2.8. Operation Sheet-8 Fracture bed making...........................................................................................41
2.2.9. Operation Sheet-9 Baby crib.............................................................................................................42

Practical Demonstration & LAP Test.....................................................................................................42-46

2.3. Removing clinical waste and soiled linen............................................................................................45
2.4. Clean the bed........................................................................................................................................46
2.4.1. Re-positioning the existing bed linen...............................................................................................47
2.5. Handling reusable clean bed linen.......................................................................................................48
2.6. Cleaning mattresses and pillows regularly and on discharge..............................................................50

Self-Check-2 Written Test.................................................................................................................51

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Unit Three: - Leave bed ready for occupancy or continued occupancy......................................................52
3.1.1. Reporting damaged Beddings...........................................................................................................52

Self-Check-3................................................................................................................................................53

Unit Four: - Manage Linen Stock at User-Locations...................................................................................54

4.1. Collecting soiled linen.........................................................................................................................55
4.2. Transport soiled linen..........................................................................................................................56
4.3. Identifying and reporting hazard..........................................................................................................56
4.4. Re-stocking linen.................................................................................................................................57
4.5. Rotating linen stock.............................................................................................................................57
4.6. Returning old stock for reprocessing...................................................................................................58
4.6.1. Principles and key steps in processing linen.....................................................................................58
4.7. Maintaining optimum stock levels.......................................................................................................58
4.7.1. Requisitioning linen to the pre-determined quantity levels..............................................................58
4.8. Maintaining storage and security of linen............................................................................................59
4.9. Maintaining linen stock records...........................................................................................................59

Self-Check -4...............................................................................................Error! Bookmark not defined.

References....................................................................................................................................................61

Developers Profile.......................................................................................................................................62

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Acronyms
AIDS Acquired Immuno Deficiency Syndrome
HCTs Health Care Textiles
HCV Hepatitis C Virus
HIV Human Immuno Deficiency Viruses
LAP-test Learning Activity Performance-test
PPE Personal Protective Equipment
TRSA Textile Rental Service Association

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List of Figures

List of Tables

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Introduction to Bed making
Bed making is an essential procedure in nursing in which nurses prepare and arrange different
types of beds for the client’s comfort in the Hospital or other care institutions. Bed making
procedures ensures the patients comfort according to the situation. It may vary on the client’s
conditions, purposes and procedures such as open bed, closed bed, occupied bed, fracture bed,
etc. There are work practices which are required for the basic level of infection control and need
to be used for the general care of all patients/clients units. Some health care facilities require that
only soiled linen be changed if the same patient/client will be using the bed. Obviously soiled or
contaminated linen must be replaced. In most cases you will need to follow standard precautions
when cleaning the bed.

They include:

Good hygiene and cleaning

practices. The use of PPE where

necessary.

Appropriate handling and disposal of sharps and other contaminated or infectious waste.

Use of aseptic techniques.

There will be occasions when you will be directed to use additional precautions. These are
necessary if a patient is suspected of, or known to be, infected with highly transmissible
organisms. These precautions are designed to interrupt further transmission of infection and are
used in addition to standard precautions.

This unit is provided as a collective unit for nursing level III Workers who have a
multifunctional role within a heath care facility but can also be adapted for workers who have a
more specific support role in relation to providing quality health care services. It covers the skills
and knowledge which you need to apply when cleaning and making a height of beds to ensure
that a patient/client can safely occupy the bed. However, by completing this unit you will gain a
better understanding of your role and responsibilities in a health care setting and thereby improve
your existing skills and knowledge in your current work role.

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Module units: - This learning guide is developed to provide you the necessary information
regarding the following content coverage and topics:

 Preparation for bed making

 Bed making
 Making bed ready for occupancy
 Manage linen Stock at User-Locations
Learning objectives of the Module
This guide will also assist you to attain the Unite stated in the above page. At the end of this
session, the students will able to:

 Adjust height of the bed when necessary

 Clean bed and surrounding areas.
 Check bed linen for displaced personal items
 Place aids and equipment in the appropriate area/container
 Perform all types of bed making
Module Learning Instructions:
1. Read the specific objectives of this Learning Guide.
2. Follow the instructions described below.
3. Read the information written in the information Sheets
4. Accomplish the Self-checks
5. Perform Operation Sheets
6. Do the “LAP test”

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Unit one: Preparation for Bed making

This learning unit is developed to provide the trainees the necessary information regarding the following content cov
Equipment used for bed making
Adjusting height of the bed
Cleaning the bed and the surrounding
Check the bed linen
This unit will also assist you to attain the learning outcomes stated in the cover page. Specifically, upon completion
Identify equipment used for bed making
Adjust height of the bed

Clean the bed and the surrounding

Check the bed linen

Learning Instructions:
Read the specific objectives of this Learning Guide.

Follow the instructions described.

Read the information written in the unit

Accomplish the “Self-check”.

Equipment used for bed making

1.1.1. Organizational policy during bed making.

In a health care facility you must ensure that you work within Occupational Safety and Health
Act and your organizations policy and procedure. In the preparation and maintenance of beds
nurses should be aware of the need to follow safe manual handling practices and techniques.

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Organizational policy should have the responsibilities of all trust staff on the importance of
correct and safe management of linen procedures, from storage to handling, bagging,
transporting and laundering. It is important that everyone who comes into contact with linen is
aware of the risks and also the appropriate precautions to take to prevent the transmission of
microorganisms.
You will also need to adopt organizational and infection control procedures including the use of
personal protective equipment (PPE) while completing the task.

Personal protective equipment (PPE)

Definition: PPE is an equipment that can protect health care workers from exposure to
potentially contaminated blood or other body fluids and clients from microorganisms present on
medical staff and others working in the healthcare setting. Protective barriers and clothing, now
commonly referred to as personal protective equipment (PPE), have been used for many years to
protect clients from microorganisms present on medical staff and others working in the
healthcare setting. More recently, with the emergence of HIV/AIDS and HBV/HCV and
resurgence of tuberculosis in many countries, PPE now become important for protecting the
healthcare providers as well.
The Health workers must follow all Organizational policy and procedures within their
organization regarding infection control. The procedures will include standard or additional
Precautions and you should be aware of which precautions you should be using before you start.

Caps are used to keep the hair and scalp covered so that flakes of skin and hair are not shed into
the wound during surgery. Caps should be large enough to cover all hair.

Eyewear protects staff in the event of an accidental splash of blood or other body fluid by
covering the eyes. Eyewear includes clear plastic goggles, safety goggles, and faces shields.
Prescription glasses are also acceptable. Masks and eyewear should be worn when performing
any task where an accidental splash into the face could occur. If face shields are not available,
goggles or glasses and mask can be used together.

Footwear is worn to protect feet from injury by sharp or heavy items or fluids that may
accidentally fall or drip on them. For this reason, sandals, “thongs” or shoes made of soft
materials are not acceptable. Rubber boots or leather shoes are acceptable, but they must be kept
clean and free of contamination from blood or other body fluid spills.

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Gloves protect hands from infectious materials and protect patients from microorganism on staff
members’ hands. They must be worn anytime there is a possibility of contact with potentially
infectious materials or when handling contaminated waste or cleaning or disinfecting
instruments. Gloves should be changed between each client contact to avoid cross contamination.
Gloves should not be worn for non-critical procedures such as bed making; however, handling
visibly soiled linen requires utility gloves.

Mackintosh or plastic apron is used to protect clothing or surfaces from contamination. Aprons
made of rubber or plastic provide a waterproof barrier along the front of the healthcare worker’s
body and should also be worn during procedures where there is a likelihood of splashes or
spillage of blood, body fluids, secretions or excretions (e.g., when conducting deliveries).

Masks should be large enough to cover nose, lower face, jaw and all facial hair. They are worn
in an attempt to contain moisture droplets expelled as health workers or surgical staff speak,
cough or sneeze, as well as to prevent accidental splashes of blood or other contaminated body
fluids from entering the health workers’ nose or mouth. Unless the masks are made of fluid
resistant materials, however, they are not effective in preventing either very well. Scrub suits or
cover gowns are worn over, or instead of, routine clothes. A V-neck shirt must not be cut so low
as to slide off the wearers’ shoulders or expose men’s chest hair.

Surgical gowns were first used to protect patients from microorganisms present on the abdomen
and arms of the healthcare staff during surgery. Lightweight cloth gowns, generally available in
Ethiopia, however, offer little protection. Under the circumstances, either wear a plastic apron
before putting on the surgical gowns or, if large spills occur, take shower or bathe as soon as
possible after completing the surgery or the procedure.

Purpose
 To reduce the risk of staff acquiring infections from patients
 To prevent staff from transmitting their skin flora to patients
 To reduce contamination of the hands of staff by microorganisms that can be transmitted
from one patient to another (cross-contamination)

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  Prevent transfer of microorganisms via the contact, droplet, and airborne modes of
transmission from one patient to another; prevent transmission of microorganisms to self
or clothing during patient care.

Adjusting the height of the bed

The nurse normally makes the bed in the morning after a patient's bath, or when the patient is out
of the room for tests. The nurse should straighten the linens throughout the day, making certain
they are neither loose nor wrinkled. Any sheets that become wet or soiled should be changed
promptly.

When changing bed linen, the nurse should keep the soiled linen away from the uniform, and
place it in the appropriate linen bag or other designated container. Never fan or shake linens,
which can spread microorganisms and, if any of the sheets touch the floor, they should be
replaced. The bed can be made in a variety of ways, depending on the particular patient situation.
Adjust the height of the bed to ensure that you are working from a comfortable height. The
height should be between your mid-thigh and hip. After you have finished the task lower the bed
to a suitable height for the patient/client. Preparing and maintaining beds can result in you
adopting sustained and constrained postures. The beds should have lockable castors on all legs
operated by a single control with indication of locked position. There should be sufficient access
for the operation of brake control. They should also have considered lightweight adjustable cot
sides which allow sufficient clearance when lowered for patient handling equipment and clear
access to the mattress for bed making.

