RLE Focus: Bed Making

Module Overview

Bed making is one of the important nursing techniques to prepare various types of beds for
patients or clients to ensure comfort and useful position for a particular condition. This module will
teach the students the various types of making a bed and to ensure comfort and cleanliness for an ill
patient.

Assessment Method:

Satisfactory Performance based on Nursing Procedure Rubrics

Desired Learning Outcomes:

1. Discuss the significance of bedmaking.

2. Enumerate the different types of bed sheets used in bedmaking

3. Identify the different types of beds made for the patient in the hospital

4. Practice proper body mechanics when performing the procedure

5. Perform the bedmaking procedure.

Definition: Preparing hospital beds in different ways for specific purposes

Main Objective: To learn how to make beds correctly for patients

Rationale: A wrinkle-free bed that remains intact when the patient moves around, does a great deal for
physical and psychological comfort.

Specific Objectives:

1. To provide a clean, comfortable sleeping environment for the client.

2. To eliminate infants to skin by providing wrinkle-free sheets and blankets.
3. To avoid client’s exertion by making the bed while occupied.
4. To enhance client’s self image by providing a clean, neat and comfortable bed.
5. To properly dispose soiled linens and to prevent cross-contamination.
6. To correctly align clients while assisting him/her in promoting a physically and emotionally safe
and comfortable position.
7. To prevent stress to the Nurse’s back or limbs while performing the procedure.

Special considerations:

A. Asepsis in Bedmaking – The principles of Asepsis to be applied to all bedmaking procedures are
as follows.
1. Wash hands thoroughly before and after handling a client’s bed linen.

Rationale: Linens and equipment that have been soiled with secretions and excretions
harbor microorganisms that can be transmitted to others directly or by the Nurse’s hands
or uniform. Note that some agencies recommend wearing of gloves when making beds.
 2. Both dirty and clean linens should be held away from the Nurse’s Uniform.
3. Never (even momentarily) place linen for one client on another client’s bed or avoid
throwing it on the floor. Always provide a clean chair for clean linen.
4. Place soiled linen directly on a portable linen hamper or tuck it in pillowcase at the end of
the bed before gathering it up for disposal in the linen hamper.
5. Never shake soiled linen in the air. Handle each linen carefully.

Rationale: Shaking or tossing can disseminate secretions and excretions. Microorganisms

move through space on air currents giving possibility to be transferred.

B. Body Mechanics in Bedmaking- the principles of body mechanics to be applied to all

bedmaking procedures are as follows:
1. To avoid unnecessary trips to the linen supply area, gather all needed linen before starting
to strip a bed.
2. Make one-half of the bed entirely, before going to the other side, and complete the head
part of the bed before going to the foot, or vice versa. An efficiency expert has said that a
bed made taking less than 50 steps or foot movements from start to finish.

Rationale: Large muscles fatigue less quickly from small muscles. Bending the knees
utilizes the large gluteal and femoral muscles, whereas bending the back utilizes the
smaller muscles such as sacrospinal muscles of the back.

3. Most hospital linen is folded in half, then folded again. The main center fold may be from
top to bottom, or from side to side. In either case, half of the sheet can be placed on the
bed and the other half unfolded to cover the remaining portion of the bed. By using the
centerfold as a guide, you can position the sheet (or other items of linen) on half of the
bed and need not go around the bed to check whether you have half of the sheet to cover
that side.
4. Point your toes and face in the direction in which you are working. Avoid twisting your
body.

Rationale: Observe good body alignment thus avoiding tiring the muscle unnecessarily.

C. Environmental safety – Providing a safe environment is the responsibility of each Nurse and
should be integrated in certain procedures like Bedmaking:
1. For the unoccupied bed – Nurses should ensure that every equipment should be
functioning well and that the area should be protected from dust and dirt.
2. For the occupied bed – Be guided that the Nurse’s main concern is always the client’s
safety. Always assess and assist the client for comfort thus creating a Nurse-Client
relationship.
3. In general – Regardless of the type of technique used, the sheets should be wrinkled-free,
movement in bed should not be impeded by the linen, and the sheets are secured so that
they do not come off the mattress.

E. Overview of the Skill:

After a bath, clean linens are placed on the bed to promote comfort and decrease the transmission
of microorganisms. If the client is able to get out of bed, assist the client to a chair and proceed to
make a bed. If the client is unable to get out of bed, the linens must be changed around the client.
Assistance will be needed if the client is in traction or cannot be turned. Care must be taken to
avoid disturbing the traction weights. If the client cannot be turned, change the linens from head
to toe. Place waterproof (rubber draw sheet) draw sheet on the beds of clients who are
incontinent or have profuse drainage. The type and amount of linens placed on the bed the client
is using. Air beds and Clinitron beds, for example, use only minimal linens under the client.
 Procedure 1: PREPARING AN UNOCCUPIED BED

A. CLOSED BED

Definition: A CLOSED BED is a bed prepared for all the reception of a new client. It is termed closed
bed because the top corners and covers are so arranged that all linens beneath are all protected from dust
and dirt.

