授课题目

Change an  occupied bed

授课形式

lecture and demonstrate

授课时间

2006.9.20

授课学时

1

教学目的

与 要 求

1. Demonstrate the whole procedure of changing an occupied bed correctly.

2. Provide comfort and safety to the client during the process

基本内容

Change an occupied bed

1．Objectives

2．Preparation

3．Procedure

4．Precaution

重 点

难 点

1. The procedure of changing the quilt cover.

2. The order of changing an occupied bed

主要教学

媒 体

PPT

主 要 外

语 词 汇

An occupied bed、Bottom sheet、Pillowcase、side-lying position

有关本内容的新进展

主要参考资料或相关网站

1、Zhou Kexiong. Basic Nursing Skills

2、SABDRA F.SMITH. Clinical Nursing Skills. Prentice Hall Health.

系、教研室

审查意见

已审合格，同意授课。

课后体会

1.  课程设置合理，无超时。

2.  本节内容操作性强，学生基本能听懂和理解。

3.  通过提问增加与学生的交流，锻炼学生口语。

教学内容

时间分配和

媒体选择

Chapter8 Environment

Section3 Change an occupied bed

u  Objective:  

1.   To provide a clean, comfortabwww.med126.com/shiti/le sleeping and resting environment for the client.

2.   To enhance client’s self-image.

3.   To prevent complications

In addition to these objectives, the procedure affords nurse time to communicate with the client and establish a positive nurse-client relationship

u   Preparation: 

1. Client

(1). Psychologic: Assess the client’s need to have linen changed. Talk with the client and explain how he or she can be involved in the procedure and have their agreement. Don’t do the procedure without client’s agreement.

  (2). Physiologic:  ask the client if he need to use bedpan

(3). The state of illness: Assess the state of illness, determine if the client’s present condition permits a change of bed linen. In some special situation, we have to put off the planning.

2.Euipment

Linens (in order of use ):

Bottom sheet

  Middle-size sheet

  Quilt cover (inside of it is folded outwardly)

Pillowcase

Brush   (placed in a square plate)

Disposable brush cover

Clean clothes, if  needed

3.Environment

(1). Adjust to a comfortable room temperature

(2). Close windows or draw the curtains

(3). Avoid the eating time or treatment

u  Procedure: 

1. Gather linens and put them on the equipment car, then bring to room

2. Talk with the client and explain the sequence for the procedure

3. Close the windows

4. Arrange furniture and equipment for convenience of use

5. Lower the head of the bed so that it is flat or as low as the client can tolerate

6. Wear a mask (put on gloves if bed linen is soiled with body fluids).

7. Remove pillow to the opposite side of the bed

8. Help client into a side-lying position

If the client is unconscious, make sure side rail on opposite side is in up position. This ensures client safety as client rolls to edge of bed.

9. Loosen all layers of the sheets on your side of the bed, including bottom sheet, middle-size sheet, rubber drawsheet

10.Push dirty middle-size sheet under or as close as possible to the client

11.Sweep away debris on the rubber drawsheet, Then put it on the client’s body

12.Push dirty bottom sheet under or as close as possible to the client

13.Sweep away debris on the mattress carefully and gently, pay attention to sweep away debris under pillow and client’s body

14.Place clean bottom sheet on the mattress with client on the opposite side of the bed

15.Unfold the bottom sheet and cover the mattress. make sure  the clean bottom sheet is underneath any used linen .

16.Tuck the top of the sheet under the head of bed

17.Make a perpendicular corner of the bottom sheet at the head of the bed.

18.Move to the foot of the bed and repeat step16 and17 orderly.

19.Tuck the remaining bottom sheet well under the mattress from head to foot.

20.Put down the rubber drawsheet.

21.Center the clean middle-size sheet on the rubber drawsheet , unfold half of it and push anther part of it unde医学考研网r the client .Tuck sides of the middle-size sheet and rubber drawsheet together under the mattress .Smooth out wrinkles.

22.Help client into a supine position.

23.Tell the client why there is a hump of linen in the center of the bed. Make the client comfortable.

24.Move to the other side of bed.

25.Assist client to roll over to the other side of the bed.

26.Loosen all layers of the sheets.

27.Pull dirty middle-size sheet to side of bed and roll into a bundle at the foot of the bed.

28.Repeat step 11

29.Gently pull dirty bottom sheet to side of bed and roll into a bundle at the foot of the bed. Then place dirty middle-size sheet and bottom sheet together under the equipment car. This reduces the spread of dust or microorganism. Never place dirty linen on the floor. Cross-contamination occurs from this action.

30.Pull clean bottom sheet across mattress and straighten under client.

31.Repeat step 16,17,18.

32.Gather bottom sheet into your hand, lean away from bed ,and pull linens downward at an angle ,Tuck remaining bottom sheet well under the mattress.

33.Put down the rubber drawsheet, pull clean middle-size sheet across mattress and straighten under client.

34.Tuck sides of the sheet under mattress. Smooth out wrinkles.

35.Help the client into a supine position and adjust the pillow.

36.Change a clean quilt cover.

37.Make a small pleat to allow room for client’s feet. This allows room for client’s feet and prevents sheets from pressing on client’s toes.

38.Remove pillow from bed and change pillowcase.

39.Return bedside table to former position. Adjust the bed to a comfortable lying height .

40.Assist client to comfortable position.

41.Dispose of soiled laundry.

u  Precaution

1. Keep safe

l  Operate gently

l  If there are any kinds of tubes the client wear, you should check if the tube is twisted or pressed during the whole procedure.

l  Keep warm

2. Observe the state of illness at all time.

3. The nurse feels no stress to back or limbs during the procedure.

[Exercise]

The client is in continuous convulsive seizure, sheets were totally wet by client’s perspiration. How can you cope with this situation?

5’

[PPT]

[Discuss]

6’

[Pictures]

[PPT]

[Question]

20’

Demenstrate

[PPT]

Question

4’

Discuss

5’

Discuss