After you have completed the bed making, the bed should be returned to an acceptable height for
the patient/ client. In long term stay wards the height that the patient’s bed is returned to, may be
marked on the wall.

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 Figure 1.1 shows an adjusted bed
The room, especially the bed is the patient’s home while he or she is in the hospital or health care
facility. A well- made bed offers both comfort and safety. It is an extremely important
contribution to the well - being of the patient. Because people are usually confined to bed when
ill, often for long periods, the bed becomes an important element in the client’s life. A place that
is clean, safe, and comfortable contributes to the client’s ability to rest and sleep and to a sense of
wellbeing. Basic furniture in a health care facility includes the bed, bedside table, over bed table,
one or more chairs and storage for clothing. Most bed units also have a call light, light fixtures,
electric outlets, and hygienic equipment in the bedside table.

Three types of equipment often installed in an acute care facility are a suction outlet for several
kinds of suction, an oxygen outlet for most oxygen equipment and a sphygmomanometer to
measure the client’s blood pressure. Some long-term care agencies also permit clients to have
personal furniture, such as a television, a chair, and lamps at the bedside. In the home a client
often has personal and medical equipment.

1.1.2. Types of bed

Hospital beds are carefully designed to provide the patients with a wholesome recovery and
healing environment while paying great attention to their comfort, stability, as well as safety.
However, whereas, one kind of bed might perfectly fulfill the requirements of a particular user;
some specific patients mat need a different type of hospital bed. Basically, different hospital beds
might be better suited for different purposes. Therefore, to help you understand the different
types, styles of beds that are available in the market, we have curated below, detailed information
about all the different kinds of Hospital Beds. Apart from that, the information mentioned below
will also help you understand the anatomy of a specialized hospital bed in a better way.

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 A. Hospital Beds based on their Functioning & Source of Power:
1. Manual Beds
2. Semi-Electric Beds
3. Electric Beds
B. Hospital Beds designed for Specific Purposes:
1. Bariatric Beds Gatch Beds
2. Low Beds 5. Fluid-Air Beds
3. Hospital Cribs 6. Freedom Beds
C. Important Features of a Hospital Bed:
1. Positioning Options 4. Trapeze
2. Side Rails 5. Gap Protection
3. Weigh Scale 6. Storage Space
4.

A. Hospital Beds based on their Functioning & Source of Power:

1. Manual Beds

Figure 1.2 Manual bed

A bed that does not has the capability of adjustments through electrical means is termed a
Manual Hospital Bed. These types of beds usually have a manual hand crack which can be used
to adjust the positions of the beds. The hand crank is usually situated near the foot or the head of
the bed.

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Pros: - This is one of the most economical types of hospital beds. Much cheaper than the electric
ones.
Cons: - Manual beds offer only limited positioning options. They usually offer only head or
foot adjustments.
 They also lack height variations.
 If the user is not physically enabled to operate the crank, a caregiver might be
required, whenever adjustments are required.
Recommended for: - Users who may not need frequent position adjustments
-Check bed sheet types.
2. Semi-Electric Beds

Figure 1.3 Semi-Electric Beds

These types of beds usually offer a combination of manual and electric adjustments. Usually, the
height of the beds can be adjusted manually with the help of a hand crank. However, the head
and foot adjustments can be done with the touch of buttons placed near the hand of the user. Also
check types of pillows.
Pros: - The user can himself adjust his head and foot positioning without anybody’s help
Perfect for people who need frequent adjustment, without paying a hefty amount for fully
automatic beds
Cons: - Height adjustments may need the help of a physically enabled caregiver.
Recommended for: - Users who may not require frequent height adjustments but are capable
enough of monitoring their head and foot adjustments by the touch of a button themselves

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 3. Electric Beds

Figure 1.4 Electric Beds

Medical Facilities often use fully automatic hospital beds which can be operated with just a click
of a button. In these types of beds, the head and foot adjustments, along with the height can be
operated without any manual input by the user or the caregiver. Apart from that, fully automatic
hospital beds also offer a few more positions/transitions which are as mentioned below.

1. Trendelenburg position: In this position, the entire bed platform is tilted at 15-30 degrees,
with the user’s feet above his/her head. This position is used to aim at blood circulation.

2. Reverse Trendelenburg Position: This position is exactly the opposite of the Trendelenburg
position, with the user’s head above their feet. This position is used to aid with breathing and
pressure relief.
3. Cardiac Chair: Patients with heart surgeries as breathing issues are believed to recover faster
if they spend most of their time sitting upright. Many fully automatic beds are often designed
with an integrated position of a cardiac char. With the help of this position, the patient or the

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caregiver can switch the bed from the flat-lying position to the cardiac chair position using the
buttons present on the bed, with minimal movement of the user.
Pros: - Patients can themselves change their position without the help of a caregiver
- A better pick for caregivers with weaker physical strength
Cons: - Highly expensive and Might stop operating completely due to equipment failure
Recommended For: - Patients who need frequent height as well as position adjustment

B. Hospital Beds designed for Specific Purpose

1. Bariatric

Figure 1.5. Bariatric Beds

Bariatric beds are usually larger and stronger than general hospital beds. These beds comprise a
larger sleeping surface and specialized mattresses to accommodate bariatric patients. These
heavy-duty beds can accommodate users weighing up to 1200 pounds and can measure up to 54”
x 88”.
2. Low Beds

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 Figure 1.6. Low Beds

Low beds are similar to standard hospital beds. They can be manually operated as well as fully
electric. However, the only additional function is that they offer extensive height adjustments.
They allow the bed platform to be lowered almost to the ground level. These beds are designed
for preventing the patient/user from falling off the bed. They are specifically designed for
patients with mobility constraints to get off and get on to the bed.
3. Hospital Cribs

Figure 1.6. Hospital Cribs

Also termed as safety beds, hospital cribs are specially used for children who may be at risk of
falling out of the bed. They usually have high railings on all the sides of the beds. It prevents the
child to get out of the bed himself. Basically, they are meant for the safety of children who are
recovering or need medical care.

4. Gatch

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Gatch beds are usually used by medical outposts and locations that may lack funds. These are
highly economical durable as well as functional medical beds. A Gatch bed generally features
three adjustable sections, which are made functional with the help of a spring mechanism. The
three movable sections comprise the head, knee, and foot. These beds also offer the patients to sit
upright to aid with breathing. The only drawback of this kind of bed is that they may need the
help of a caregiver to adjust to different positions.

Figure 1.7. Gatch beds

5. Fluid-Air

Figure 1.8. Fluidized air beds

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Fluidized air beds are specially used by medical care facilities for patients with wounds that are
really difficult to heal. These types of beds usually distribute the weight of the patient evenly
over the complete mattress. These beds provide temperature-controlled air through tiny holes to
minimize the pressure on the patient’s body.
They are designed to create an ideal environment for wound recovery by controlling factors like
body friction, temperature, pressure, as well as moisture. These beds are meant only for
specialized hospitals and cannot be used for long-term recovery or care at home.

6. Freedom

Figure 1.9. Freedom beds

This is one of the most advanced types of hospital beds available in the market. It uses a 3-part
rotation platform that can help reposition the patients in the smoothest way possible, without
disturbing them. The seamless repositioning technique of a Freedom bed prevents any kind of
pressure injuries to long-term bed-ridden patients. One of the unique features of Freedom Bed is
its air system, which is located between the platform and the mattresses, which allows the users
to be repositioned automatically even when their upper torso is in a raised position. By all means,
this is one of the latest and most comfortable medical beds that one can get hold of.

C. Important Features of a Hospital Beds

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Different types of hospitals may feature different elements. Moreover, different types of patients
and users may need different particular features to be integrated into their hospital beds to
provide them with complete safety and comfort. Below mentioned are the various major
elements of hospital beds along with their uses, which may be helpful for patients with different
health issues and disabilities.

1. Positioning Options

Figure 1.10. Positioning beds

Most of the standard hospital beds are competent enough of providing basic position
adjustments, including lowering and raising your head or feet. However, if the patient requires
any additional positioning options like Trendelenburg, Reverse Trendelenburg, Cardiac Chair
position, or Fowler’s position, look out for special beds that offer the same.

2. Side

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 Figure 1.11. Beds with side rails

Bed Rails are hand grabs that are installed on either side of a hospital bed. Apart from providing
them with support while moving in or out of the bed, the handrails also prevent the user from
falling off the bed while being asleep. These rails also act as a source of providing stability to the
users while transiting from one position to the other. Some beds offer full-length rails, extending
down to the floor level, whereas; others may offer rails up to half-length.

3. Weigh

Figure 1.12. Weigh scale beds

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Many hospital beds come integrated with weigh scale that can help weigh the users without
having them be transferred to and from the bed. These are highly effective for those patients that
need to be weighed at regular intervals of time.
4. Trapeze

Figure 1.13. Trapeze beds

Trapeze usually hands over the head over the bed to provide support to the patients while
repositioning them. This equipment is either integrated with the frame of the bed or also can be
used as a freestanding structure if the bed does not have one. These can highly effective for those
who need some support while switching positions or getting in or out of the bed.
5. Gap Protection

Figure 1.14. Gap Protection beds

Gap support is one of the most important safety elements for those users who experience
nocturnal movements or seizures. Most hospital beds are specially designed with efficient gap
protection. However, if you are additionally providing railings or the bed does not offer bed

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protection, it is very important to add on the same to prevent the user or patient from getting
stuck into the gap between the sides and the bed.

