Care Entry: Prepare and EnterOnline version Initial care entry steps by Markayla Schorr 1 Standard Pre-Steps identify resident according to facility policy check assignment Explain to resident what you are going to do Answer questions the resident may have to be certain the resident understands Raise the bed to a comfortable working height knock on door and identify yourself Be aware of what the care plan states regarding side rail use Assure the resident is in a safe and comfortable position for the procedure Ensure bed brakes/wheels are locked Provide privacy Face resident and speak clearly, slowly, and directly gather supplies perform hand hygiene Apply PPE if necessary 2 Standard Post-Steps Put gloves on, remove and clean dirty supplies Leave the resident in a safe, comfortable position Replace supplies as needed Remove gloves and perform hand hygiene Ask the resident if there is anything you can do for him/her Place the bed, chair, or other equipment in a safe, low, or locked position Make sure the call light is within reach Open the privacy curtain Report/record the procedure, your observations, and the resident's response 3 Handwashing Wash wrists with soap Scrub/wash with interlaced fingers pointing downward with soap Wet your hands and wrists thoroughly Stand away from the sink. Your uniform and hands must not touch the sink at anytime Rinse all surfaces of your wrists, hands, and fingers. Keep your hands lower than your elbows and your fingertips down **Scrub/wash hands together for at least 20 seconds with soap **Do not re-contaminate hands at any time during the hand washing procedure. (This includes touching the sink, faucet, counter, paper towel holder, or any surface with bare hands. Do not crumple the paper towel that was used to turn off the faucet or in any way touch the surface of the towel Apply soap to hands Turn on the faucet. Adjust the water temperature Turn off faucet with a clean, dry paper towel and discard paper towel in trash container as used or use knee/foot control to turn off faucet Starting at the fingertips, use a clean, dry paper towel to dry all surfaces of your fingers, hands and wrists. Dispose of paper towel in the waste container Wash all surfaces of hands with soap Rub hands together using friction with soap Clean your fingernails by rubbing your fingertips against the palm of the opposite hand 4 Unoccupied Bed Making Apply gloves and remove the soiled linens, without touching your uniform. Keep dirty surfaces of the soiled linens inside by rolling the soiled linen into a ball If reusing the bedspread, remove and fold it Place the bed in a high, flat, position **Place the direty linens in the laundry hamper/container. Do not put linen on the floor, over bed table, or on other clean areas Apply gloves to remove use linens 5 Occupied Bed Making Remove the used bottom sheet, avoiding contact with your uniform Assist the resident to roll onto their side toward the raised side rail. Keep the resident covered with the top sheet or bath blanket Move to the other side of the bed and lower the side rail. Assist resident to roll onto their side away from you, toward the raised side rail Lower the bed Place the clean top sheet without exposing the resident Raise the side rail Remove pillow, put on clean pillowcase, and replace under resident's head Please the bedspread on the bed over the top sheet Remove and fold the bedspread if reusing bedspread Raise the side rail on the opposite side of the bed and raise the bed to a working height Assist the resident to roll onto their back Tuck the top sheet and bedspread under the mattress at the foot of the bed. Make mitered corners (hospital corners) at the foot of the bed Grasp the top sheet and bedspread over the toe area and pull them upward to relieve pressure. This is called creating a toe pleat Lower the side rail on the side of the bed you are working on (working side of bed) Loosen the used bottom sheet and roll it, dirty side inside, toward the center of the bed and tuck it underneath the resident Unroll the clean bottom sheet from under the resident and adjust the corners around the mattress at the head and foot of the bed. Smooth out any wrinkles Lower the head of the bed before moving resident Place clean linens on a clean surface within reach Place soiled linens in a linen bag or container. Do not place linens on the floor Place the clean bottom sheet on the side of the bed you are working on and adjust the corners around the mattress at the head and foot of the bed. Tuck the clean bottom sheet under the used bottom sheet