B. OPEN BED

Definition: An OPEN BED is a bed remade for the same patient. It is usually made when patients are
either up for a brief period in the room (Convalescent Patients) or perhaps out of the Unit for X-rays,
Laboratory or other procedures like Physical therapy. Generally, the top covers of an open bed are
folded back to make it easier for the client to get in.

It is also termed open, if bed spread is removed so it would be ready for the newly admitted patient.

Equipment:
PROCEDURE RATIONALE
1. Always bear in mind the principles of 1. Handwashing deters the spread of
asepsis and Body Mechanics. microorganisms. Maintaining body alignment
prevents fatigue on the part of the Nurse.
a. Prepare Clean linens

b. Wash hands

c. Maintain body alignment

2. Assemble equipment, fold linen and 2. Readily available equipment saves time
arrange on a bedside chair in the order of and helped
which items will be used.
an organized Nurse or Health Care giver in
a. Bedspread – with wrong side out, fold in carrying out a procedure.
half crosswise then quarters (wider hem
outside)

b. Pillow with Pillow Cover

c. Pillow cases – wrong side out, fold in half

crosswise

d. Top Sheet – with right side out, fold in

half crosswise then in quarters (wider hem –
outside)

e. Cotton Draw Sheet – with wrong side out,

fold in half crosswise

f. Rubber Draw Sheet – with wrong side out,

fold in half crosswise

g. Bottom Sheet – with wrong side out, fold

in half crosswise then quarters (shorter hem
outside)

h. Mattress Pad – with wrong side out, fold

in half crosswise

i. Mattress Cover – with wrong side out, fold

in half crosswise then quarters.
3. Adjust the Client’s bed to a high position, 3. Having the bed in the high position and the
and drop the bedside rails side rails down puts Nurse’s work at a
comfortable level and helps to reduce or
prevent back strain.
4. Adjust mattress. Put on a mattress cover 4. This allows more foot room for the Client
starting from the top smoothen it free of and moves the mattress against the head of
wrinkles and secure it to the mattress: with the bed.
elastic, ties or zipper if any of these are used.
5. Place mattress pad or mat. It simply lies 5. For the Client’s comfort.
over the mattress with mattress cover and are
not secured.

Note: Sometimes, an eggcrate is used

instead.
6. Place the bottom sheet over mattress pad. 6. Having an extra sheet at the head part,
Place the centerfold at the center of the bed. helps in keeping the linen in place when the
Seam should be facing toward mattress. The head of the bed is raised and lowered.
lower hem of the sheet should be even with
the edge of the mattress at the foot part. Then
unfold the top layer onto the distal half of the
bed, and pull the remaining folded ones
towards the head of the bed.
7. Moving at the head of the bed, miter the 7. Mitered corner is a smooth fitting corner
corner where the sheet has been tucked under made of folding the sheet in such a way that a
the mattress. 45 degree angle and the corner of the
mattress is sharply outlined.
a. Beginning to make a mitered corners
by creating a

triangular fold.

b. Laying triangular fold on top of bed.

c. Tuck the part of the sheet that is

hanging below the mattress smoothly under
the mattress.

d. Hold the sheet in place beside the

mattress with one hand. Lift the corner
of the sheet laying on the bed

with the other hand, bring it down over

the side of the mattress, and tuck the
hanging portion under the side of the
mattress.

e. Tucking end of the triangular linen

fold under the

mattress- completes the mitered

corner.
8. Tuck the sheet securely and neatly from 8. Flexing the knees, shift the work to the
the head to the foot part of the bed. While largest and strongest muscles and keeps the
performing this, place one foot forward, flex back in good alignment. This ensures further
the knees and while rocking backward, tuck a wrinkle-free bed.
the sheet along the side of the bed all the
way to its foot part.
9. Working in the same side, place rubber 9. Foundation bed (mattress cover and
draw sheet at corner of bed or over the mattress pad) should be protected from
middle section of the bed. Unfold, and tuck possible genital and perineal secretions and
from the center to the sides. excretions.
10. Place cotton draw sheet over the rubber 10. For neater appearance.
draw sheet, then tuck from the center to the
sides.
11. Place top sheet, with its center fold along 11. This is to ensure that when you straighten
the center and starting from the head part of it from the other side of the bed, it will fall
the bed. The wider hem should be even with equally over each side of the bed.
the head part of the mattress and seam side
up. Unfold the upper layer, and draw towards * The right side of the linen is designed to
foot part of the bed. Tuck foot part and miter touch the client.
corners. (Please see procedure for Miter)
12. Tuck foot part and miter corners. 12. The toe pleat (optional) provides room
for the feet to move in bed and prevents
(Please see procedure for Miter). pressure and strain on the toes or ankles.

