La unidad del paciente.

Unit 1
hospital bed

In this unit we will learn to:

Describe the characteristics of the unit

of nursing.
Describe the characteristics of the unit.
of the patient and the conditions
environmental.
Identify and describe the furniture
and the material means and accessories
that integrate the unit of the patient.
Explain the sequence of operations
and information to the patients
during the act of reception and admission
in the hospitalization unit.
Define the concept of hospital bed
and explain its types.
• Explain the bed accessories for use
And we will study: more frequent in the hospital setting.
• Explain the production techniques
The patient's unit. of the different types of bed,
according to the patient's condition.
The furniture and the materials
from the patient's unit.
The functions of the care technician
nursing auxiliaries (technician)
in relation to the patient unit.
The nursing unit.
The different types of hospital beds.
The accessories of the hospital bed.
The various arranging techniques
from the bed.
 1 The patient's unit. Hospital bed

1.The nursing unit

Important
The nursing unit is the set of departments and material resources re-
In the hospital, there are so many wounds related to nursing staff, which are available to provide the
as a nursing function- necessary care for patients admitted to a hospital.
nes and care specialties
are carried out in it. To each of
they are assigned to her: Each nursing unit consists of the following elements:
A certain number of pa- • Nursing or floor control (Fig. 1.1). It is located in a strategic area,
cientes. to facilitate the work and control of the different units of the patient that he/she has
A healthcare team formed assigned to their position. Generally, it consists of a counter, a system of
by: a supervisor of in- intercommunication with the rooms, computer media, etc.
nursing, various DUE (Diploma in Nursing)
University Trends in Nursing Patient rooms. They include one or more patient units.
Mérida) and several assistants of
nursing. Specific area for recording information. Place where the sheets are stored.
nursing, medical records and other documents. It is located in the control itself or
nearby.
• Warehouse for linens. Place where bedding and materials are stored.
clean.
Warehouse of medical materials and products. Place where the materials are stored.
the essentials to meet the care needs of patients.
Office. It is the place designated for the preparation of some meals for the patients.
It is usually connected to the kitchen service via a freight elevator.
• Medication room. It is intended to store and prepare the necessary medication.
it would be removed for the patients on the floor.
Fig. 1.1.Nursing control.
Multipurpose room. Intended for the entertainment of patients.
Important Living room or rest room. Intended for the healthcare staff.

The most important functions Visiting room. It is also equipped with the necessary furniture.
from the nursing unit are: • Dispatches. Of various uses.
• Respond to the needs
of the patients. Restrooms for healthcare personnel.
• Ensure your safety (physical Restrooms for visitors. They are clearly identified to facilitate their location.
and psychological).
Provide the necessary means Space or room to store devices, equipment, and mobility apparatus
for the application of the pro- and the movement of patients. Among them are canes, crutches, walkers, chairs
sanitary procedures. of wheels, cranes, etc.
Enhance and stimulate the work
Storage space. Area to store, for example, the stop car,
of the healthcare personnel, po-
having the right means
the electrocardiogram, etc.
for the environment of tea- Room designated for the on-call doctor.
under be effective and rewarding.
Hallways. They connect the different elements of the nursing unit.

Activities

1. Create a mural that reflects a map of the university-3. Search for information on the Internet about rights of
nursing dad and indicate each of his com- the patients, and make a list with them. I recommend you
speakers. we give you to consult the document 'Rights of the
2. Besides the ones described, what other functions do you think patients," written by Miguel Casares Fernández-Alvés
What can nursing staff carry out? and published by Medical Tribune.

10
 The patient's unit. Hospital bed 1
2. The patient's unit
Important
The patient unit is the set formed by the room space,
the furniture and the materials used by the patient during their stay in the center
The number of beds per room
hospital. Therefore, the number of patient units will be equal to the number ción(unidades del paciente) va-
of beds that the hospital has. transferring from one hospital to another, being
the vast majority of two or three
beds.
In rooms with multiple beds, each unit can be separated by dividers.
The ideal situation is to be able to
or curtains to ensure and respect the privacy of the patients. In the rooms
to arrange on each floor, or with-
Individuals, the term 'patient unit' refers to all the content and physical space. nursing trolley, of room-
from the own room. individual nests and of habitat-
Single rooms must be preserved for the isolation of patients. shared actions, to use-
who have serious conditions in their general state, infectious contagious diseases, operated on carry out one option or another in
at risk of being infected, immunocompromised, patients with some type of alteration function of the characteristics of
the patients.
psychic action, etc.

A. Characteristics of the standard patient unit

The patient's pathology and age are determining factors that must be taken into account.
counts in the organization and arrangement of the patient's unit.
The dimensions of the room depend on the number of beds. The approximate dimensions
the following are:
Single rooms (1 bed): the dimensions should be about 10 m2.
Double rooms (2 beds): the dimensions should be about 14 m2.
Triple rooms (3 beds): the dimensions should be about 18-20 m 2.
The maximum number of beds per room should not exceed four. The room-
there must be sufficient space, from 1 to 1.20 meters, between the beds and between
the bed and the wall; in such a way that it is possible to attend to the patient from both the
lateral like from the foot of the bed, allowing, in addition, the passage of a stretcher.
and the stretcher bearer (Fig. 1.2).

Complete yourself The painted walls of Loading of oxygen and the system of
per room, with door light colors and without shine. empty, which are fixed to the wall
easily accessible entrance and at the head of the patient's bed.
and adapted for the sick
with some type of
physical disability, and that
The system of
allow to do the work communication
patient care of internal, with the
form comfortable and secure.
nursing control,
through a team of
intercommunication of
Wide door light signals.
to allow passage
from a bed with system
de goteo.
The light naturally there
adequate ventilation
The size is enough for that guarantee
that can be distributed the renewal of air.
with comfort and order
all the furniture,
and that allows to carry out its
cleaning easily. Ladder of 2.5 meters.

Fig. 1.2.Characteristics of the standard patient unit.

11
 1 The patient unit. Hospital bed

B. Other types of patient units

Important Each hospital unit is designed taking into account the type of patients it will serve.
welcome. We can differentiate the types of units in Table 1.1.
The geriatric units or of
It should be designed and decorated with colors and motifs that catch the eye.
patients with some type of de- Unit
of the child and are joyful and attractive to him (for example, scenes of drawings
physical pendency must be available of pediatrics
animated on their walls).
adapted desires to your disca-
capacity (Fig. 1.3); that is to say, that In the case of patients dependent on a wheelchair or others
they bring shower tray (instead Unit assistive devices, the rooms must have more space
of the bathtub), with anti-slip floor of geriatrics and access to the room and the bathroom suitable for them to be able to
rails and handholds on the wall. wheelchairs, carts, stretchers, tow cranes, etc.
They will also be equipped with
handles or fastening bars In these cases, due to the special characteristics of the patients,
to facilitate the use of the inode- It is necessary to adapt all or part of the equipment, and they must also have available
Units
without any risks to the of other types of utensils, equipment, and different devices that are
with characteristics
patients. necessary to provide the appropriate care for these patients.
specials
Example: intensive care, obstetrics, pediatrics, traumatology,
burned, radiotherapy, etc.

Remaining units They have the same characteristics as a standard patient unit.

Table 1.1.Other types of patient units.

Practical case 1

In the nursing home where you work, Andrés and Justo are admitted, who
They share a room. You must arrange the beds in such a way that they allow for
physical care of patients in a comfortable manner. What aspects should you consider?
count?
Solution
It is important to arrange the beds in such a way that there is a space of 1 to
At least 1.20 meters between the beds, and between them and the wall. It must be kept clear.
the access in and out to both the bathroom and the room itself, about
everything if any of the patients show any type of physical dependency.

Activities

4. How should the units intended for patients with certain conditions be?
type of physical dependency?
5. For which type of patients should rooms be prioritized for preservation?
Fig. 1.3.Mug with a handle for gripping. individuals?
6. Define the concept of patient unit and specify how it differs from.
the patient's room.