Most of the standard hospital beds do not offer any kind of storage space. However, a few latest
6. Storage
models come attached with basic storage spaces. These spaces can come in really handy for the
user as well as the caregiver. They can be used to store essentials like gloves, medical supplies,
and other commodities like books, remotes, and magazines.

7. Stryker frame, spinal bed or wedge bed- a turning frame that serves the3 same
purpose as the CircOlectric but is operated manually. Once the patient is secured by placement of
the upper frame, a crank is used to turn the entire frame and the patient. After turning, the patient
is on the abdomen. The patient lies on the frame until turned once more.

Hospital Bed Buying Guide: - If you are planning to get a hospital bed installed at your
home to aid your loved one’s recovery or care, you need to carefully assess the below-mentioned
points to shortlist the best option for them.
Review the mobility of the user:-The very first thing that needs to be considered while
searching for a hospital bed is the mobility of the user. If the user is capable enough of getting in
and out of the bed themselves, is stable on their feet without any aid, and has a basic level of arm
strength, using a budget-friendly yet completely functional may work. However, if they have
even the slightest difficulty in maneuvering their own movement, you should go in either with a
semi-automatic or automatic hospital bed.
Know the timeframe for which you may need the bed:-If the user is required to be in bed for a
major part of the day or is to be bed-ridden for a long duration of time, you should simply go
ahead with a fully electric hospital bed. However, if the user needs the bed only for a short
period of time, you should go in with a semi-automatic or manual hospital bed, along with hiring
a part-time caregiver, if required.

Choose the bed based on the size of the user:-Normal-sized patients can be easily
accommodated and comfortable in a standard-sized hospital bed. However, if the user is extra-
ordinarily heavy or large, they may need a heavy-duty bariatric bed to accommodate them

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comfortably. If the bed is to be acquired for children, you should go in with specially curated
hospital cribs that may prevent them from falling off the bed and keep them safe.

Pick a bed based on the user-friendliness of the caregiver:-If the patient or user requires the
attention of a caregiver and is being attended to by a family member or even a medical
professional, it is important to keep in mind the strength of the caregiver. If the caregiver has the
basic strength to operate a manual hand crank, you can go in for a manual hospital bed.
However, if the caregiver is not physically competent, a semi-electric or electric hospital bed is
good to go.
1.2.3. Parts of Bed
Head part of the bed- it is where the head of patient is position.

Foot part of the bed- it is where the foot of patient is position.

Side Rails- safety device used in preventing clients from falling out of bed.

The use of side rails has been routine practice with the rationale that the side rails serve as a safe
and effective means of preventing clients from falling out of bed.

Footboards- Used to support the immobilized client’s foot in a normal right angle to the legs to
prevent plantar flexion contractures.

Mattresses - large pad on which to sleep. They are used in hospitals to relieve pressure on the
body’s bony prominences, such as the heels.

They are particularly helpful for clients confined to bed for a long time.

 Bottom sheet
 Top sheet
 Rubber sheet, Bed linen

1.3. Cleaning beds and area of other equipment

1.3.1. Cleaning a client area
Definition: -It is keeping of the patients’ room neat & orderly. There are two types of cleaning
that are concurrent and terminal cleaning.

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A. Concurrent cleaning: - is a daily cleaning of the patient’s room. It consists cleaning the
room by damp mopping the floor and dusting with damp cloth.
B. Terminal cleaning: - is cleaning the room that is done after the patient is discharged or
transferred to another room. Clear the bed and surrounding area of medical and other equipment
to allow access to carry out the task. Return them to the correct location. Cleaning equipment
should be placed on a trolley so that it can be easily moved within the bed space. A linen skip
should be placed close to the bed whilst stripping soiled linen to minimize your handling of it.
You should separate each linen item before it is placed into the skip to avoid injuries to those
involved it’s processing.

1.4. Check bed linen for displace personal items and place
equipment in the appropriate area
1.4.1. Placing aids and equipment in the appropriate area/container
As hygienically clean linen is distributed throughout a medical facility, staff members must take
care that it remains as clean as when it was laundered. They must presume that linen storage
covers, cabinets, door handles or anything they contact are contaminated.
Staff members should follow proper hand hygiene procedures and sanitize prior to handling
healthcare textiles and after touching potentially contaminated surfaces. Throughout the process
of transporting, storing and distributing clean linen it is imperative to avoid any possibility of
mixing it with soiled linen. When handling any type of soiled linen in a hospital setting, TRSA
recommends the Six C’s: Cover, Collect, Contain, Consolidate, Clean, and Cooperate. Following
these practices not only reduces the spread of infections and promotes a culture of safety in
hospital settings, but it also reduces healthcare costs by eliminating the expense of lost linen
products. Although soiled linen may contain large numbers of microorganisms, there is little risk
to health workers during linen processing.
When work related infections occur, they often are the due to healthcare workers not using
gloves or not washing their hands during or after collecting, transporting and sorting soiled
items.
The used linen must be placed into a white plastic bag; filled no more than ⅔ full and
securely tied at the neck. All used / dirty linen is to be stored in a secure external area for
collection by the laundry contractor. The infected linen must be placed in a red dissolve liner, tie
when ⅔ full and placed in a red plastic bag with a label attached identifying the ward or
department. Linen that has been taken into room where a patient has been barrier nursed

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and then not used must be removed and sent to the laundry, this must not be used for another
patient. All infected linen is to be stored in a secure external area for collection by the
laundry contractor.
Self-Check -1
Test-1 Multiple Choices

I. Choose the best answer.

1. W/ c one of the following is incorrect about Personal protective equipment (PPE)
A. Gloves should be worn for non-critical procedures
B. Glove must be worn anytime when there is contact with potentially infectious materials
C. Gloves should be changed between each client contact to avoid cross contamination
D. Gloves should be worn for critical procedures
2. It is a special bed frame placed within a circular frame.
A. Gatch bed
C. Low bed
B. Electric bed
D. CircOlectric bed
3. It is a turning frame that serves the3 same purpose as the CircOlectric but is operated
manually
A. Gatch bed C. Stryker Frame
B. Electric bed D. CircOlectric bed
4. It is safety device used in preventing clients from falling out of bed.
A. Head Board
C. Side Rails
B. Foot Board
D. Mattress
5. Which part of the bed where the head of patient is position?
A. Foot Board
B. Head Gear
C. Head Board
D. Head Part of the bed
5. Used to support the immobilized client’s foot in a normal right angle to the legs to prevent
plantar Flexion contractures.
A. Foot Board C. Foot Rest
B. Head Board D. Over Bed

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 II. Write “TRUE” if the sentence is correct and “FALSE” if it is incorrect
1. Use of PPE is only during invasive procedures not in bed making?

2. Bed making is one of the comforting devise for a client’s?

III. Short answer questions

1. Describe the purpose of closed bed making for the clients?

3. During bed making, what is the purpose of adjusting the height of the bed?

Unit Two- Make a bed

This learning unit is developed to provide the trainees the necessary information regarding the following conte
Maintaining client’s dignity and privacy
Striping bed linen
Remove clinical waste and soiled linen
Clean the bed is according to the established procedures
Re-positioning the existing bed linen.
Asking the client for comfortable and/or specific bed needs.
Handling reusable clean bed linen
Cleaning mattresses and pillows regularly and on discharge
This unit will also assist you to attain the learning outcomes stated in the cover page. Specifically,

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upon completion of this learning guide, you will be able to:
 Maintain client’s dignity and privacy
 Stripe Bed linen
 Remove clinical waste and soiled linen
 Clean bed according to the established procedures
 Re-position existing bed linen
 Handle reusable and clean bed linen
 Clean Mattresses and pillows regularly
Learning Instructions:
1. Read the specific objectives of this Learning Guide.

2. Follow the instructions described.

3. Read the information written in the “Information Sheets

4. Accomplish the “Self-check”.

2.1. Maintain client’s dignity and privacy

This provides the skills and knowledge which you need Maintain client’s dignity and privacy to
ensure that a patient/client can safely occupy the bed. Patients and residents have all these basic
human rights plus other special rights just for those in an assisted living home, a nursing home or
a hospital. We all must know about these rights when we work in health care. We must know
what these rights are so we can make sure that all of our patients and residents have these rights
while we provide care to them by completing this unit you will gain a better understanding of
your role and responsibilities in a health care setting and thereby improve your existing skills and
knowledge in your current work role. People do not lose their right to privacy because they are in
a hospital or nursing home. They also do not lose this right when they have home health care.
Patients and residents have a right to:

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 Talk privately with family, friends and other patients or residents. Do not interfere.
 NEVER open a patient's closet or pocketbook without getting their permission. If you are in
the person's home, do NOT enter any area or open any closets unless the person tells you that
you can.
 Knock on the patient or resident door before walking in. Their room is their own private
space, just like yours is in your own home. Do NOT enter their space unless they allow you
to or there is an EMERGENCY.
 Personal privacy. Provide personal privacy when bathing or caring for a patient. Patients and
residents have a right to have personal information kept secret from all other people, except
those that are giving her care. NEVER talk about one of your patients with friends,
neighbors, other patients or residents. Some confidentiality rights are found in laws. For
example, if you tell your sister that Mrs. M, your patient has AIDS/HIV, you have broken the
law. It is not legal to tell anyone that a patient has AIDS/HIV. Health care workers, including
nursing assistants, should NEVER tell a person's diagnosis or condition to anyone that is
NOT caring for the patient. Do NOT talk about patients in halls or coffee shops. You never
know who is listening. All patient charts and records must also be kept in a safe place so that
people not caring for the person cannot read them.

