Effects of occupied and unoccupied bed making on myocardial work in healthy subjects

Strict bed rest prescribed after acute myocardial infarction provides rest for the heart in an effort to lessen myocardial work. However, bed rest has been implicated as a threat to physical and psychosocial well-being. Nurses must question whether activities associated with bed rest, such as bed making by hospital personnel while the patient is occupying the bed, actually require less myocardial work than out-of-bed activities. In this study we examined cardiovascular function of 22 healthy individuals, 10 (45.5%) men and 12 (54.5%) women ranging in age from 34 to 69 years (mean 48 years), during occupied (side to side method) and unoccupied (patient up to chair) bed making. Cardiac output, heart rate, stroke volume, systolic blood pressure, diastolic blood pressure, mean arterial pressure, total peripheral resistance, and the ratio of preejection period to left ventricular ejection time were measured by using an impedance cardiograph and vital signs monitor. Although differences between these measurements during the two bed making procedures were statistically significant (p less than 0.001), they were not deemed clinically significant for healthy subjects because they represent transient reflexive responses to posturally induced changes in venous return rather than substantial increases in myocardial work. When the goal is minimal myocardial energy expenditure, making the bed when it is unoccupied may offer a sound alternative to making an occupied bed.