I deal with the patient C. Environmental conditions

The patient's state of mind

The environment surrounding the patient has a notable influence on their response.
you can be affected as the treatment he is receiving. In general, the rooms have to be spacious.
consequence of the characteristics quiet, calm, and sunny, and must be kept clean, airy, and tidy for
environmental statistics; therefore, prevent the emergence of psychological or pathological problems (infections).
cleanliness and security are
two important factors that make Hospital rooms must meet a series of environmental conditions that
they expedite and facilitate the process of will have a direct impact on the health status and evolution of the patient
patient healing. The environmental conditions that have the greatest impact on the patient are the
atmospheric, lighting, soundproofing, and cleaning.
12
 The patient's unit. Hospital bed 1
The atmospheric conditions with a greater incidence on the patient are (Table 1.2). Important

Temperature The decrease in the degree of moisture-

dad favors, generally, the
The ambient temperature of the hospitalization unit should be between 20-22 °C, although
dissemination of the microorganisms
it can vary in different areas of the hospital. Thus, in the hallways, it will be between 20-21 °C,
mechanisms that affect the system
in outpatient consultations between 21-23 °C, in operating rooms between 25-28 °C, etc.
respiratory.
It is regulated by thermometers or thermostats that are placed in the units. Increase in the level of moisture
of the patients, the hallways, the special areas, etc. the diseases
Many hospitals have closed ventilation circuits, which are incorporated into that affect the heart and the sys-
an automatic temperature control system. my circulatory.
It is important that proper maintenance and cleaning of the control systems is carried out.
of the temperature to prevent contamination of cooling systems, especially
for Legionella.

Humidity

The optimal humidity values range between 40 and 60%.

It is controlled using hygrometers placed in the patient unit,
the hallways and the special dependencies.
In some pathological states, such as certain respiratory conditions, a degree of humidity
relative low (10 to 20%) is more comfortable for the patient.

Ventilation and air purity Dealing with the patient

Ventilation is usually done by opening the windows and the door for short periods.
Effective direct sunlight
time spaces. To renew the air in the room, it is enough to open the window.
to increase resistance to
for 10-15 minutes.
the diseases. It has been demo-
Whenever possible, it is carried out during clothing change procedures. traded its therapeutic value, espe-
bed and room cleaning. specifically to reduce the susceptibility
susceptibility to diseases such as
To ventilate the room, drafts will be avoided. The use of
of screens to prevent the air from reaching the patient directly.
rickets and tuberculosis.
In addition to its importance as
In modern hospitals, with closed circuit air conditioning or systems essential factor of health, light
for air conditioning, the windows of the rooms should not be opened for ventilation, as the air solar provides natural lighting
It is in constant renewal, and if the window were to open, there would be imbalances. to the rooms, which influences
in the air circuit. positively in the state of
The usual impurities found in the air are gases, dust particles. patients' spirits.
and microorganisms. Respiratory diseases can spread through
these impurities when sneezing, talking or coughing, and spreading through the air.
In the rooms, patients must be protected against infections by applying techniques.
Isolation, dust release, good ventilation, and ample space between the beds.

Table 1.2.Atmospheric conditions with more impact on the patient.

Lighting conditions have a direct impact on the

well-being and in the evolution of the patient's disease. The ilumina-
Care in healthcare centers can be of two types:
• Natural light (Fig. 1.4). It is produced by sunlight;
healing properties, disinfecting, thermal, etc., is the most indi-
each for the care and recovery of the sick. Some
experts believe that a room is well lit if it has
a window space equal in area to almost a quarter
of the soil.
• Artificial light (electric lighting). It is designed in such a way that it can-
to be used according to needs. It can be adapted so that
provide indirect light, such as direct spotlight for the examination
for the patient, light to read or low intensity light. Fig. 1.4.Room with natural light.

13
 1 The patient unit. Hospital bed

The room must have an electrical communication system with the control of
nursing, placed at the head of the bed and that has a pilot light so that it is
visible in the dark (Fig. 1.5). When the patient activates it, a light turns on.
of a specific color (preset by the hospital), which in the nursing control is
identifies as a call for help.
The soundproofing conditions are also very important. The researchers
they have shown that environmental noise, expressed in decibels (dB), causes fatigue
physics and nervous or emotional disorders. The noise generated in the hospital environment
Treasury can come from abroad or from within.

Fig. 1.5.Intercom systems • Outside noise. It generally occurs as a result of activities of

with nursing control. the street (construction, traffic, ambulance sirens, etc.) which can also lead to
associated with the production of vibrations. These noises can be mitigated through systems-
more insulation placed on the windows, in order to reduce the influence
of these factors on the emotional state of the patients.
• Interior noise. It is produced as a consequence of the movement of people in the hallway.
the activity and the work activity of the healthcare center itself. To avoid the production of
It is important that healthcare personnel comply with and enforce the following
standards (Fig. 1.6):
1. Respect the 'Silence' recommendation signs.
2. Speak in a moderate tone and avoid loud or scandalous laughter.
3. Moderate the volume of the television or radio in the rooms.
4. Control the use of mobile phones.
Treatment with the patient 5. Open and close the doors carefully, avoiding slamming.
6. Move the furniture gently and without dragging it.
It must remain overnight
an indicator light on the wall 7. Use flexible-soled or rubber footwear to avoid noisy movements.
(in case of emergency), so that the dosos.
the room should not be left in the dark
8. Transport the beds, wheelchairs, carts, drip stands, etc.
and the patient can see, if they have
carefully, avoiding hitting the walls, furniture, or doors.
need to get up.

Fig. 1.6.Three simple habits that help reduce indoor noise:

moderate the volume of voice, restrict the use of mobile phones and carry
flexible or rubber soled footwear.

The conditions of hygiene and cleanliness seriously affect the patient's evolution.
Important The accumulation of the patient's eliminations (urine, vomit, exudates, feces, etc.)
in a semi-closed or closed environment leads to unpleasant odors being produced.
To enhance comfort blessings, which have repercussions on the patient himself, on the healthcare personnel, on other patients
of the patient, in addition to the
and in the visits.
atmospheric conditions, of
lighting and soundproofing, All of this makes the environment uncomfortable and, from a health perspective, a
we must take into account the im- possible and important source of infection, which makes cleaning and removal necessary
importance of maintaining to avoid the risk of hospital infections.
the hospitalization unit in
optimal cleaning conditions If the nursing staff considers that the patient's room does not meet the
and hygiene. proper hygiene conditions, will notify the cleaning staff to mop the
I clean the floor and the furniture to prevent the spread of microorganisms.
14
 Patient unit. Hospital bed 1
When the patient is discharged, a more thorough cleaning must be performed. I deal with the patient
unit, and all the material that has to be reused; and it is necessary to disinfect
and sterilize it. When cleaning the room, it is important to keep in mind the The TCAE are responsible
next of personal hygiene of the pa-
client, as well as maintaining the
It should be done daily and whenever necessary. bed in ideal conditions
All necessary materials must be prepared in advance. to facilitate your comfort.
They must carry out the withdrawal of
Whenever possible, it should be done with the windows open, but it has to be
eliminations in the conditions-
avoid drafts. safety and hygiene standards more
suitable, to avoid the risk
Don't forget that one of the best disinfectants is bleach. of possible infectious diseases
ciosas.

Practical case 2

Juan has just been admitted to the hospital and has been assigned a room.
she feels fear at night because of another patient:
a) Wants to know how to orient herself to go to the bathroom.
b) She is concerned about how she can communicate with the nursing staff.

Solution
a) Hospital rooms are equipped during the night with an emergency light.
agency, which is attached to the wall and in a visible place, remains in-
turned on so that the room doesn't stay dark and the patient can see
he has to get up.
b)Para que el paciente pueda comunicarse con el control de enfermería dispone
of an electrical intercommunication system, placed at the head of the
bed, which usually has a pilot light so that it can be seen in the dark.

Activities

m
orssalcehtdnm
oaorruoyfoerutarm
epetehterusM
ae.7
about the temperature that must be in the hospital environment.

8. Pair up and simulate the situation in which a patient goes to the control.
of nursing and is attended by it. Pay special attention to the treatment with the
patient and strategies to avoid noise.

h9ftIe.sraindelnriyouarfm
ylg(iarndpaer,snk)htemabohutehefcta
it has the sunlight over sick people.

10. Are there any regulations to consider to prevent noise production in the
health centers? Also indicate if you have seen any symbol elsewhere.
or indication not to make noise.

