Making an occupied bed-help me settle a debate!

[Dorali]

A co-worker and I were making an occupied bed when we got into a debate.

When you roll up the dirty linen and then lay out the clean, right before you roll the person to the other side of the bed, does the clean linen go over the TOP of the dirty or UNDERNEATH.

My thought was to go on top so the dirty touches underneath the clean.

I hope this makes sense. How do you do it??

Dondie

[aimee1963]

Clean is rolled under the dirty as the dirty is rolled away. The dirty linen is rolled away with the patient who is then rolled back onto the clean. That's how I remember it.

[benr98]

I just recently learned this skill also in my CNA class. We were taught to roll the dirty sheet up and tuck it under the patient. Next we were taught to roll or accordian fold the clean sheets up against the dirty sheet. This leaves the clean sheet touching the "clean side" of the dirty sheet. Roll the patient over and remove the dirty sheets then roll out the clean sheets, this is supposed to limit the cintact of the dirty side of the sheet to the clean sheets. My thought is if the patient was laying on the dirty sheet aren't their clothes or gown also dirty and wouldn't that contaminate the clean sheet as well?

[FranEMTnurse, CNA, LPN, EMT-I]

I just recently learned this skill also in my CNA class. We were taught to roll the dirty sheet up and tuck it under the patient. Next we were taught to roll or accordian fold the clean sheets up against the dirty sheet. This leaves the clean sheet touching the "clean side" of the dirty sheet. Roll the patient over and remove the dirty sheets then roll out the clean sheets, this is supposed to limit the cintact of the dirty side of the sheet to the clean sheets. My thought is if the patient was laying on the dirty sheet aren't their clothes or gown also dirty and wouldn't that contaminate the clean sheet as well?

This is the way I was taught also oh so many years ago. Way before chux were created, and we used draw sheets instead. The draw sheet was placed on top of the bottom sheet then, then the top sheet, and rolled next to the patient after the dirty linen was tucked under the patient.

[Maddie-LPN]

i have always done "clean under dirty"

[jock]

A co-worker and I were making an occupied bed when we got into a debate.

When you roll up the dirty linen and then lay out the clean, right before you roll the person to the other side of the bed, does the clean linen go over the TOP of the dirty or UNDERNEATH.

My thought was to go on top so the dirty touches underneath the clean.

I hope this makes sense. How do you do it??

Dondie

Hi there

Neither. The patient is rolled over to the left or right and the dirty linen is rolled toward the patient's back. Then clean linen is placed on the bed (not on the dirty linen). The patient is then rolled onto the clean linen in the opposite direction and the dirty linen is removed gently. The linen is then pulled into position on the other side of the bed and the patient can be rolled gently back into the centre of the bed onto the clean linen. Whew! Hope it makes sense. Please see my other explanation it makes more sense.

[jock]

A co-worker and I were making an occupied bed when we got into a debate.

When you roll up the dirty linen and then lay out the clean, right before you roll the person to the other side of the bed, does the clean linen go over the TOP of the dirty or UNDERNEATH.

My thought was to go on top so the dirty touches underneath the clean.

I hope this makes sense. How do you do it??

Dondie

Hi there again. Maybe this one will make more sense.

Neither. The patient is rolled either to the left or right. While the assisting nurse or nurse assistant is holding the patient the dirty linen is rolled to the centre of the bed towards the patient's back (almost under the patient). The clean linen is then placed on the side of the bed where there is no linen at this time. The patient is then gently rolled over to the opposite side of the bed onto the clean linen and the assisting nurse/nurse assistant pulls the clean linen into place after removing the dirty linen.Then the patient is rolled gently back to the centre of the bed. Hope this makes sense.

[systoly]

Yeah it seems like this issue is insignificant, but imho, efficiency in making a heavily soiled, occupied bed is a SKILL which greatly benefits the patients by ensuring less discomfort (emotional as well as physical) for the occupant, more time for other care, less waste (on one occasion I went through 3 pads, 2 sets of linens and 2 towels before I got it right - what can I say - the early days). I believe the way you go about it depends on the situation such as soil level, physical limitations of occupant, etc. If the bed is heavily soiled, you probably have to clean the mattress anyway. Far more important than over or under is the fact that people care enough to post about how to change a bed sheet, which makes me feel good to be part of this profession.

[nursedora]

No matter how you were taught or do, over/under, remember no matter if the bed is made occupied or unocupied, you DON"T want any, repeat ANY wrinkles whatsoever, I've seen how in a very short period of time, less than an hour, a simple wrinkle in any of the bottom linnens will crate skin breakdown. Not good for pt or business. So, learn the skill well, and keep your pts clean and wrinkle free.

[Dorali, BSN, LPN, RN]

Thank you everyone! I guess I lost the bet, but it's ok because my friend doesn't work there anymore! Ha ha!

Jock-Thank you for taking the time to explain what you were trying to say. It did make sense!

PS-Did anyone see that this thread made it into the AllNurses email newsletter a few weeks ago?!?