All patients and residents have a right to:

 Respect and dignity  Choose their own doctor(s)

 Privacy  Make decisions about their medical
 Confidentiality care
 Freedom from abuse and neglect.  Competent care
 Control over their own money  Religious and social freedom
 Have their personal property  Accurate bills for services given
 Know about their medical condition  Complain and be heard
and treatments.
All people have the right to respect and dignity. We must:

 Speak to our patients with respect and polite way.

 Use good communication skills.

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  Call people by their name. Do not call people 'momma', 'poppa', 'sweetie' or 'honey'.
 Let the person talk about their feelings. Give them the time to talk with you. Do NOT
look like you are in a hurry. Always make the time to talk to a person with respect.
 NEVER treat an adult like a child. Do NOT talk 'baby talk' with adults.
 Help patients and residents so they can be as independent as they can. Help them with
their self-care and activities of daily living.
 Make sure the person looks good and is clean. We must make them look clean, shaved
and without dirty finger nails.
 NEVER allow a person to stay wet with urine, dirty or with a bad odor. These things take
away a person's dignity.
 Give people as many choices as possible. Let the person choose unless their choice can
cause them harm or can harm others. For example, let a person pick a fresh fruit for their
snack. Let the resident pick out the activities they want to attend over the next week. Let
them pick out their own clothing for the day.

General instruction
1. Put bed coverings in order of
use Order of Beddings
1. Mattress cover 5. Top sheet
2. Bottom sheet 6. Blanket
3. Rubber sheet 7. Pillow case
4. Cotton (cloth) draw sheet 8. Bed spread
2. Wash hands thoroughly after handling a patient's bed linen
3. Linens and equipment soiled with secretions and excretions harbor micro-organisms that can
be transmitted directly or by hand’s uniforms
4. Hold soiled linen away from uniform
5. Linen for one client is never (even momentarily) placed on another client’s bed.

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6. Soiled linen is placed directly in a portable linen hamper or a pillow case before it is
gathered for disposal.
7. Soiled linen is never shaken in the air because shaking can disseminate secretions
and excretions and the microorganisms they contain.
8. When stripping and making a bed, conserve time and energy by stripping and making up
one side as completely as possible before working on the other side.
9. To avoid unnecessary trips to the linen supply area, gather all needed linen before starting
to strip bed.
10. Make a vertical or horizontal toe pleat in the sheet to provide additional room for the
client’s feet.
11. While tucking bedding under the mattress the palm of the hand should face down to
protect your nails.
Note:-Pillow should not be used for babies
The mattress should be turned as often as necessary to prevent sagging, which will cause
discomfort to the patient.

2.2. Striping bed linen

Definition: Stripping of a bed is removing the bed linen from a bed which had been previously
made-up.

Bed linen consists of sheets, blankets and counterpane or duvet. Cotton is the preferred fabric to
use. Duvets are usually made of a fiber filling encased in a washable or impermeable cover

The following is a representative guide of what is involved:

 Remove bedspread or duvet. – inspect and air, or replace as required. All bedspreads etc.
are washed or dry-cleaned periodically.
 Remove blankets (where provided) - inspect and air, or replace as required. All blankets
are washed or dry-cleaned periodically

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  Remove pillowcases – place into soiled linen bag. Inspect pillow and pillow protectors to
determine if they require attention or replacement
 Remove sheets - place into soiled linen bag
 Check mattress protector – spot clean as necessary or replace if required due to staining
or damage
 Inspect electric blanket – safety check and for signs of staining. Replace as per house
protocols.
 Items that have been stripped from the bed should not be placed on the floor. Check what
applies in your establishment but options include placing them on chairs, tables, couches
in the room.

2.1.1. Operation sheet -1 Procedures on Stripping of a bed

A. Purpose

 To prevent cross contamination

 Ventilate the bed and bedding, and
 Prepare the bed for remaking
 To prevent damage of bedding

B. Precautions:

No bedding, either clean or soiled, should ever be put on the floor. It should be discarded in
hamper. Do not let your uniform touch the bedding. Woolen blankets are never discarded in
soiled clothes hamper. If soiled, they should be dry-cleaned or washed carefully or treated
with direct sunlight. Use glove if the bed soiled or used by patient

C. Equipment

o Bed side chair

o Hamper
o Glove as necessary
D. Procedures

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Step 1- Wash hand

Step 2- Place chair conveniently at the foot of the bed

Step 3- Place pillow on seat of chair

Step 4- Loosen the bedding all around, starting from the right

Step 5- Fold bedspread twice, bring top hem (edge) to bottom hem, and pick up

Step 6- Fold the blanket and the top sheet in similar manner

Step 7- Place soiled linen in the hamper

Step 8- Place other soiled bedding on chair, and place that which is to be used again, over
back of chair

Step 9- Fold the draw sheet in two and place it over the chair if clean or on the- chair if soiled.

Step 10- Do likewise with mackintosh.

Step 11- Remove and fold the bottom sheet in the same manner as the bedding

Step 12- Turn mattress from top to bottom or from side to side.

Step 13- Wash hands

Step 14- Recording and documenting

2.1.2. Operation sheet-2 Making Unoccupied Bed (Closed bed)

Definition: Closed bed is a smooth, comfortable and clean bed, which is prepared for a newly
admitted patient. In closed bed: the top sheet, blanket and bed spread are drawn up to the top
of the bed and under the pillows.
Purpose: - To receive new patient and to keep the bed neat and clean until a new patient is
admitted
Equipment  Bed sheets(2): Bottom sheet (1),
Top sheet (1)
 Mattress (1)

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 Pillow (1)  Sponge cloth (4): to wipe with solution
 Pillow cover (1) (1) to dry (1)
 Mackintosh/ Rubber sheet (1)  When bed make is done by two
 Draw sheet (1) nurses, sponge cloth is needed two
 Blanket (1) each.

 Savlon water or Dettol water in basin.  Laundry bag or hamper (1)

 Trolley(1)
Procedure  Clean glove
1. Wash hands and collect necessary
materials
2. Place the materials to be used on the chair. Turn mattress and clean the mattress.
3. Move the chair and bed side locker.
4. Clean Bed-side locker, chair: Wipe with wet and dry.
5. Clean the mattress:
 Stand in right side.
A. Start wet wiping from top to center and from center to bottom in right side of mattress.
B. Gather the dust and debris to the bottom.
C. Give wiping as same as procedure 2
 Move to left side, Wipe with wet and dry the left side.
6. Move to right side. Start making the bed, Place bottom sheet with correct side up, center of
sheet on center of bed and then at the head of the bed.
7. Tuck sheet under mattress at the head of bed and miter the corner.
Mitering steps:
A. Face the side of bed and lift and lay the top edge of the sheet onto the bed to form a
triangular fold.
B. With your palms down, tuck lower edge of sheet (hanging free at side of mattress) under
mattress.
C. Grasp the triangular fold, bring it down over the side of the mattress and tuck the sheet
smoothly under the mattress Straighten the free hanging sheet on mattress side.

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 Figure 2:15 mitering bed corner
8. Remain on one side of bed until you have completed making the bed on that side.
9. Tuck sheet on the sides and foot of bed, mitering the corners.
10. Tuck sheets smoothly under the mattress, there should be no wrinkles.
11. Place rubber and draw sheet at the center of the bed and tuck smoothly and tightly.
12. Place cotton draw sheet on top of rubber draw sheet and tuck. The rubber draw sheet should
be covered completely.
13. Place top sheet with wrong side up, center fold of sheet on center of bed and wide it at head
of bed.
14. Tuck sheet of foot of bed, mitering the corner.
15. Place blankets with center of blanket on center of bed, tuck at the foot of beds and miter the
corner.
16. Fold top sheet over blanket
17. Place bed spread with right side up and tuck it.
18. Miter the corners at the foot of the bed.
19. Go to other side of bed and tuck in bottom sheet, draw sheet, mitering corners and
smoothening out all wrinkles, put pillow case on pillow and place on bed.
20. See that bed is neat and smooth
21. Leave bed in place and furniture in order
22. Wash hands

23. Recording and documenting.

2.1.3. Operation Sheet-3 Open bed

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Definition: Open bed is one which is made for an ambulatory patient are made in the same way
but the top covers of an open bed are folded back to make it easier of a client to get in.

Purposes of making open bed

 To provide clean and comfortable bed for the patient
 To reduce the risk of infection by maintaining a clean environment
 To prevent bed sores by ensuring there are no wrinkles to cause pressure points
Equipment

 Two large sheets  Pillow cases

 Rubber draw sheet  Bed spread
 Draw sheet  Clean glove
 Rubber sheet (Mackintosh )  Chart
 Blankets
Procedure

1. . Wash hands and collect necessary materials.

2. . Place the materials to be used on the chair. Turn mattress and arrange evenly on the bed.
3. . Place bottom sheet with correct side up, center of sheet on center of bed and then at the
head of the bed.
4. . Tuck sheet under mattress at the head of bed and miter the corner.
5. . Remain on one side of bed until you have completed making the bed on that side.
6. . Tuck sheet on the sides and foot of bed, mitering the corners.
7. . Tuck sheets smoothly under the mattress, there should be no wrinkles.
8. . Place rubber and draw sheet at the center of the bed and tuck smoothly and tightly.
9. . Place cotton draw sheet on top of rubber draw sheet and tuck. The rubber draw sheet should
be covered completely.
10. Place top sheet with wrong side up, center fold of sheet on center of bed and wide it at head
of bed.
11. Tuck sheet of foot of bed, mitering the corner.

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12. Place blankets with center of blanket on center of bed, tuck at the foot of beds and miter the
corner.
13. Fold top sheet over blanket
14. Place bed spread with right side up and tuck it.
15. Miter the corners at the foot of the bed.
16. Go to other side of bed and tuck in bottom sheet, draw sheet, mitering corners and
smoothening out all wrinkles, put pillow case on pillow and place on bed.
17. See that bed is neat and smooth
18. Leave bed in place and furniture in order
19. Wash hands
20. Recording and documenting
2.1.4. Operation Sheet-4 Making an unoccupied Bed
Definition: An occupied bed is a bed prepared for a weak patient (bed ridden) who is unable to
get out of bed.