11. The hygrometer (Fig. 1.7) is a device necessary for measuring one of the parameters-
Environmental factors that must be controlled in the hospital environment. Look for
information on the internet about this device. What is it used for? What types exist?
How are they used? Visit the virtual classroom on the website www.teleformacion.
edu.aytolacoruna.es, go to Natural Sciences and select the course
Atmosphere and climate. In it you will find a method to build your own hygrometer.
metro. What is its functioning based on?
Fig. 1.7.Hygrometer.

15
 1 Patient unit. Hospital bed

3. Furniture and materials of the unit

of the patient
Important The furniture that must be part of a hospital room varies depending on
special units (ICU, coronary, dialysis, etc.) or hospitalization units
Depending on its purpose, to- general (internal medicine, general surgery). The furniture that is part of a unit-
scammers can have the The type of dad is the one that collects Figure 1.8.
following accessories:
Electronic system for re- The bed
regulation of height.
Remote control to place the It is used to accommodate the patient, so it must be in perfect condition.
bed in different positions. servación y mantenimiento, para que este se sienta más cómodo. Debe estar provista
•Other accessories such as triangle- with all the necessary clothing.
weights, pull-up bars, weights, It is placed in the room in such a way that three of its sides are free, to facilitate
pulleys, etc. the work of healthcare staff (postural changes, patient hygiene, application of
care, etc.).
It is arranged so that the headboard is in contact with the wall, but without it
either under the window or near the door (to not obstruct access to the)
room or to the bathroom).
It is important that they are articulated, with an adjustable height plan and easily ma-
movable and portable, which is why they are equipped with wheels.

Oxygen tanks
and empty
Support
of serum

Bed Armchair Table

of bed

Sofa bed
of
companion

Railing

Fig. 1.8.Patient unit furniture.

Important

The bed accessories are:

Mattress covered with a stretchy, breathable vapor-resistant, waterproof cover
water-resistant, hypoallergenic, and fireproof.

Pillow with cover.

Side railings.
Manually adjust the height and articulate the bed.

16
 Patient unit. Hospital bed 1
B. Another type of furniture
In addition to the hospital bed, the patient unit must have the elements
from Table 1.3.

It is placed next to the bed, so that it is accessible, so that the patient can
take any object or utensil you need.
Small table In many healthcare centers, extendable and adjustable bedside tables are used.
in height and position, which can also be transformed into a side table for support
the food trays and adapt to the patient to enhance their comfort.

It is used to place food trays on it. Due to its special design,

Bedside table it allows adjusting its height to the patient, so that they can eat
semi-incorporated and with greater comfort.

They are used as a resting place for independent patients.

and for the mobilization of dependents. They usually have arms and footrests,
they can also have an adjustable device for the placement of the tray
of the food. They are situated next to the patient, on the opposite side of the bedside table.
Chair or armchair
and near the head of the bed, so that one can sit easily
without the need to travel.
Whenever space permits, a chair or armchair should be provided.
for the companion, to have the same characteristics.

It is usually placed inside the restroom and is used to collect waste (garbage,
Trash can
papers, etc.) generated by the patient (that are not healthcare or biological).
the cube
It has a plastic bag inside to facilitate its collection and cleaning.

Support
It is used as a support system for IV bags or medication bags.
of serum

• Wardrobe. It is used to store the patient's clothes and belongings, and a spare blanket in case the patient needs it.
It is needed. It usually includes hangers.
Others • Lamp. Generally fixed to the wall so it doesn't take up space. It is used in examinations, for reading.
accessories or as indirect light. Lamps are not used on the bedside tables to avoid the risk of accidents.
• Paravan. It is used to separate one bed from another, that is, each unit.
of the patient, within the same room. Its objective is to maintain and preserve the intimacy of the patients.

Table 1.3.Patient unit furniture.

17
 1 The patient unit. Hospital bed

C. Materials and equipment of the patient unit

In addition to the described furniture, the patient should be provided with a series of mate-
Important rails or products for carrying out daily personal hygiene activities,
feeding and excrement elimination, as well as to facilitate the execution of the
The furniture must be made care that is needed (Fig. 1.9). The material that should be included in a type unit
falling with colored materials
clear, so that it does not get masked
it can be classified as in Table 1.4.
about the dirt and be easily A glass and a pitcher. Pajamas or nightgown and robe.
washable, as it can be a im-
Another glass for the realization of the Gloves.
important source of infection.
oral hygiene (in the bathroom). A pack of tissues
A basin. disposable or gauze.
Material for use A wedge or bottle for collection Thermometer.
Risk prevention habitual from the feces and urine (in patients Tongue depressors for
bedded. oropharyngeal inspection.
Commonly used material understands, Suitable containers for the Bedding (sheets,
increasingly often, to sample collections. cushion, protector or absorbent
being disposable, to avoid with- blanket and bedspread.
tagios and infections among the pa- Liquid soap (gel). Towels.
Material
clients and biological risks.
of hygiene Single-use sponges. Moisturizing cream.
personal Comb. Toilet paper.
Bed arch: device for • Bed sentinels: they are
the bedding should not be in contact polyethylene pads that are
directly with the patient. they place on the sides of the bed to
Others
Desk: it has an adjustable backrest, prevent injuries or falls of the patient.
materials
formed by a metal arch, that • Equipment or devices for
(based on
it is used to help the patient the mobilization or displacement
of pathology
to adopt the Fowler position. patient: wheelchair;
of the patient)
• Cushions: allow the patient towing cranes, bed cranes,
can adopt different positions. of bipedalism; crutches
or canes; walkers, etc.

Table 1.4.Common materials in the patient unit.

Case Study 3

At the Virgen del Mar clinic, they are proceeding to renew the elements that consist of
they are called "patient unit". Nursing staff is requested to prepare
a list of these elements, classifying them based on their use in: a) furniture;
b)materiales de uso habitual yc)materiales para la higiene y aseo del paciente.
Solution
bed, bedside table, nightstand, armchair, wardrobe, lamp, screen, wastebasket and foot
of serum.
b) Glasses, jug, basin, wedge or bottle, sample collection container,
pajamas or nightgown, gloves, disposable handkerchiefs, thermometer, tongue depressors
sheets and all the necessary bedding for the patient's bed.
Fig. 1.9.Most commonly used material Soap, sponges, comb, towels, moisturizer, and toilet paper.
in the patient's unit.

Activities

12.Indicatehowthescreensareplacedwhentheroom. 14. Explain the purpose of bed arches.

action is shared.
15.Whatcharacteristicsshouldthefurniturepresent?
Are you involved in the hospital environment? Justify your answer.
13.Selectthecommonlyusedmaterialsforthe
patient in the workshop classroom, and arrange them correctly 16.SearchtheInternetforimagesofgeriatricfurniture
mind in the patient's unit. y describe sus características.

18
 The patient unit. Hospital bed 1
4. Functions of the TCAE in relation to the unit
of the patient
When a patient enters the hospital, the TCAE will be the professional in charge. Dealing with the patient
I should receive it, so you need to consider a series of aspects that will help you.
to settle in and adapt to the hospital environment.
When a patient enters in
a hospital experiences a
Lasnormasque must take into account the TCAE to assist both the patient and series of negative sensations
the relatives are: that can affect your state
emotional and the evolution of
1. Receive the patient upon entering the hospital unit, directing them to your illness, due to the cam-
he by his name and treating him with all due respect. bio of habitual residence, the
loss of their independence and
2. Gather all documentation related to your admission, ensuring that
contact with the outside, and the
All necessary data is included. adaptation to the rules and to the rhythm
the way of life that marks the center
3. Complete the nursing control labels with the patient's information.
sanitary.
(if it is provided for in the hospital protocols).
The TCAE must treat the patient
4. Accompany them to the room or unit assigned to the patient, with respect, seeking that it is-
explaining to him whether it is individual or shared and leaving him comfortably installed. those changes are for him
our drastic and traumatic that
5. Explain the rules for using all equipment, materials, and devices. It may be possible.
that are part of the patient's unit. Will always be willing to
listen, both the messages see-
6. Inform them of the hospital rules regarding:
dance like the non-verbals.
Visiting hours: of the doctor, of family members, of friends, etc.
Meal times and menus available for your choice.
- Cleaning service.
Use of the phone and receiving calls from outside, television or radio.
Smoking is prohibited.
Other services available at the hospital, etc.

