Bed linens in the ICU

[Steph41]

Our ICU has recently been instructed on how we are to put linens on the bed. First we now have to put a fitted sheet. Then directly on top of that goes a flat sheet followed by a chucks pad which the pt. lies on.

We we used to just use a flat sheet and an absorbent pad. Someone, somewhere, decided that because we started the flat sheet low, it increase a risk of infection. We put it low to account for the boosting and turning.

I feel, as do my peers, this new way is a skin risk. QUESTION: How does your ICU do bed linens and how would you feel about an extra linen under your pt. ?

[Greenclip]

We use a fitted sheet and a large blue absorbent pad (cloth, not paper) as our standard. We use the blue pad as a draw sheet to turn patients. We have superb skin outcomes.

Patients at high risk for skin breakdown get different treatment, including a special mattress or special bed.

[smf0903]

We use a fitted sheet and a large blue absorbent pad (cloth, not paper) as our standard. We use the blue pad as a draw sheet to turn patients. We have superb skin outcomes.

Patients at high risk for skin breakdown get different treatment, including a special mattress or special bed.

Same here.

[MunoRN, RN]

On the floors, a fitted sheet with a wicking/breathable pad is the standard. The beds in ICU are much different and the manufacturer recommends against using a fitted sheet on these beds as it interferes with the function of the mattress and bed, and prevents the active therapies the bed provides to protect skin from working correctly.

I get the concern about the patient coming in direct contact with the mattress, but there's no actual reason to believe this poses a infection control risk, the pathogen load of a cleaned mattress cover is extremely low, quite possibly lower than that of clean hospital linen, which have been shown to still carry significant amounts of pathogens.

[Kuriin, BSN, RN]

Wouldn't all the linens pose more of a risk of skin breakdown? How does your facility propose to use specific mattresses such as P-500s for skin breakdown when you can't put many sets on?