Purposes
 To provide comfort and to facilitate circulation of the patient
 To provide cleanliness and facilitate position of the patients bed
 To conserve patient’s energy and maintain current health status
 To comfort the patient

Equipment

 Two large sheets  Pajamas or gown, if necessary

 Draw sheet  Spread sheet
 Rubber sheet (mackintosh).  Chart
 Pillow case  Clean glove
Procedure
1. Wash hands and collect equipment
2. Explain procedure to the patient

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3. Carry all equipment to the bed and arrange in the order it is to be used.
4. Make sure the windows and doors are closed.
5. Make the bed flat, if possible
6. Loosen all bedding from the mattress, beginning at head of the bed, and place dirty pillow
cases on the chair for receiving dirty linen.
7. Have patient flex knees, or help patient do so. With one hand over the patient’s shoulder and
the other hand over the patient’s knees, turn the patient towards you. Never turn a helpless
patient away from you, as this may cause him/her to fall out of bed.
8. When you have made the patient comfortable and secure as near to the edge of the bed as
possible, go to the other side carrying your equipment with you.
9. Loosen the bedding on that side.
10. Fold, the bed spread half way down from the head. Fold the bedding neatly up over patient.
11. Roll dirty bottom sheet close to patient
12. Put on clean bottom sheet on used top sheet center, fold at center of bed, rolling the top half
close to the patient, tucking top and bottom ends tightly and mitering the corner
13. Put on rubber sheet and draw sheet if needed.
14. Turn patient towards you on to the clean sheets and make comfortable on the edge of bed.
15. Go to the opposite side of bed. Taking basin and wash cloths with you, give patient back
care.
16. Remove dirty sheet gently and place in dirty pillow case, but not on the floor.
17. Remove dirty bottom sheet and unroll clean linen.
18. Tuck in tightly at ends and miter corners.
19. Turn patient and make position comfortable.
20. Back rub should be given before the patient is turned on his /her back
21. Place clean sheet over top sheet and ask the patient to hold it if she/he is conscious. Go to
foot of bed and pull the dirty top sheet out
22. Replace the blanket and bed spread
23. Miter the corners
24. Tuck in along sides for low beds
25. Leave sides hanging on high beds

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26. Turn the top of the bed spread under the blanket
27. Turn top sheet back over the blanket and bed spread
28. Change pillowcase, lift patient’s head to replace pillow. Loosen top bedding over patient’s
toes and chest.
29. Be sure the patient is comfortable
30. Clean bedside table
31. Remove dirty linen, leaving room in order
32. Wash hands.
33. Recording and documentation
NB: If a full bath is not given at this time, the patient’s back should be washed and cared for
2.1.5. Operation Sheet-5 Making cardiac bed
Definition: Cardiac bed is a bed prepared for a patient with heart disease or dyspnea and to
provide easy breathing for patient with minimum strain.

Purpose

 In order to ease difficulty in breathing

 To Provide comfort and safety

 To relieve dyspnea

 To prevent complication

EQUIPMENT

1. Linens 6. Cylinder with oxygen

2. Bed spread 7. Draw Sheet
3. Blanket 8. Footrest& back rest
4. Extra pillows (4 – 6 Pillows) 9. Rubber sheet
5. Pillowcase 10. Over bed table
Procedure

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1. Wash your hands
2. Assemble the necessary equipment and carry to bed side
3. Place chair at the foot of the bed
4. Arrange the linen on chair in the order that it will be used
5. Turn mattress and arrange on the bed.
6. Put on mattress cover if available
7.Place bottom sheet with right side up, center of sheet on center of bed and wide hem at the
head of the bed.
8. Tuck sheet under mattress at head of bed and miter the corner.
9. Remain on one side of bed until you have completed making the bed on that side.
10. Tuck sheet on the sides and foot of bed mitering the corners.
11. Tuck sheets smoothly under the mattress. There should be no wrinkles.
12. Place rubber draw sheet in the center of the bed and tuck tightly.
13. Place cotton draw sheet on top of rubber draw sheet and tuck. Rubber draw sheet should be
covered completely.
14. Place top sheet with wrong side up, center fold sheet at center of bed and wide hem at foot of
bed.
15. Tuck sheet at foot of bed mitering the corner.
16. Place blankets with center of blanket on center of bed and tuck at the foot of bed and miter
corner. Fold top sheet over blanket.
17. Place bed spread with right side up. Tuck at the foot of bed miter corners and cover top
bedding.
18. Go to other side of bed fanfold the top covers at the center of bed and tuck in bottom sheet
and draw sheet mitering corners, smoothing out all wrinkles, continue with blanket and
spread the same with the opposite side.
19. See that bed is neat and smooth
20. Put bed in semi fowler’s position by raising the head of bed; if bed is gatched raise at the
head of bed, if bed is normal bed put extra pillows.
21. Put footrest to prevent the patient from sliding down.

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22. Place over bed table over the bed and a pillow over it to allow the patient’s hands to rest on
it.
23. Wash the hand thoroughly
24. Record in the nurse’s order of any observation made on the patient
2.1.6. Operation Sheet-6 Post-operative/anesthetic bed making
Definition: Anesthetic bed is a bed especially prepared to receive a patient after surgery
and major recovery from general anesthesia.
Purposes
 To facilitate easy transfer of the patient from stretcher to bed.
 To facilitate removal of secretion
 To protect the mattress and bedding from bleeding, vomiting, drainage or discharges.
 To protect the patient from becoming chilled or give warmth.
Equipment
A. For bed making
1. Two large sheets.
7. Small towel.
2. Draw sheet(two)
8. Pillow case
3. Bath blanket
9. Spread sheet
4. Woolen blanket
10. Additional Sheets and blanket
5. Rubber sheet (Mackintosh)
11. bed blocks as needed
6. Two tongue blades or a mouth
gag.
12. An extra rubber sheet & draw sheet for operated areas
B. For first aid activity
1. Emergency drug
needed).
2. Minor set
9. Airway tube
3. Vital sign equipment
10. Sterile drainage bottle with tubing,
4. Suction machine
11. IV Stand.
5. Oxygen cylinder
12. Emesis basin and paper bag.
6. Sterile Suction catheter
13. Iv fluid
7. Sterile glove
14. Hot water bag
8. Examination lamp (at hand if
15. Safety pin
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 16. Bed cradle 18. An emesis basin
17. Tissue paper 19. Chart
20. Paper and pen for recording vital signs and charting
Procedure
1. Wash your hand & prepared equipment
2. Strip the bed
3. Make the foundation of the bed as usual with large sheet, rubber draw sheet, bath blanket,
draw sheet, etc.
4. Place one rubber sheet where the site of operation will rest
5. Place other rubber sheet across head of the bed where head will lie to protect bed from
vomitus}
6. Cover each rubber sheet with draw sheet tucking it firmly under matters
7. Place top bedding as before but do not tuck in the bottom. Fold down the top as you would
do in an occupied bed.

Figure 2.16 Post-operative/Anesthetic bed

8. Then fold the bottom of the linens up so that the fold is even with the bottom of the
mattress. Do not tuck the linen in.
9. Unfold the top linens to the side so that they lay opposite from where you will place the
client’s stretcher. Alternatively, you may fanfold the linens to the foot of the bed. Leave a
tab on top for easy grasping.
10. In cold season, place hot water bottles in middle of the bed, and cover with fanfold top
bedding temperature of hot water is never to exceed 50°C (122°F).

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 11. Have two or more pillows available, but do not put them on the bed. Rationale: A pillow
may be contraindicated for a client; usually the physician or charge nurse will determine
when it is safe for the client to have one.
12. Place pillow at the head of the bed between bed & mattress and tie it back with a piece of
bandage to protect had of Patient.
13. Place all necessary materials at the side of the bed opposite to the stretcher on which the
patient will come
14. Arrange emergency equipment{ B/P apparatus ,suction machine, Drug}
15. Close the windows. Leave the room clean and in order
16. Receiving the patient from operation room
A. Remove folded to cover of the bed
B. Place the patient on bed and cover quickly
C. See that patient is properly placed in bed with head to the left side and comfortable
D. Check patient s condition operated area, urine, vital sign, color of patient etc.
E. Do after care and Comfort the patient after procedure
17. Return used equipment to utility room and wash your
hand
18. Document the procedure done
2.2.7. Operation Sheet-7 making an amputation bed
Definition: - Amputation: - is the surgical removal of a part of the body or a limb, performed to
treat recurrent infections or gangrene in peripheral vascular disease, to remove malignant tumors,
& in severe trauma. Amputation bed/ stump bed is a regular bed with cradle, which is prepared
for amputated patient.

Purpose
 To give extra warmth

 To leave the part open for observation.

 To ensure more safety and comfort by preventing soiling and staining.