7. Show them where the common services for all staff are located: the phone,
the chapel, the television room or multipurpose room, etc.
8. To ensure that all the patient unit materials are complete.
9. Ensure that the furniture is in perfect working condition.
10. Check that the ventilation systems are working correctly.
management with nursing control, light, water, etc.

Activities

ogntiogsilatipsoehtfeocivreesnicm
idleanretneihntI.71 d) Perform an endoscopy.
admit a a 45-year-old patient for undergoing a e) Administer serum.
series of diagnostic tests, in order to rule out
f) Collect your documentation.
a gastric carcinoma. Indicate which of the following
which activities are the responsibility of the technician and which are not. g) Explain the hospital rules.
other professionals (doctor and/or nurse): h) Perform a venous puncture.
Take the blood pressure.
a) Receive the patient.
j) Inform you about the usage guidelines of the
b) Perform a bladder catheterization. services.
c) Accompany him/her to the room. k) Observe the changes in attitude.

19
 1 The patient unit. Hospital bed

5.Types of hospital beds

Web The hospital bed is the resting place where a patient can spend, according to their
illness, most of the hours of the day.
In 2009, the Ministry of Health- In it one rests and remains convalescent, sometimes for long periods of time.
dad, Social Policy and Equality time, so the bed becomes something belonging to the patient, which provides them
published the guide titu-
comfort, security, sleep, pain relief, etc. In addition to all this, it facilitates
nursing unit in
multifunctional hospitalization of
implementation of the various sanitary techniques.
sharp (UEH). Standards and re- Some of its characteristics are:
recommendations.
In its section 6 ('Structure') In general, they are made of hollow tubes, which can be easily washed to
and material resources") you will be able to facilitate their cleaning and disinfection.
get more information about
They are usually equipped with mobile wheels on each leg and a braking system.
for example, the characteristics
and distribution of the unit of
to block them; this facilitates movement, both inside the unit in
hospitalization, with photographs that the patient is admitted as in their transfer from one service to another.
from the different spaces. You can The bed frame can be divided into 1, 2, or 3 mobile segments, which can change.
easily find this docu- of position when activated with a crank.
I search through a search engine
of the Internet. The dimensions of the bed are usually:
90-105 cm in width.
190-200 cm in length.
70 cm in height (without mattress).
The most commonly used mattress is generally made of a single piece of springs and semi-rigid.
gido, with lateral reinforcements that serve as support for the body. There are, however-
go, another type of mattresses that are used in special situations.
The mattress is usually covered with a semipermeable and flexible cover to protect it.
of the possible secretions of the patient.
The bedding must be wide enough to be able to secure it correctly.
Risk prevention It must be resistant to frequent washing, but not rough.
There are different types of beds that adapt to specific needs.
The design of the beds, moreover
the patients. In general, two groups can be distinguished: the exploration stretchers
to facilitate the accommodation and the
and the rest beds.
patient retention
must allow professionals
they carry out their tasks with A. Exploration stretchers
security, preventing risks,
for example, how they relate Sirven para la exploración y el transporte del paciente. Se utilizan en los consultorios
two with the posture. For that, one of the hospitals, health centers, etc. They must be covered with a sheet before
will take into account:
place the patient, which will be changed after its use.
The patient's unit is co-
will be arranged so that it can be ac- Examination tables can be:
easily give in to her for three Rigid. They have a tube structure.
from its sides. hollow metal, on which it rests
Thestandarddistancesof a mattress with a rigid base, covered
the beds are: 120 cm apart made of leather or some similar easy material
bed and bed;112cm, like washable mind. It can have wheels for
minimum, from the bed to the facilitate their movement, and a system
pared.
brake that blocks them.
The headboard of the bed is
in contact with the wall. • Articulated. They usually have a single joint.
It will never be located under a tion, located at the headboard, that can be
window not too close to raise up to 90° with respect to the plane of
of a door. the bed. Currently they can carry
various points of articulation (Fig. 1.10). Fig. 1.10.Articulated camilla.
20
 The patient's unit. Hospital bed 1
B. Rest beds
They are intended for patients who will stay in the hospital for long periods.
two of time. The main types appear in Table 1.5.

Metal bed It consists of a rigid bed base, without joints. In some models, it can be elevated.
of rigid slat the head part using a crank.

It is the one most used in hospitals and consists of a metal bed frame.
articulated, formed by two, three, or four movable segments that are actuated
with a crank located at the foot or on the sides of the bed. In the beds
motorized mobilization is carried out from an electric control.
Each joint allows the bed to be divided into two segments; therefore, the bed
Adjustable bed With two joints it has three segments and the bed with three joints has four.
segments. In the three-segment one, the upper part supports the head and the back,
the central one is for the pelvis, and the inferior one is for the lower limbs.
In the four-segment one, another possibility of mobilization is differentiated.
good in the head/shoulders, good in the knees. This type of bed facilitates
the patient's accommodation and postural changes.

It consists of a frame, called 'Balkan frame', which holds some rods.

metallic, located above the bed, to attach some pulleys that,
through ropes, they support different weight systems. To perform the traction,
one of the ends is applied to the patient and weights are placed on the other.
Traction is a therapeutic technique that applies forces to a bone, muscle.
The joint. It can be cutaneous or skeletal. In the first, the force is exerted
Orthopedic bed, about the skin, and in the second, about the bones, starting from surgical nails,
traumatological wires, etc. The objectives of this technique are to align a fractured extremity,
of the County
prevent deformities in the case of paralysis and alleviate the pain from a trauma
osteoarticular (fracture, dislocation, etc.).
It is also equipped with a stirrup or 'Balkan triangle', which allows the patient
to move slightly to sit up or change position.
It is mainly used in traumatology, with patients suffering from fractures,
dislocations, paralysis of the limbs, multiple traumas, etc.

It is made up of two circular metal frames, connected to each other by a plane.

rigid that rotates over the previous ones.
The bed can take any position: horizontal, vertical, inclined in all
the angles and upside down. In addition, it is equipped with a switch that allows
a slow circular movement that can be controlled by itself
Bed
patient.
electrocircular
Footrests, side rails, and securing straps can be attached.
and any other element that facilitates pressure changes on the surface
corporal, thus avoiding pressure ulcers. It is used for severe burns,
polytraumatized or with spinal cord injuries, that is, in cases of immobilization
in the long term.

Table 1.5.Types of resting beds. (Continues)

21
 1 The patient unit. Hospital bed

(Continuation)

It is a bed that keeps the patient secured while constantly rotating.

for distributing pressure points. It is used to prevent
the appearance of pressure ulcers. Allows turns and lateral position changes
Broken Bed Rest and longitudinal.
For this type of beds, side frames or supports are used,
from the head, from the feet, and for the turn, as well as pads
shock absorbers.

It is used to keep premature newborns in an environment

adequate temperature and humidity, in order to ensure their conditions
of life. It allows for the manipulation of the baby from the outside, through a few
devices in the form of gloves or doors.
Humidity, temperature, and concentration can be precisely regulated.
of oxygen.
They allow monitoring of the newborn (heart rate, respiratory rate.
and temperature), as well as connecting him to a respirator, performing suctioning on him
Incubator
secretions if necessary, use the nebulizer unit, apply the lamp
of blue light (hyperbilirubinemia), etc.
The chamber where the baby is placed is made of transparent material, which facilitates both
isolation as its control and observation. It is usually placed on a metal piece of furniture,
with compartments that allow for storing the necessary materials for care.
There are incubators equipped with wheels that facilitate movement in those.
cases where it is appropriate, and some are equipped, even, with all the material
necessary to provide intensive care.

Tabla 1.5.Types of rest beds.

Case study 4

Marilen is a TCAE and works in the Clinical Hospital, in the cardiology department, in the
that the beds are articulated.
Today, during coffee time, another colleague tells her that she knows that the hospital has
acquired several models of beds: RotoRest, electrocircular and incubator.
For which patients would they be suitable?

Solution
The RotoRest bed is suitable for patients with limited mobility,
to prevent pressure ulcers. The electrocircular also serves to prevent
pressure ulcers in major burn victims, polytrauma patients, and injured people
Incubators are indicated for premature children.