Make a toe pleat if possible or the top sheet

over the toes will be made elevated to
provide additional space.
13. Fold the upper layer 6-8 inches of the 13. If the bed will be occupied, this makes it
top sheet down over the spread sheet and easier for the client to get into the bed and
make a cuff. pull the covers up.
14. Identify the free sides. Fold the free sides 14. Ensures neater appearance and free from
of the sheets toward the center, then fold further or possible wrinkle and
back halfway towards the sides. contamination.
15. Get the pillow with pillow cover. Put on 15. Pillow cases protect pillow with pillow
a pillow case this way: cover from soiling and gives them a pleasing
appearance.
a. If both ends of the pillow case are open,
insert one arm through the pillow case. Pull
in the pillow by grasping it at one end
while the other hand adjusts the pillow case.
 b. If one end is open, hold one corner from
the inside. With the same hand, grasp one
corner hand and adjust pillow case on the
pillow to cover completely.
16. Place the covered pillows on the head 16. This gives the bed a neater appearance.
part of the bed. See to it that the open end of
the pillow facing towards the window and
does not face the door.
17. Place the bedspread, starting from the 17. This gives the bed a neater appearance.
head part over the pillow. Unfold and draw
towards the foot part. Tuck foot part and
miter corners. Allow extra lengths to dangle
at the side.
18. Move to the other side of the bed to 18. Working on one side of the bed at a time
complete making the bed. Pass by the foot saves energy and is more efficient.
part.
19. Fold back the unfinished sheets to the 19. Tucking the sheet under the mattress
center of the bed. Pull the bottom sheets secures it in place and prevents wrinkles. A
tightly. Tuck the bottom sheet under the head mitered corner presents a neater appearance.
of the mattress and make a mitered corner.
20. Grasp the edges of the bottom sheet 20. The longest and strongest muscles of the
tightly in both hands with the knuckles on body produce the most efficient action.
top, pull tightly and smoothly down over the Lumps and creases in the bed produce
side of the mattress and tuck under the uneven pressures and predispose to impaired
mattress. Repeat pulling and tucking all skin circulation.
along the side, working toward the foot part
of the bed
21. Grasp the edge of the rubber draw sheet 21. Pulling the rubber and the cotton draw
and pull toward you from the center. Tuck it sheets tight helps prevent wrinkles from
under the mattress then from the center to the developing under the patient when he/she
sides. Do the same with the cotton draw moves around the bed.
sheet. (or you may pull, straighten and tuck
them together).
22. Move to the foot part of the bed. 22. Mitered corners help secure the linen at
Straighten and tuck the top sheet at the foot the foot of the bed.
part of the bed. Miter corner. Arrange the
free sides by folding it toward the center,
then fold back halfway towards the sides
23. Cover the entire bed with a bed spread. 23. That completes the closed bed making.
Miter corners at the foot part of the bed. The covers are well arranged to protect the
Allow the extra length to dangle at the sides. bed made from dust and dirt.
24. Prepare the bed and unit for the patient.

a. Lower the bed to its lowest position a. This is the most convenient for newly
admitted ambulatory, and semi ambulatory
patients to get into bed.
b. Attach the signal cord to the bed in a place b. Attach the signal cord to the bed in a place
where the patient can reach it easily. Don’t where the patient can reach it easily. Don’t
 place the plug yet. place the plug yet
c. Apply the brakes at the foot part of the c. The brake should be in the locked position
bed. to prevent the bed from moving when the
patient attempts to get into bed.
d. Tidy the unit. Place furnishings in a neat d. This completes the preparation of the unit
arrangement in the room and remove linen in case there will be patient to be admitted.
and other items not needed for the patient’s
use.

1. Linen hamper 8. Two Pillow cases

2. Bedside Chair 9. Rubber Draw Sheet
3. Bed 10. Cotton Draw sheet
4. Mattress 11. Two Bed Sheets
5. Mattress cover a. Bottom Sheet
6. Mattress pad b. top Sheet
7. Two pillows with Pillow covers 12. Bed Spread

Note well: Bedspread is not included in making an Open Bed

Procedure: CLOSED BED

PROCEDURE RATIONALE
1. Always bear in mind the principle of
Asepsis and Body Mechanics.
2. Assess and prepare your client. 2. Assessment is always a part of the Nurse’s
activity.
a. Explain the activity for the patient.
a. To enlist the patient’s cooperation.
b. Determine what linens are needed or
needs to be changed. b. To organize and prepare the needed linens

c. Assess for drainage or incontinence

to determine whether personal protective
equipment such as procedure gloves and c. To follow the principles of Asepsis and
gown are needed. ensure the Nurse’s protection.

d. Assess whether the patient is able to

be out of bed during the linen change.

e. Assist the patient to a chair. Provide

a robe if needed. d. The Nurse should be decisive in judging
whether a patient may be permitted to sit on a
chair while the bed is being made.

e. Ensures that the patient is comfortable and

will be warm enough during the bed change.
3. Position the bed flat if possible and 3. Maintain good body mechanics during the
raise it to appropriate working height. procedure. * Raising the bed to its highest
Disconnect the call device, and remove position eliminates the need to bend or stretch
 the patient’s personal items from the bed. over the mattress.