 To keep the stump in a good position

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  To prevent jerky movements for the amputated leg

 To prepare for emergency, to have easy access and economy of time and energy

Equipment
1. Linens (3) 9. Draw sheet
2. Pillow 10. face &bath towel
3. Blanket(2) 11. Tourniquet
4. Pillow case 12. Rubber sheet
5. Bed cradle 13. Mackintosh
6. Trolley 14. Small rubber sheet with cover
7. sponge 15. Dressing set
8. safety pin 16. Sand bags with cover

Procedure

1. Wash hands thoroughly

2. Collect equipment’s arrange fresh folded linens in following order on trolley. ( blanket, towel
,sponge, face and bath towel , draw sheet , mackintosh , bottom sheet, mattress cover)
3. Clean mattress, similar with open bed
4. Cover mattress with fresh cover and tuck firmly
5. Spread long mackintosh length and top to bottom covering mattress
6. Spread bottom sheet and tuck neatly
7. 7. Top sheet, draw mackintosh and draw sheet will be received along the patient which should be
firmly tucked
8. To make the lower half, use one sheet and blanket, for upper also ,one top sheet and blanket
9. Keep the lower half of the bed overlapped with the upper half as, in this way ,we can easily separate
the two halves and observe the stump
10. Elevate the stump over the soft pillow covered with mackintosh
11. Place the sand bags on either side of the stumps to prevent it from jerking ,sand bags help
prevent bleeding from jerking
12. Bed cradles are used to take up the weight of the bed linen
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 13. Cover the patient and make the unit tidy.
14. Wash the hand thoroughly and document the procedure and any observation made on the patient
2.1.7. Operation Sheet-8 Fracture bed making
Definition: Fracture bed is a hard firm bed designed for a patient with fracture.

Purpose

 To give firm, even support to the broken limbs and back.

 To maintain position.
 To make the patient comfortable.
 To provide a flat, unyielding surface to support the fractured limb.
Equipment

 Articled as for a closed bed  Small rubber sheet

 Small blanket or draw sheet  Draw sheet
 fracture board  Sand bags
 Bed cradle  Pillow if required
Procedure:

1. Place the fracture board directly over the bed springs and the mattress on it. If the mattress is
thin, an extra mattress must be added to prevent pressure sore due to pressures on the head
surface.
2. Make the bottom bed as usual, and then place the small rubber sheet covered with draw sheet
at the place where the injured part will be resting.
The small rubber and draw sheet are easier to change then the whole bed. This applies
specially to an arm or a leg, which is bleeding or has discharge.
3. Fold back the bed cloths at foot of the bed for leg fracture. Cover the uninjured limb with a
small blanket. On draw sheet placed the cradle over the linen to adjust the cover over it.
Extra blanket and spreads may be necessary. Be sure that the covers come high enough on
the shoulder
4. Do after care and Comfort the patient after procedure
5. Return used equipment to utility room and wash your hand

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 6. proper documentation
N.B:- Never cover a plaster cast until it is thoroughly dry.
The fracture board keeps the bed with no danger of sagging. It is also used for fracture of
the spine. A bed cradles are a frame made of wire wood or iron .it is used to keep the top
cover from touching the injured part.
2.1.8. Operation Sheet-9 Baby crib
Definition: A the bed that prepare for pediatric case with bed side safety

Purpose: - To make comfort for baby with safety

Equipment: - The same with closed bed
Procedure
1. Place baby at the foot of bed
2. Loosen bottom sheet at head
3. Place clean bottom sheet and tuck in
4. Place small rubber sheet or water proof pad on top
5. Place baby at the head of bed
6. Remove soiled linen and tuck clean bottom sheet mitering corners
7. Place clean top sheet and tuck at the bottom
8. Place blanket and tuck, and place baby bed spread
9. Complete making bed on both sides
10. Raise side rails of bed and leave baby comfortable in bed.

LAP Test-1 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary materials you are required to perform the correct steps of
Stripping of a bed within 15 minute.
Quality Assurance: - Performed partially performed Not performed

4
LAP Test-2 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform the correct steps of
closed bed within 20 minute.
Quality Assurance: - Performed partially performed Not performed

LAP Test-3 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform the correct steps of
opened bed within 20 minute.
Quality Assurance: - Performed partially performed Not performed

LAP Test-4 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform an unoccupied bed
within 20 minute.
Quality Assurance: - Performed partially performed Not performed

4
LAP Test-5 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform cardiac bed within 20
minute.
Quality Assurance: - Performed partially performed Not performed

LAP Test-6 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform Anesthetic bed
within 20 minute.
Quality Assurance: - Performed partially performed Not performed

LAP Test-7 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform Amputation bed
within 20 minute.
Quality Assurance: - Performed partially performed Not performed

LAP Test-8 Practical Demonstration

Name: Date:
Time started: Time finished:

4
 Instruction I: Given the necessary equipment, you are required to perform fracture bed within
30 minute.
Quality Assurance: - Performed partially performed Not performed

LAP Test-9 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform baby crib within 20
minute.
Quality Assurance- Performed Partially performed Not performed

2.3. Removing soiled linen

Definitions

Linen: Articles and garments made form linen or similar textile, such as cotton or manmade
fibers.
Soiled linen: Refers to linen which has been used but which remains dry. Used Linen which has
been used but is not contaminated with blood or body fluids. Used dry linen from non ‐infected
patients.
Removing clinical waste: - Refers to waste produced from health care and similar activities
that may pose a risk of infection, for example, swabs, bandages, dressing etc.
Clinical and related waste is waste which has the potential to cause sharps injury, infection or
public offence. Clinical waste is divided into the categories of:

a. Sharps (hypodermic needles, IV sets, Pasteur pipettes, broken glass, scalpel blades, and some
hard plastics).

b. Laboratory waste (e.g. tissue cultures, specimen collection waste) Exceptions: bedside urine
& fecal samples, hair, nails, teeth (unless contaminated with free-flowing blood).

c. Human tissue or blood (e.g. biopsy specimens). Exceptions: corpses, fetuses, recognizable
limbs

4
Soiled linen periodically means collecting used linens from user locations for the purpose of
laundry or discarded. Solid linens can be collected based on the item type or department in the
bag. After laundry processes the clean linens can be transport to user locations using appropriate
equipment and safe handling techniques. Collect used linen in cloth or plastic bags or containers
with lids. If linen is heavily contaminated with blood or body fluids, carefully roll the
contaminated area into the center of the linen and place in a leak proof bag or container with a
lid. Cloth bags are adequate for the majority of the patient care linen. They require the same
processing as their contents. Handle soiled linen as little as possible and do not shake it. This
helps prevent spreading microorganisms to the environment, personnel and other patients.

It is not necessary to double-bag or use additional precautions for used linen from patients in
isolation. Do not sort and wash soiled linens in patient care areas.

Collect and remove soiled linen after each procedure on daily basis or as needed including
patient rooms. Transport collected soiled linen in closed leak proof bags, containers with lids or
covered carts to the processing area daily or as needed. Transport soiled linen and clean linen
separately.

If there are separate carts or containers available for soiled and clean linen, they should be
labeled accordingly. If not, thoroughly clean the containers or carts used to transport soiled linen
before using them to transport clean linen.

2.4. Clean the bed

Definition of terms:-

Cleaning: A process that removes micro-organisms and the organic material on which
they thrive. It is a prerequisite for effective disinfection or sterilization

A bed: The hospital bed consists of a bed frame, mattress, pillows and bed clothes. Clear
guidelines should be formulated for bed cleaning and systems established, such as labeling
to indicate when a bed has undergone decontamination. To make such reductions a realistic
target, nurses need clear and simple guidelines on how and when to decontaminate equipment.
The hospital bed is comprised of different components which pose a potential risk of

4
infection for the patient if not adequately decontaminated. The hospital bed is the most
frequently used piece of equipment in the clinical area. The constant high turnover of
patients often leaves little time to clean equipment effectively. Bed components, including
bed frames and mattresses may become contaminated by micro-organisms through direct
contact with skin scales and body fluids, thus becoming a source of infection.

Cleaning bed is recommended that the bed, including the frame, undercarriage, mattress and
base, should be decontaminated between each patient and once per week if bed is occupied
by same patient. This aims to prevent dust collecting and helps to prevent the harboring of
micro-organisms. On discharge or transfer of patient, the locker, bed table, nurse call systems,
bed controls, patient chair, oxygen and suction canister and tubing system also need to be
included in this decontamination process. This is a procedure for environmental cleaning of
a room / bed space following discharge or transfer of a patient with no indication of
colonization or infection requiring isolation precautions.

Decontaminate hands before and after carrying out procedure. Put on aprons and disposable
gloves. All linen should be placed in the appropriate color coded bag using the appropriate. Trust
approved disinfectant solution; clean all surfaces, fixtures and fittings in the patient’s immediate
environment. All items of nursing or medical equipment should also be thoroughly cleaned
with the solution. Clean bed, bed frame, undercarriage and both sides of the mattress.

The mattress should be turned as per cycle.

 Always use disposable cloth. Do not return cloth to solution. Replace cloth frequently
(minimum of 3 per bed).
 Attach and date green assurance label on bed when procedure completed.
 Domestic Duties – Request to spot check walls, clean and enquire facilities
 appropriate, empty waste bin, replenish towels and soap if necessary and check
toilet brush and replace if necessary.

2.4.1. Re-positioning the existing bed linen

4
When removed the blanket or duvet, you may wish to place this in the cupboard or folded back
at the end of the bed. If they have more pillows, make the bed and position the pillows
accordingly if items such as books, magazines, glasses, clothes or other personal items were
found on the bed, place them neatly back on the bed in a similar position. Making the bed
„properly‟ is an extremely important part of servicing any room because the bed is often the
focal point of the room and one of the first things in the room that the guest looks at. It is
important that clear procedures are identified when re-positioning the existing bed linen.

 Remove pillows and place them on a clean surface, checking for stains or need for
replacement
 Straighten bottom sheet, again checking for stains or need for replacement. If a new sheet is
required, change accordingly
 Re-tuck in sheet
 Smooth out creases
 With seams up, position top sheet – top edge even with mattress at bed head
 Position blanket – seams up
 Turn head of top sheet over blanket
 Smooth out creases
 Tuck in top sheet and blanket on sides
 Miter all corners, top sheet and blanket together
 Smooth out creases
 Position bedspread so it is straight and all corners are even
 Fold back bedspread at bed head end
 Place pillowcases on fluffed up pillows
 Position pillows on the bed as required
 Fold bedspread over pillow and neatly tuck in.