Activities
Important
18. Indicate the characteristics that a hospital bed should have.
Motorized articulated arm 19. Why do you think the placement of the bed is related to prevention?
permite la movilización de una the occupational risks of the TCAE?
very simple way with only ac-
turn on the positioning device 20. Create a diagram in your notebook, in which you gather the different types of
in motion/braking. Each time beds and their main characteristics.
its use is spreading more
in the home environment, like 21.Gotohtewebsetiwwwd.aylimooitnc.omandsearchforthevdieo'Unytiof'
part of the adaptation plan of premature (Spain), from the Documentaries TV program. Among other information,
patient environment depend- In this video, the use of several incubators is shown. Are they all the same or
teeth. Do you identify various types? Note the characteristics that distinguish them.

22
 The patient unit. Hospital bed 1
6. Hospital bed accessories
All those elements (including the mattress) are considered accessories.
to position oneself in bed to facilitate the stay, hygiene, comfort, and the
patient welfare.

For a better understanding, and aiming to provide didactic clarity, we will

to classify into three groups: pillows and mattresses, bedding, and other accessories.

A. Pillows and mattresses

The red pillow is usually made of foam, soft and low, intended to facilitate positional changes.
naturals and the accommodation of the patient. In general, there is more than one pillow available.
per patient.
Mattresses (Table 1.6) can come in various shapes and structures. These different
models aim to contribute to the prevention of pressure ulcers. The
the most important are the following:

Latex mattress. Nowadays they are used more and more, as they constitute a good base.
for the patient's rest.

Foam mattress. It is more easily compressed by the weight of the body.

It can be one piece or divided into blocks (40-50 blocks). It favors
the comfort and coupling of the patient, distributing the pressure of the body,
and avoiding excessive friction and rubbing on the skin.

Air mattress, with tubes or cells. It is filled with air and placed on
the bed. Its purpose, like the others, is to prevent pressure ulcers.

Fluidized sphere mattress. It is made up of very fine glass spheres that

they remain in motion thanks to the air blown between them, which allows
distribute the pressure exerted by the patient's body weight, experiencing
a feeling of floating.

Anti-pressure sore alternating mattress. It consists of a series of pneumatic tubes that

they inflate and deflate alternately through the operation of two
engines. While the even-numbered tubes are inflated, the odd-numbered ones
they remain deflated, automatically reversing the cycle every four
minutes. This type of mattress, by shifting the pressure points, prevents pressure
and, in addition, provides a continuous massage.

Table 1.6.Types of mattresses.

In addition to those already mentioned, there are spring mattresses (although they are used less and less)
less), of water (used to prevent pressure ulcers, and also little
use) and water with polyurethane balls (which are placed on the mattress h
and allow to reduce the amount of water needed.

23
 1 La unidad del paciente. Cama hospitalaria

B. Bedding
Within the bedding (Fig. 1.11) we can include:
Web
• Mattress cover. It is a waterproof cover that is adjustable at all four corners, which
On the following webpage of
a manufacturer you can see different it is used to protect the mattress from moisture and dirt coming from the
such materials as mattresses and removal of the patient's secretions.
cushions of varied composition:
www.ortoart.es • Sheets. They are generally made of cotton or a similar material. They are used every time.
more adjustable points. In services such as emergencies, dialysis, or consultations, they usually
Use disposable sheets. A fitted sheet and a top sheet are necessary.

The fitted sheet is folded lengthwise, with the right side facing inward.
The top sheet is folded widthwise, with the underside facing inward.

• Bedspread. It is made of the same fabric as the sheets. It is placed in the center of the bed.
at the level of the pelvis. It can also be used to move the patient towards the
headboard of the bed, when it has slid. Nowadays, they are used more and more
disposable bed pads.

• Manta. It is usually light in color. Its fabric must withstand frequent washes and have
lightweight. It should keep warm without being heavy. It folds widthwise.

Bedspread or coverlet. It is the piece that covers the sheets and the blanket. It must be re-
resistant to washes and light colors. It is generally white. It folds at a
wide, with the right side facing inward.

Pillowcase and cushion. They are made of cotton or a similar material. The case
it is directly in contact with the pillow and closes with a zipper
or another system. The cushion is placed over the cover and must always be changed.
as necessary and at least once a day.

bedspread Manta Cushion

Intrusive

Sheets Mattress cover

Fig. 1.11.Bedding.

24
 The patient unit. Hospital bed 1
C. Other accessories
This category includes those that appear in Table 1.7.

Handrail or security railing Railing protectors wedge stops Anti-rotation splint

It is a metal protector that is They are usually polyethylene bags. They are triangular pieces It consists of an exterior surface
put on each free side air cushions, pillows, padded that are useful for made of hard plastic and an interior
from the bed to prevent falls etc. Its function is to prevent the maintain stability of the cushioned in which
of the patient. It can cover everything patients are injured. Also patient or of some segment insert the foot, keeping it
the lateral length of the bed they are called 'sentinels of of the body. The same result. immobilized and in position
or only the upper half. They have bed. it can be obtained through correct. It avoids plantar flexion
a mechanism that allows of pillows, cushions, and the foot in a pendulum.
download them to facilitate access sheets or folded towels.
to the patient without removing them.

Protection arch or bed arch Support of serums Diuresis bag support I stir the "Balkan triangle"

Maintains the weight of the clothes It can be portable or adaptable It is used to hold the bag Allows the patient to perform
from the bed, avoiding that to the bed. It consists of a of diuresis and maintain it small displacements
they are born and exert pressure on hollow metal tube, whose hung over the bed base corporal within the bed,
the patient. When installing it is the upper part ends in two or the edge of the bed. how to move to join,
it is necessary to take into account that small hangers of which change position, etc. It
the bedding needs more the solutions are hung that used in paraplegics and in
looseness to cover the patient they will be diffused. The height is prolonged stays in bed
up to the shoulders. adjustable. with mobility limitation.

Table 1.7.Other accessories of the hospital bed.

Case study 5

In the internal medicine hospitalization unit, admitted Solution

Anselmo, an elderly man suffering from dementia and undergoing study. En la cama debería tener la ropa necesaria (cubrecolchón,
diagnosis. Last night he hardly slept at all, he got up several times bedspread, cushion, sheets, blanket and quilt). Ade-
times and one of them fell. Today the doctor prescribed the more, bed rails should be used (preferably -
placement of physiological saline and the insertion of a probe minds with protectors), the support of serums and the support of
bladder. What accessories would be indicated in your situation? the diuresis bag.

Activities

22. Relate the terms from the two columns below:

Bed ladders Avoid the weight of the clothing.
Hold the serum bottles Maintain stability.
Top wedges Facilitate movements in bed.
Protection arch Avoid plantar flexion.
Anti-rotation splints Support for serums.

