Care Entry: Prepare and EnterVersión en línea Initial care entry steps por Markayla Schorr 1 Standard Pre-Steps Ensure bed brakes/wheels are locked Be aware of what the care plan states regarding side rail use perform hand hygiene Explain to resident what you are going to do gather supplies check assignment knock on door and identify yourself Answer questions the resident may have to be certain the resident understands Raise the bed to a comfortable working height Assure the resident is in a safe and comfortable position for the procedure Provide privacy identify resident according to facility policy Apply PPE if necessary Face resident and speak clearly, slowly, and directly 2 Standard Post-Steps Open the privacy curtain Leave the resident in a safe, comfortable position Put gloves on, remove and clean dirty supplies Make sure the call light is within reach Place the bed, chair, or other equipment in a safe, low, or locked position Report/record the procedure, your observations, and the resident's response Replace supplies as needed Ask the resident if there is anything you can do for him/her Remove gloves and perform hand hygiene 3 Handwashing Wet your hands and wrists thoroughly Rub hands together using friction with soap Turn on the faucet. Adjust the water temperature 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 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 Scrub/wash with interlaced fingers pointing downward with soap Apply soap to hands Wash all surfaces of hands with soap **Scrub/wash hands together for at least 20 seconds with soap 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 Wash wrists with soap Clean your fingernails by rubbing your fingertips against the palm of the opposite hand **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 4 Unoccupied Bed Making Place the bed in a high, flat, position 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 Apply gloves to remove use linens If reusing the bedspread, remove and fold it **Place the direty linens in the laundry hamper/container. Do not put linen on the floor, over bed table, or on other clean areas 5 Occupied Bed Making Place clean linens on a clean surface within reach 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 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 Assist the resident to roll onto their side toward the raised side rail. Keep the resident covered with the top sheet or bath blanket Remove and fold the bedspread if reusing bedspread Assist the resident to roll onto their back Place the clean top sheet without exposing the resident Raise the side rail on the opposite side of the bed and raise the bed to a working height Please the bedspread on the bed over the top sheet 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 Loosen the used bottom sheet and roll it, dirty side inside, toward the center of the bed and tuck it underneath the resident Grasp the top sheet and bedspread over the toe area and pull them upward to relieve pressure. This is called creating a toe pleat 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 Remove pillow, put on clean pillowcase, and replace under resident's head Lower the bed Remove the used bottom sheet, avoiding contact with your uniform Lower the side rail on the side of the bed you are working on (working side of bed) Raise the side rail