2.5. Handling reusable clean bed linen

4
Conscientious linen service providers make great efforts to meet standards that ensure hospitals
and other medical facilities receive the healthcare textiles (HCTs) they need to operate safely.
But once HCTs reach the facility’s doors, launderers’ role in maintaining their hygiene is limited
or nonexistent, unless the laundry’s service includes linen distribution. Healthcare linen
providers who adhere to Hygienically Clean Healthcare standards are certified through laundry
plant inspection and third-party, quantified biological testing. Inspection and re-inspection verify
that items are washed, dried, ironed, packed, transported and delivered using best management
practices to meet key disinfection criteria.

Between inspections, ongoing microbial testing quantifies cleanliness and adherence to best
management practices. Clean linen should always be stored in a clean, designated area,
preferably a purpose built cupboard, off the floor to prevent contamination with dust and/or
aerosols. If a linen trolley is used for the storage of linen it should be enclosed. Ideally, linen
should not be decanted onto different trolleys, or stored in corridors when delivered, as
this may result in contamination. Linen can be machine dried or air dried in direct sunlight, if
possible, keeping the fabric off the ground, away from dust and moisture. After the linen is dry,
check for holes and threadbare areas. If damaged, either discard or repair before reuse.

The linen that is not going to be sterilized should be ironed and folded. If surgical drapes are to
be sterilized, do not iron. Ironing dries out the material, making autoclaving more difficult.
Sorting is carried out primarily to make counting possible as well as for streamlining laundry
procedures. Linen is counted in order to make a record so that issuing to departments may be
accurate and it is possible to tally the exchange of linen between the linen room and the laundry
and a basis for billing exists.

Operation Sheet-10 Linen Handling Procedure

Equipment: - Hamper, bags, chair, PPE

Purpose: - To prevent infection and cross-contamination

Handling Procedures

4
 1. Handle stored linen as little as possible
2. Keep clean linen in clean, closed storage area
3. Use physical barriers to separate folding and storage rooms from soiled areas Keep shelves
clear
4. Clean and soiled linen should be transported separately Containers or carts used to transport
5. Soiled linen should be thoroughly cleaned before using same for transporting clean line
6. Clean linen must be wrapped or covered during transport to avoid contamination
7. Protect clean linen until it is distributed, do not leave extra linen in patient’s area
8. Handle clean linen as little as possible
9. Avoid shaking clean linen. It releases dust and lint into the room
10. Clean soiled mattresses before putting clean linen on them
11. Sterilization is a preferred end process for surgical gowns, linen drapes and wrappers

LAP Test-10 Practical Demonstration

Name: Date:
Time started: Time finished:
Instruction I: Given the necessary equipment, you are required to perform Linen handling
within 15 minute.
Quality Assurance- Performed Partially performed Not performed
2.6. Cleaning mattresses and pillows regularly and on discharge
All linen items including bed sheets, surgical drapes, masks, gowns should be thoroughly washed
before reuse. Decontamination of linen before washing is not necessary unless linen is heavily
soiled and will be hand washed. The workers should not carry wet, soiled linen close to their
body even though they are wearing a plastic or rubber apron.

The storage time for soiled linen before washing is related to practical issues, such as available
space and aesthetics, not to infection prevention practices.

5
Hand washing Linen:-Wash heavily soiled linen separately from nonsolid linen. Wash the
entire item in water with soap to remove all spoilage, even if not visible. Use warm water and
add bleach to aid cleaning and bactericidal action. Also add some sour (mild acetic acid) to
prevent yellowing of linen, if available.

NB: - Presoaking in soap, water and bleach is necessary only for heavily soiled linen. Check
items for cleanliness. Rewash if it is dirty or stained/discolored/marked. Rinse linen with clean
water.

Self-Check-2 Written Test

I. Choose the correct answer from given alternatives
1. W/c one of the following is Precaution about Stripping of a bed
A. Prepare the bed for remaking C. Use glove if the bed used by patient
B. let your uniform touch the bedding D. Woolen blankets are never discarded in hamper
2---------Is a bed prepared for a patient with dyspnea and minimum strain?
A. Anesthetic bed
C. Amputation bed
B. Cardiac bed
D. Closed bed
3. Which part of bed is used to open for
observation?
C. Amputation bed
A. Fracture bed
D. None of the above
B. Open bed
4--------------Is unwrinkled bed surface with a minimum of energy expenditure
A. Unoccupied bed
C. Occupied bed
B. Surgical bed
D. Fracture bed

II. True /False Question

1. Shaking soiled bed linen during stripping is used to remove soils?
2. Bed making is one of the comforting mechanisms of a client’s?
III. Short answer question
1. List the common equipment used to prepare a bed?
2. Describe and discuss the use of PPE during bed making?
5
Unit Three:-Leave bed ready for occupancy or continued occupancy

This learning unit is developed to provide the trainees the necessary information regarding the
following content coverage and topics:
 Report damaged and/or faulty beds and beddings
 Clean and return cleaning materials to storage area
This unit will also assist you to attain the learning outcomes stated in the cover page. Specifically,
upon completion of this learning guide, you will be able to:
 Report damaged and/or faulty beds and beds and beddings.
 Clean materials implements and returned to storage area

Learning Instructions:
1. Read the specific objectives of this Learning Guide.
2. Follow the instructions described.
3. Read the information written in the “Information Sheets
4. Accomplish the “Self-check”.

3.1. Report damaged and/or faulty beds and beddings

3.1.1. Reporting damaged and/or faulty beddings
Remove soiled bed linen from the bed and look at the mattress pad / mattress protector to see if it
is stained, torn or damaged. If it is not straighten it and make sure the mattress and box spring are
even. If the mattress pad is stained then remove it and get a clean mattress pad and place it on the
mattress. Do not use a stained or torn sheet. Place them immediately in your solid linen bag.
Condemned linen is converted into useful items called cut-downs/ makeovers. It is important to
maintain a record of the condemned articles and the makeovers, so that they can be adjusted in
the stock record. Report to the supervisor if you notice stains or tears in the bedspread.

3.2. Clean and return cleaning materials to storage area

Clean linen should always be stored in a clean, designated area, preferably a purpose
built cupboard, off the floor to prevent contamination with dust and/or aerosols. If a linen trolley
is used for the storage of linen it should be enclosed. Ideally, linen should not be decanted

5
onto different trolleys, or stored in corridors when delivered, as this may result in
contamination.

Self-Check-3
I. Chose the correct answer from the given alternatives
1-------------Is the method to removes micro-organisms and the organic material on the bed
A. Clearing
B. Cleaning
C. decontamination
D. All
2. W/c one of the following is incorrect about linen
A. Do not leave extra linen in patient’s area
B. Sterilized linen should be ironed
C. Avoid shaking clean linen
D. soiled linen should be transported separately

II. Short answer questions

1. Describe the methods of cleaning soiled linens

2. When does HCWs record and report the damaged bedding

5
Unit Four: - Manage Linen Stock at User-Locations

This learning unit is developed to provide the trainees the necessary information regarding
the following content coverage and topics:

 Collect soiled linen

 Transport soiled linen
 Identify and report hazards
 Re-stock linen
 Rotate and return linen for processing
 Maintaining optimum stock levels
 Maintain storage and security of linen.
 Maintain records of linen stock.

This unit will also assist you to attain the learning outcomes stated in the cover page.
Specifically, upon completion of this learning guide, you will be able to:
 Collect soiled linen.
 Transported soiled linen.
 Identify Hazards and report
 Re-stock Linen
 Rotate linen stock and return for reprocessing.
 Maintain optimum stock levels.
 Requisition Linen to the pre-determined quantity levels.
 Maintain storage and security of linen.
Learning Instructions:
1. Read the specific objectives of this Learning Guide.
2. Follow the instructions described.
3. Read the information written in the “Information Sheets
4. Accomplish the “Self-check”.

5
4.1. Collecting soiled linen
Collect soiled linen periodically means collecting used linens from user locations for the purpose
of laundry or discarded. Solid linens can be collected based on the item type or department in the
bag. After laundry processes the clean linens can be transport to user locations using appropriate
equipment and safe handling techniques.

It has been shown that used linen, within healthcare settings, in particular, can harbor
large numbers of potentially pathogenic microorganisms. Therefore, it is important that the
appropriate precautions are taken to ensure contamination to/from linen does not occur as this
might then lead to transmission of microorganisms to people or to the environment
potentially causing infection. Such important precautions apply to all stages of linen
management: storage, handling, bagging and transporting. The provision and management of
linen services is an important function to enable sustainable delivery of patient care. By
complying with this policy staff will facilitate the continued delivery of these services,
minimizing risks to health & safety, complying with infection control requirements and
ensuring best value for the trust.

After invasive medical or surgical procedures or when changing linen in patient rooms: - Collect
used linen in cloth or plastic bags or containers with lids. If linen is heavily contaminated with
blood or body fluids, carefully roll the contaminated area into the center of the linen and place in
a leak proof bag or container with a lid. Cloth bags are adequate for the majority of the patient
care linen. They require the same processing as their contents. Handle soiled linen as little as
possible and do not shake it. This helps prevent spreading microorganisms to the environment,
personnel and other patients. It is not necessary to double-bag or use additional precautions for
used linen from patients in isolation. Do not sort and wash soiled linens in patient care areas.
Collect and remove soiled linen after each procedure on daily basis or as needed including
patient rooms.