25
 1 Patient unit. Hospital bed

Treatment with the patient 7.Bed making techniques

The attitude of the technicians is very
The objective of these techniques is to promote the overall well-being of the patient and meet their
important when it comes to fixing
the bed. Put yourself in the place of need for rest and sleep. Therefore, it is important to keep the bed clean, without
a patient in these two situations wrinkles, in order to provide comfort to the patient and allow them to move
a) Two assistants arrive without feeling overwhelmed.
from nursing to making your bed, In addition, it helps to promote rest if the room is clean, without bad odors.
and all the time they talk about their
smells, without noise or annoying stimuli and with appropriate environmental conditions.
things from the movie they watched
last night, of the day off that I didn't con-
From a psychological perspective, rest will be enhanced by interventions.
they continued, etc. b) If upon arrival you of nursing that reduce anxiety.
they greet you, and explain that they are going
General rules for making the bed and understanding must be taken into account.
to make the bed, they ask you the specific procedures that are used in each situation.
How are you, they listen to you.
and they take you into account. Sure
that the patient will feel a lot
A. General rules
more comfortable in the second if-
The bed linens will be changed in the morning, after the patient's bath or hygiene.
situation.
and also whenever it gets stained or wet.
Before starting the bed-making technique, everything must be prepared.
necessary material.
In the event that multiple teams are prepared to remake more than one bed, they
will use a car for clean clothes, with all the necessary equipment, and another for clothes
dirty, in which the bags containing the removed bedding are deposited
each patient (Fig. 1.12b).
• To prevent these cars from serving as vehicles for the transmission of microorganisms of
a patient to another, they will be left in the hallway, at the door of the rooms.
Hygienic hand washing must be done before and after carrying out.
the procedure. The gloves are put on.
The procedure is explained to the patient and their collaboration is requested.
When not contraindicated, the bed is placed in a horizontal position.
The mattress cover, the fitted sheet, and the mattress pad should not be wrinkled, as they can
cause discomfort and promote the appearance of irritations and pressure sores.
The countertop, the blanket, and the quilt must cover the patient up to the shoulders. It is adjusted
so low under the mattress, in the foot area, without tucking them in on the sides.
Dirty bedding should not come into contact with the TCAE uniform.
will be deposited directly in the bag that is inside the room or in the car
what is at the door, but will never be left on the floor or on another bed or chair
What would have been in the room.
Fig. 1.12.a) Clean clothes; The removed bedding should not be shaken in the air to avoid dispersion of
b) dirty laundry cart.
microorganisms.
The bed must be made quickly and accurately, but avoiding the mo-
Important sudden movements when the patient is in it.
A screen is used to protect the patient's privacy when necessary.
Before making the bed, there is
What equipment is needed to prepare? B. Bed making procedures
it is important to wash your hands, just like
check that the bed is not We describe the appropriate procedures for preparing a bed according to different
occupied by no patient. If situations:
it was occupied by an infected patient
• Closed bed. It is the hospital bed that remains empty until the admission of
tagious, one must use a a new patient. It can be done by a single nursing assistant.
special dirty bag for the
clothing, of a specific color Open bed. It is one that corresponds to a patient admitted who occupies it.
according to hospital regulations but it can be lifted. It can be done by a single TCAE.
of object treatment against- • Occupied bed. The patient remains in it while getting ready.
mined.
Surgical bed. It is the one prepared to receive a post-operative patient.
26
 Patient unit. Hospital bed 1
Closed bed
Action protocol 1

Arrangement of a closed bed

Objective. To properly make a bed that will receive a new patient.

Necessary equipment
Mattress protector. Manta. Clean and dirty laundry cart.
Top and bottom sheets. Bedspread. Plastic bag for dirty clothes.
• Soaking or dipper Pillowcase. Disposable gloves.
of cellulose. Cushion. • Bed crank.

Operational process
Wash your hands and put on the gloves.
2. Place all the necessary material on a chair in reverse order to how it is
Keys and tips
you are going to use. That is, cushion, pillowcase, quilt, blanket, sheet
countertop, mattress pad, absorbent, fitted sheet and mattress cover.
Sometimes, the drawings that
3. Brake the bed wheels and place it in a horizontal position. they carry screen-printed sheets
nas in the longitudinal direction
4. Remove the blanket and the quilt. If they are going to be used again, fold them properly.
to make the bed with them. with the name of the hospital we
will serve as a reference for
5.Remove the dirty clothes, piece by piece, without shaking, folding, or rolling them. its centered placement on the
about herself, and drop it in the dirty laundry. mattress.
6. Extend and secure the mattress cover.
7. Place the fitted sheet so that the right side is facing up. The appropriate length should be left to be able to
place it under the mattress, first tuck in the head area and then the foot area, making the corners mitre or bevel,
feed it through the sides. To make it:

7.1 The fitted sheet is tucked under the mattress, and it is lifted up. 7.2 That part is let fall. 7.3 It is submitted all under the
about 25-30 cm from the end tucked in with the other hand. of sheet. mattress, stretching well.

8. Place the intermediary in the middle third of the bed, centering it, and paddle.
running along both sides of the mattress. If necessary, the em- will be placed.
cover the meddler completely, so that it is completely covered.
for her. Both the fitted sheet and the mattress protector must remain
perfectly stretched and without wrinkles.
9. Place the top sheet centered, leaving the underside of the sheet facing up.
up. Tuck the bottom part under the mattress and
leave the corners to do them together with the blanket
and the quilt (although it can also be made into a piece to
piece). The sheet can be extended longitudinally.
longitudinal or transversal (stretching from the head
towards the feet). It can extend like the sheet
inferior.

(Continues)

27
 1 The patient's unit. Hospital bed

Protocol of action 1 (Continuation)

10. Extend the blanket so that the top is at the height of

the shoulders, about 20 cm from the headboard of the bed.
11. Place the quilt and center it. With the quilt, the blanket, and the top sheet.
A border is made at each corner of the mattress.
Mitra. At the top, fold the sheet over the blanket and the bedspread,
to make the tuck. The top sheet, the blanket, and the quilt must
hang equally on both sides of the bed and should not be tucked under the
mattress
12. After checking the good condition of the pillow, it is placed the
I put the sheet and, on top of it, the pillow, leaving it at the head of the bed.
Important
13. Check that the bedding is well stretched.
In some hospitals, when the bed
14. Tidy up the room and check that the doorbell is working. it is closed, they leave the countertop and the
Remove the used clothes and take them to the dirty room or follow the procedure. stretched blankets on the mattress, and with
lie of the institution (hospital). the bedspread covers the pillow, up to
the arrival of the patient.
16.Take off the gloves and wash your hands again.

Open bed
Protocol of action 2

Arrangement of an open bed

Objective. To correctly make a bed already
occupied by a patient who can get up.
Necessary equipment. The same as in the technique of-
written for the closed bed, but in this case they must add
give the patient the pajamas or nightgown and the robe, and a
two towels for your personal hygiene. 2.2 In fan or bellows. It is grabbed.
all the bedding su-
Operational process. The procedure is carried out following perior (top sheet,
the steps described for the closed bed, but they must be blanket and bedspread) and they form
take into account some differences: small folds until you go-
at the foot of the bed,
1. After extending the top sheet, it is advised in such a way that the disguise
leave space for the patient's feet. One of the I remained accessible and looking
Means to achieve it is to make a small fold. towards the head.
the fold in the transverse direction at the height of the feet
from the bed. This is a measure of comfort to the year-
extra space for the feet.
2. If the patient were to occupy the bed again, it will be opened.
in such a way that accessing it is easy for you. There are several
ways to open the bed:
2.1 In peak. It bends the
2.3 From top to bottom. It bends.
upper extreme of
the top sheet all the bedding super-
blanket and the quilt by prior to the feet of this (of
such a way that it remains open
el lado por donde va
to access the patient and then, it becomes the em-
diagonally to bozo towards the head.
the bed.

28
 The patient's unit. Hospital bed 1
Occupied bed
To make an occupied bed, the procedure to follow will be different depending on the
degree of patient collaboration. If they can collaborate, a nursing assistant will be sufficient, I deal with the patient
It will indicate to the patient how to position themselves to facilitate the performance of the Before making a bed, it is necessary to...
technique. If you cannot collaborate, it is advisable for two healthcare assistants to intervene, so that the
It's important:
the bed making is done in a more comfortable manner and without risks for the patient (such as
Get informed about the situation of the
the one that falls to the ground).
patient to know if he is
When mobilizing the patient within the bed, the nursing assistants must prevent can move, or if it is necessary-
risks, such as the accidental fall of the patient from the bed, causing skin injuries. the collaboration of the in-
with watches or bracelets (which can also be a reservoir of microorganisms), etc. farmer.
• Observe the therapeutic teams-
If the patient had IV fluids, drains, or other therapeutic systems, normally the pro- symptoms that the patient has
the procedure is carried out by the nurse and the TCAE to avoid accidental disconnections, to avoid the risk of un-
drainage reflux or from the urine bag, etc. connections, refluxes, extraction
In this section, we will see the arrangement of the occupied bed performed by two nursing assistants. of catheters, etc.

Protocol of action 3

Making a bed that is occupied

Objective. To properly make a bed that is already occupied by a patient who cannot get up.
Necessary equipment. The same as for the closed bed, to which a pajamas or nightgown is added.
two towels for personal hygiene and a robe for each TCAE (optional). If the room is shared, it
will use a screen.
Operational process. In general, the procedure is carried out following the same steps described for the bed.
closed, but some differences must be taken into account:
1.Prepare the necessary equipment and, after washing your hands, take it to the patient's room, leaving it
about a chair as described for the closed bed.
2. Wash your hands and put on gloves and the gown, if necessary.
3. Explain to the patient the procedure that will be performed, requesting their cooperation.
4. In case of a shared room, place a screen to preserve the patient's privacy.
Each of the TCAE will be positioned at one side of the bed and will simultaneously follow these steps:

1 Remove the quilt, bringing the top and bottom edges closer together, 2 If the top sheet is not dirty, it is loosened at the feet and
and put it in the dirty bag. Do the same with the it is placed over the patient, to cover him while he
blanket. If the quilt and the blanket are going to be reused, fold them and I made the bed. A part of it will be folded towards the patient.
place them on a chair. sheet so that it doesn't get in the way while the technique is being performed, ase-
ensuring that the patient is not uncovered.

(Continues)

29
 1 Patient unit. Hospital bed

Action Protocol 3 (Continuation)

3 Remove the pillow, of- 8 Between the two TCAE, cam-

leaning on it give way to the pa-
a chair or armchair, and remove client, turning it towards the
the cushion. In determi- opposite side, in form
in any situation, it can let it remain lying on the
let oneself for the pa- the other side of the bed (already
client feels more comfortable. clean.

4 Place the patient in 9 An assistant holds the pa-

lateral decubitus, in shape
client, while the other one
let it be subject to one change to the other side and ex-
from the TCAE and rest
lay the pieces out well
on one side of the bed.
the bed (fitted sheet,
sucker and meddlesome), this-
rounds to prevent that
wrinkles form. Remove
the dirty clothes without airing them out

and place it in the bag

from dirty.

5 The otherTCAE will collect

the meddler, the oilcloth or 10Fix the clothes on the ski.
bed pad and the sheet nas; for this purpose, the
lower from the side more Mitra corner on the CA-
far from the bed towards Molten and the feet with the
the patient's body. bottom sheet.

6 Extend the sheet down-

ra. Subject it under the col-
11 Place the patient in
bun on the head and the
supine position, with the
feet, and do in both
head on the pillow
corners the fold in
given in which it has been put-
Mitra. Gather the rest of
to a clean cushion.
clean sheet, they roll up
Extend the sheet in-
dola towards the patient.
clean room, at the time
that the piece is collected
that covered the patient.

7 Place the meddlesome one

in the middle third of the
bed, fixing it under the 12 Put the blanket on afterwards
mattress. The rest is reco- y la colcha, haciendo las
get close to the body of corners in miter.
patient.

30
 The patient unit. Hospital bed 1
There are various ways to position the patient to redo their
bed while using it. It is important to use it at every moment.
that offers them more security and comfort, while providing
it gives the TCAE greater ease of execution. The technique of
the arrangement of the occupied bed will adapt to the particular conditions
homes of each patient.
The patient's data that can be observed during the procedure.
the technique will be noted on the evolution sheet, in the book of
nursing observations (Fig. 1.13) or in the computer record
specific.

Surgical bed

Surgical bed, also called anesthesia bed or

postoperative, it is one that is prepared to receive a pa-
aware that he has been operated on or to any person who has
was anesthetized.

The general objective is to provide a clean and comfortable means, thus

how to facilitate the transfer of the patient from the operating table
yes, or the stretcher, to the bed.
The bed may be found in the patient's unit, in the room
post-surgical recovery room or recovery room, etc. It will be
placed in a horizontal position. Additionally, they will be prepared in the ha-
room those systems that are anticipated, or that is known, that will
need the patient. Fig. 1.13.Nursing progress sheet.

Action Protocol 4

Arrangement of a surgical bed

Objective. To properly arrange a bed that must accommodate a patient.
recently operated on or anesthetized.

Necessary equipment. The same as for making the closed bed, including,
also, a field cloth or a bedspread for the head of the bed and, if
if necessary, a pad.
Operational process
1. After preparing the equipment, washing hands, and putting on gloves, one
place the bottom bedding (sheet, mattress protector, and bedspread) according to the
technique described for the arrangement of the closed bed or the open bed.
2. Spread the top sheet, the blanket, and the quilt (as described for the
bed closed) without tucking the clothes at the feet or on the sides of the bed.
3. Make the header and footer fold, folding the blanket over itself.
the same, then the blanket and, lastly, the top sheet.
4. Remove the pillow, with the case and the cushion changed, and place it on
a chair (never on the bed).
5. Prepare the surgical package with the clothing that will later cover the patient.
give me countertop, blanket, bedspread). There are different ways to prepare it:

(Continues)

31
 1 Patient unit. Hospital bed

Protocol of action 4 (Continuation)

a) In general, it involves folding the upper clothing (in pleats or in

5.1
fan shape) from the bedspread to the feet of the mattress 5.1 ,
or from one side to the opposite side of the bed, leaving it free
the one through which the patient will enter. It can be left folded like this.
on a shore or at the foot of the bed.
b) It can also be opened in a triangle or peak. The ends are held.
from each fold (head and feet) and are folded over the center of
the bed, forming a triangle. The peak of the triangle is taken and
fold towards the open side of the bed.

The field cloth is spread over the upper part of the bed, where the
the patient will place their head. The pillow is not placed to avoid
the aspiration in case of vomiting.

7. When the patient is transferred to the bed, the sheet is unfolded.

countertop, the blanket and the quilt. A fold is made at the height of the
legs to leave space and it is tucked under the mattress, making the
corners in mitra.

Additionally, safety grills or railings will be installed if the spa-

the client requires it.

Activities

23. Amalia, TCAE, is attending to Jacinto, a patient with 27. Pilar will undergo surgery for nodules on a vocal cord,
Very advanced Alzheimer's, 84 years old, bedridden and for which he/she needs general anesthesia. He/She has just arrived.
with incontinence. They need to change the bed for him/her, but he/she is a guard will go to get her, and she will walk to the operating room.
alone at that moment. How should I act in that Before finishing the intervention, the orderly comes to
situation? make your bed to bring Pilar from the table here
While in this situation, the doorbell rings. surgical. How would it be advisable to prepare for it?
next room, and hear someone complaining about someone who
has fallen to the ground.

a) What should be Amalia's conduct, the TCAE?

b) How should I prioritize tasks or act in this?
situation?
24. Observe Figure 1.14 and reflect on the procedure.
lie about the arrangement of this patient's bed that
he has a traction placed, which the doctor prescribed
wrote to stay in bed. How should I carry out
Are you serious? What specific precautions should be taken?
when making your bed?
25. The bed 323-B is now vacant since it was given
the discharge of Jacinto, an adult patient who was occupying it.
What should the TCAE do about it?
26. Jacinto's companion, from bed 323-A, can be
to get up to take small walks, and to remain
sitting on the couch. What type of bed arrangement corresponds to you? Fig. 1.14.Making the bed for a patient with
traction.
pond?

32
 Patient unit. Hospital bed 1
Synthesis

The patient's unit. Hospital bed

Set of departments and material resources

related to nursing staff.
Nursing unit
Objective. To provide nursing care
to the patients.

Atmospheric: temperature, humidity, ventilation.

Room Lighting: natural/artificial light.
Environmental conditions Noises: external, internal.
Hygiene and cleaning.

Furniture Bed: accessories, bedside table, armchair, wardrobe, folding screen, etc.

•Common use: glass, basin, wedge, thermometers, etc.

Materials/equipment
Personal hygiene: sponge, towel, comb, creams, etc.

Characteristics: metallic, articulated,

wheels, braking system.

Of rest: articulated, Foster,

RotoRest, electrocircular,
traumatological, etc.
Types

Of exploration: rigid
hospital bed and articulated.

Accesorios:almohada, colchones,
lingerie, railing, arches, etc.

General rules of arrangement.

Arrangement techniques
Specific procedures: closed,
open, occupied, surgical.

Welcome the patient upon their admission to the unit

of hospitalization.
Technician functions Collect the clinical documentation.
en unidades auxiliares
Accompany the patient to their room.
of nursing
Explain the hospital rules.
Support the patient and their family environment.