All linen bags must be placed in the correct color bag, securely tied, labeled as appropriate and
stored in a room or area designated for the purpose, which is safe and separate from service user
areas. A laundry poster explaining the color coding of laundry bags to be displayed in the
laundry storage areas. Bags must be less than 2/3 full. Laundry bags holding used linen should
not be left unsealed/tied for long periods i.e. longer than 24 hours. All trust owned items that are

5
sent to the laundry must be appropriately marked including mattress overlays and patient
clothing.

Plastic aprons and gloves should be worn when handling used, soiled or infected linen. Hands
must be washed after handling all used soiled or infected linen even though gloves have been
worn. Linen should be held away from the body to prevent contamination of clothing. The
amount of space to be allocated for storage depends on the size and type of operation and the
linen coverage.

When designing the storage space for linen it is necessary to consider the type of
shelves required, the method of storage as well as hygiene and safety factors. Using the
appropriate equipment and safe handling techniques.

4.2. Transport soiled linen

Transport collected soiled linen in closed leak proof bags, containers with lids or covered carts to
the processing area daily or as needed. Transport soiled linen and clean linen separately. If there
are separate carts or containers available for soiled and clean linen, they should be labeled
accordingly. If not, thoroughly clean the containers or carts used to transport soiled linen before
using them to transport clean linen.

Used linen must be handled with care to prevent environmental contamination with excretion or
secretions, skin scales or bacteria. Staff must wear gloves and linen must be bagged at the
bedside, never shaken or allowed to touch the floor. No extraneous items must be placed in the
laundry bags, especially sharp objects. Use physical barriers to separate folding and storage
rooms from soiled areas keep shelves clear. Clean and soiled linen should be transported
separately Containers or carts used to transport soiled linen should be thoroughly cleaned before
using the same for transporting clean line. Protect clean linen until it is distributed, do not leave
extra linen in patient’s area. Avoid shaking clean linen. It releases dust and lint into the room.
Clean soiled mattresses before putting clean linen on them

4.3. Identifying and reporting hazard

Hazard – a substance or situation that can cause injury or illness, damage to property, damage to
the workplace environment, or any combination of these.

5
Reporting is a part of the internal responsibility system. Everyone shares in the responsibility for
identifying, reporting & controlling hazards

Reporting hazards is a first step to workplace safety. Reporting hazards comes through worker
reports safety inspections of work areas investigation reports employers must have a way for
workers to report hazards, and a way or supervisors and the employer to follow up on them.
Workers must report workplace hazards. Even if they aren’t sure whether it’s a “real” hazard or
not. Reporting hazards comes through:

Worker reports
Safety inspections of work areas
Investigation reports

4.4. Re-stocking linen

Once the clean linen is delivered at each area’s closet, it is ready for use by the nursing staff
when needed. The nursing staff refills the side carts and side closets after the clean linen is
delivered. The nurses and nursing assistants refill drawers outside each room with yellow
prevention gowns after the large tubs are refilled. Nurses, nursing assistants, and housekeepers
then utilize the linen as needed throughout the day by taking it from the side carts or closets, and
bringing it to the patient who needs it. When the linen gets soiled, the nursing staff or
Housekeeping disposes of it in the soiled linen bags located in each individual room.
Housekeeping is responsible for taking the soiled linen bags every day to the soiled linen closet
and placing them inside the empty tubs located there. Finally, whenever the nurses believe that
the linen is running low, they call EMS to request a linen refill

4.5. Rotating linen stock

Stocktaking is counting what you have (Actual or Physical Stock) and comparing
it with what you are supposed to have (Book or Recorded Stock). It is an essential
activity that must be carried out at regular intervals. Any discrepancies should be
accounted for and adjusted in the records. It is an operational necessity in order to
be able to predict future requirements. Stocktaking acts as a control measure by
highlighting discrepancies, thereby promoting investigation. It also acts as a deterrent for
pilferage and ensures rotation of stock.

5
4.6. Returning old stock for reprocessing
Soiled linen may contain large numbers of microorganisms; there is little risk to health
workers during linen processing.

When work related infections occur, they often are the due to healthcare workers not
using gloves or not washing their hands during or after collecting, transporting and
sorting soiled items. No additional precautions are necessary, regardless of the patient’s
diagnosis, if standard precautions are used in all situations

4.6.1. Principles and key steps in processing linen:

 Housekeeping and laundry personnel should wear gloves and other personal protective
equipment as indicated when collecting, handling, transporting, sorting and washing
soiled linen. When collecting and transporting soiled linen handle it as little as
possible and with minimum contact to avoid accidental injury and spreading of
microorganisms
 Consider all cloth items (e.g., surgical drapes, gowns, wrappers) used during a
procedure as infectious. Even if there is no visible contamination, the item must be
laundered.
 Carry soiled linen in covered containers or plastic bags to prevent spills and splashes,
and confine the soiled linen to designated areas (interim storage area) until transported
to the laundry. Carefully sort all linen in the laundry area before washing.

4.6.2. Maintaining optimum stock levels

4.7. Requisitioning linen to the pre-determined quantity levels
The stock level is the quantity of an item that is available for use in a given period of time. The
reserve stock (sometimes also called safety stock or buffer stock is the lowest level of stock for
each item, and quantities should not be allowed to fall below this level. Your reserve stocks are
essentially extra supplies to ensure that there are no stock outs if there is an unexpected increase
in demand or a delay in receiving supplies. The quantity of reserve stock depends on the average
monthly consumption and the lead time. If there are factors that could increase lead times, for
example, bad roads, unreliable transport or conflict, consider increasing the amount of reserve
stock. The minimum stock level (sometimes called the re-order level) is the stock level that
indicates you need to place an order to avoid running short of supplies. The minimum stock level

5
can change over time, so check it regularly and make any necessary adjustments to the stock card
and your orders. To calculate the minimum level, use the formula:

Minimum stock level = Reserve stock + Stock used during lead time

The order quantity is the quantity of items that is ordered to be used in one supply period, and it
depends on the length of time between orders (i.e. frequency of ordering) and average monthly
consumption.

If, for example, you place an order every 6 months, the quantity ordered should maintain stocks
above the reserve stock level until the next supplies are received i.e. last for 6 months. To
calculate the order quantity, in other words how much you need for the supply period, use the
formula: Order quantity = Time between orders x Average monthly consumption

The maximum stock level is the maximum amount of any item you should have in stock at any
time. You will usually only has the maximum level in stock just after receiving a delivery. The
maximum level helps to prevent you from over-ordering. This level can change over time, so
check it regularly and make any necessary adjustments to the stock card and your orders. To
calculate the maximum stock level, use the formula:

Maximum level = Reserve stock level + Order quantity for one supply period

4.8. Maintaining storage and security of linen

Clean linen should always be stored in a clean, designated area, preferably a
purpose built cupboard, off the floor to prevent contamination with dust and/or
aerosols. If a linen trolley is used for the storage of linen it should be enclosed. Ideally,
linen should not be decanted onto different trolleys, or stored in corridors when
delivered, as this may result in contamination.

4.9. Maintaining linen stock records

Many records are entered on a day-to-day basis for the exchange of linen between the
linen room, laundry and floors/departments. Purchase records are essential and records of
condemned linen and makeovers are usually maintained. Periodical stocktaking is carried out
and the annual stocktaking is recorded in the stock register, thereby providing the value of linen
as an asset. Stocktaking is counting what you have (Actual or Physical Stock) and

5
 comparing it with what you are supposed to have (Book or Recorded Stock). It is an essential
activity that must be carried out at regular intervals. Any discrepancies should be accounted for
and adjusted in the records. It is an operational necessity in order to be able to predict
future requirements. Stocktaking acts as a control measure by highlighting discrepancies, thereby
promoting investigation. It also acts as a deterrent for pilferage and ensures rotation of stock.

Self-Check -4

I. Multiple Choices: Choose the correct answer

1. Which one of the following is incorrect statement
A. Collect and remove soiled linen after each procedure
B. All linen bags must be placed in securely tied
C. In laundry bags used linen should be longer than 24 hours
D. None
2.Is a first step to workplace safety
A. Investigation reports
B. Identifying hazard
C. Reporting hazard
D. Reporting work
3.Is the quantity of an item that is available for use in a given period of time
A. Stocktaking
B. stock process
C. stock level
D. All
I. TRUE/FALES QUESTION
1. Clean linen should always be stored in a clean, designated area, preferably a purpose
built cupboard?
2. Wear gloves only when collecting, handling, transporting, sorting and washing soiled linen?

6
3. No extraneous items must be placed in the laundry bags, especially sharp objects?

III. Short Answer Question

1. Describe Infection prevention precautions in linen handling?
2. When handling linen what technique would minimize the spread of microorganisms?

References

1. Abraham Alanso. 2002. Lecture note on basic clinical Nursing skills:-Hawassa University
2. DeLaune S C & Ladner P K. 2002. Fundamentals of Nursing: standard and practice. 2nd:
Delmar/Thomson learning. Also available on http://delaune.DelmarNursing.com.
3. Fundamentals Of Nursing skill lab Manual

6
 Developers Profile

No Name Educational Qualification Field of Study Organization/ Phone E-mail

back (Level) Institution number
ground
1 Tesgera Medical PHSC
MSc (A)
Begize BSc Nursing Nursing 0945747265 [email protected]
2 Fikre Master in Public Health ACHS
Bojola BSc Nursing public health 0924744202 [email protected]
3 S/ r Medical DHSC
MSc in
Dinkie Nursing
nursing
Tadele BSc Nursing 0914736645 [email protected]
4 Habtamu Master of epidemiology MACOHS
Teshome Bsc nursing Public health 0921897815 [email protected]
5 Kitesa Health MPH in ShHSC
Biresa Officer MPH Epidemiology 0902774004 [email protected]
6 Assistant Adult Health ENA & JU
Professor of Nursing
Admasu Adult Health
Belay Nursing Nursing 0925270512 [email protected]