33
 1 The patient's unit. Hospital bed

Reviewtest
1. To the set formed by the space of the room, 8. What accessories are essential for the
the furniture, and the material that is used in it is patient can make small movements
denomination in bed:
a) Nursing unit. Top wedges.
b) Hospitalization room. Night Sentinels.
c) Patient unit. c) Protection arch.
d) Nursing room.
Balkan Triangle.
2. The recommended ambient temperature for the unit
the patient's is: 9.Top
evso
renltalfhetdbeidnrh,tenotiw
platonlfgisu
ieds

a)20-22 °C. as an accessory:

b)27-29 °C. Bed arch.
c)15-20 °C. b) The Balkan triangle.
d)30-32 °C. c) Railings or security fences.
3. It is not included within the atmospheric conditions: d) Railing protectors.
a) The humidity.
10. It is false that it is a general rule, in the arrangement of
b) The exterior noise. the bed
c) The ventilation.
a) Explain the procedure to the patient.
d) The temperature.
b) Place the dirty cart next to the bed.
4. Specific spaces that are part of c) Prepare all the necessary equipment in advance.
the nursing unit:
d) Make the bed in the morning.
a) The linen store.
b) The room of 'dirty'. 1.Thebednw
i chihertsap
i ,b
entiaut notti
c) E-office kitchen. it takes at the time of doing it, it is called:

d) All of the above. Open.

5. The dimensions of the bed, in terms of length, b) Occupied.
may vary: c) Surgical.
from 200 to 300 cm. Closed.
From 190 to 200 cm.
12. In the bed arrangement technique, the difference between
c) From 180 to 190 cm.
the closed and the open is as follows:
From 150 to 200 cm.
It is left open even if the patient is not there.
6. The bed that can adopt any position, turns in The clothes from the bed are tucked under the mattress.
the circular sense, and it is used for spinal cord injured
c) The pajamas or nightgown, the robe, and are added to the outfit
it is called:
the towels.
Electrocircular.
There are no differences.
b) Traumatological.
c) Of levitation. 13. On the surgical bed:
RotoRest. All clothing that will cover the patient is removed.
i tnevenrdpeisutosnsiessertem
tsaehhftcoW
.7ih The pillow will not be placed.
of pressure ulcers? A field cloth can be placed.
Alternating. d) All of them are true.
b) From the springs.

c) Of fluidized spheres.
d 1 3c, 1 2a, 1 1b, 1 0c, 9d, 8b, 7a, 6b, 5d, 4b, 3 4a, 2c, 1 Solutions:
of water.

34
 The patient unit. Hospital bed 1
Checkyourlearning
Describe the characteristics of the nursing unit. Definir el concepto de cama hospitalaria y explicar sus tipos.
1.Explain theconceptofuni- in yourownwords. 17. Indicate the dimensions of a hospital bed.
nursing dad. standard wings.
2. Where are the nursing controls usually located? 18. In what type of situations or patients are they used?
meria? adjustable beds?
3. What are the most important functions of the person? 19.Name four different types of beds that can
What integrates the nursing unit? to be in the hospital setting.
Describe the characteristics of the patient's unit and of 20.Describe the characteristics of the incubator.
the environmental conditions. 21. Indicate what the RotoRest bed is used for.
4. Analyze and compare the environmental conditions of 22. In what type of pathologies is the use indicated?
Workshop classroom that the hospitable room must meet Foster's bed?
talaria. Highlight the similarities and the differences.
5.Describe the most significant characteristics of a Explain the most commonly used bed accessories.
pediatric unit. the hospital environment.
6. Indicate what the measurements of the rooms should be. 23. Name five bed accessories, indicating for
hospital facilities with one, two, or three beds. what they are used for.
syw
al laehhnteiebrehdtluohesrutarem
peetgarevatW
a.h7 24. Describe the alternating mattress, indicating what it is.
the operating rooms and the outpatient clinics? advantage of its use for the patient.

Identify and describe the furniture and material means 25. In what type of patients is the triangle usually used?
from the Balkans?
and accessories that integrate the patient unit.
8. What material is included in the group of 26. Specify what anti-rotation splints are and indicate
patient's personal hygiene? for what they are used in the hospital environment.
9.Namesxi msaelirthtataerni use.
Explain the techniques for carrying out the different types of
habitual for the patient.
bed, depending on the patient's condition.
10. Name four devices used for the des-
27. What is the difference between the open bed and the
placement and mobilization of the patient.
closed?
11. What furniture is part of the patient unit?
hospitality? 28. What are the necessary material resources for
make the hospital bed?
Explain the sequence of operations and information to the 29. Name five general rules to take into account in the
patients at the reception and admission in the unit of bed making technique.
hospitalization.
30. Describe the protocol for making the bed
12. List five rules to consider in the hospital that surgical.
the TCAE must inform the patient for compliance
lie. 31.Prepare aPowerPonitpresenatoinonthe
bed arranging procedures, emphasizing on
13. How should the nursing assistant receive the patient when
those aspects that have to do with the follow-
Are you entering the hospital?
Patient and TCAE privacy. Conduct a visit.
14. Which healthcare professional is responsible for explaining... hospitality, to observe the cleaning procedures
Inform the patient of the type of room that has been assigned to them. piece, drying, ironing, storage and distribution
swim? Why? selection of the lingerie that will be used in the units of the
15. Indicate what kind of sensations it may produce to patient.
patient the fact of having to enter a center 32. In small groups, imagine a situation in the
sanitary. that there is a bedridden patient; define the context,
16. What actions should be taken when the people who intervene with their specific traits,
a patient is discharged and leaves the unit and the and stage the responses that are most appropriate
bed that he used during his admission? as TCAE.

35
 1 The patient unit. Hospital bed

Finalpractice
Sara has just been hired to do a replacement. You should not bring the cars into the room, but instead
in summer (probably for three months), in the hospital He/She will take out the bag with the dirty clothes to the dirty car.
provincial of your city, Teruel. This can have one or more compartments that allow
He will be in the operating room, although they have told him in the classify the lingerie for the laundry.
Nursing management that will have on weekends In general, in all beds, you will ensure that no remains are left
to go reinforce other hospitalization rooms, due to the wrinkles.
staff breaks. In the case of the open beds, it will have towels (for washing)
Today he is going over some things in his house, to be and shower) for the patient.
more prepared and calm at the start of her tasks, although In the case of occupied beds, moreover, it will be cover-
You know that in each room or unit of hospitalization there can be
a mental that explains to the patient what it is going to do, and pe-
to have the help of colleagues and the supervisor, and It will say its collaboration as much as possible. In this
you can always ask, because remember that it teaches you- In case there are not two people to perform the task, it is
Ron, which is very important, 'do not do what you do not'
it is essential to use the bed rails to avoid
"knows", especially when it involves risks for a patient falls when laterally positioning.
patient or another person, or herself.
In the beds of patients being discharged, when
The first day arrives at the surgical hospitalization and they tell him
the redoing (after having been cleaned), will not take
on that day, since all the beds are occupied by pa- no pajamas, no slippers, no towels until the new one arrives
patients, we need to make 14 open beds (because the patients- assigned client.
they can move and lift) and 3 beds with patients
bedridden (who have the medical indication not to get up)
(discharge). Additionally, three patients are being discharged from the hospital. What if a patient in an open bed requested help?
at midday, after the visit of the responsible doctor, to lie down?
and to deliver the discharge report.
In this case, the bed would be prepared by opening it with the
Today, no income is expected in the morning, during your shift of technique indicated for this case, to facilitate your intro-
work, although a patient could arrive through deduction in it.
Emergencies.

What is the first thing Sara should consider?

Before starting, you can plan the bed order.
to redo (and ask the colleagues in the room which
it is usually the custom there), starting with those of the pa-
clients that can be raised, continuing with those of the
bedridden patients and ending with those of the patients
those who are discharged, because they can occupy the unit
of the patient until near noon.
It would also be advisable for you to notify or oversee that
the cleaning service will carry out its task more thoroughly
the bed, the mattress, the bedside table, the wardrobe and other furniture
used by the patient who will leave the unit.
She will prepare all the linen she will need later. Questions:
clean laundry cart; will also prepare the laundry cart 1Im
. agnie benig caeld from hte operanitg room ot go down whti a
dirty.
bed to pick up a newly operated patient
logically, that entered through Emergencies. How should it
What aspects or rules should I take into account in these? to prepare oneself?
procedures?
2. If while fixing one of the beds with a patient...
You should wash your hands and put on gloves (you must I would have observed pressure ulcers, what type?
carry out before and after carrying out each procedure mattresses could have been used to prevent
(lie). its evolution?

36