* Prevents items from getting lost.

4. Loosen all the bedding. Disconnect the 4. Prevents items from getting lost.
call device, and remove the patient’s
personal belongings.
5. If the bedspread or top sheet is clean, 5. Folding saves time and energy. Reusable
fold it and place it on the clean area or the linen is replaced on the bed. Folding linens
chair. Do not place on another patient’s while they are on the bed reduces strain on the
bed or furniture. Nurse’s uniform.
6. Remove the remaining linens. To 6. Ensures removal of soiled linens. Never place
remove the soiled linens fold it into dirty linens on the floor because cross-
square or bundle, making sure that soiled contamination can occur. Hold dirty linen away
side is turned in. Holding the items away from your uniform to prevent contamination.
from your body, discard them properly
using soiled pillow case as linen bag or
directly place it in the linen hamper.
6. Follow steps in Closed Bed from #2 to
#22.

Note well: for the open bed, do not tuck

the remainder of the top sheet. Allow it to
hang smoothly and freely
7. Secure the signal device on the bed 7. Having the signal device handy for the client
according to agency policy. makes it possible for him/her to call for the
assistance if necessary.
8. Adjust the bed to the low position 8. Having the bed in the low position makes it
easier and safer for the client to get into bed.
9. Dispose soiled linens according to 9. This deters the spread of microorganisms.
agency policy.
10. Rearrange furniture. Place personal 10. Always provide your patient’s safety and
items within reach. Assist the patient to leave him/her comfortably positioned in bed.
bed. Put side rails up when necessary.
11. Evaluate tolerance of client to sitting 11. Nurse’s assurance for the client’s comfort
up in chair. Ask the client if she feels and safety.
weak or dizzy. Assess Blood pressure if
necessary.
12. Remove from the room other 12. This is to ensure that the Nurse-patient
equipment which is no longer being used relationship was established.
and return it to its proper place. Tell the
patient when you expect to return.

Procedure: OPEN BED

Procedure #2: CHANGING AN OCCUPIED BED

Definition: An OCCUPIED BED is a bed made with the patient in it because the patient is too ill or
disabled to get out of bed.
 Purpose: To make a clean and neat bed which will stay tight, smooth and comfortable for the longest
time possible.

Points to Remember:

1. All linens should be folded lengthwise except for the rubber and cotton draw sheets so with
pillow cases.
2. Remember to use good body alignment and movements as you work.
3. Determine the patient’s ability to assist with the procedure and whether additional help is
needed.
4. As you instruct the patient where to move, you should be concerned with his alignment as well.
Use smooth, coordinated movements in your work to avoid jarring the patient or causing him
discomfort.
5. Explain what you are doing as you go along so the patient will be better able to cooperate and to
understand what is expected of him.
PROCEDURE RATIONALE
1. Wash hands. Gather and arrange 1. Readily available equipment saves time
equipment in order of use. (Refer to and helps ensure organization in carrying
Closed Bed procedure #2) out a procedure.

Note well: All linens should be folded

lengthwise except for the rubber and
cotton draw sheets so with pillow cases.
2. Explain procedure to the patient. 2. Decreases anxiety and increases
Provide privacy by closing the door, pull cooperation.
the bedside curtains, or use the screens.
3. Place a chair at the foot part of the bed. 3. Pillow case will be used as laundry
Remove one pillow from the bed. Remove hamper for soiled linens when necessary
the pillow case and place over the back of or before placing them to the laundry
the chair (wrong side out). Place pillow on hamper.
the chair.
4. Leave one pillow under the patient’s 4. To provide comfort for the patient.
head. Cover the patient with a bath Covering the patient ensures that she will
blanket, if available, or leave the top sheet not become chilled and preserves
over the patient. Have the patient hold modesty.
bath blanket’s (or top sheet) top edge or
tuck top of the blanket under the patient’s
shoulder.
5. Position the bed flat if possible, and 5. Maintain body mechanics during the
raise it to appropriate working height. procedure.
6. Loosen all the beddings. Disconnect the 6. Prevents items from getting lost.
call device and remove the patient’s
personal items from the bed. C heck that * Prevents dislodging tubes accidentally.
no tubes (e.g. IV, NGT, Catheter) are
entangled in the bed linens.
7. Lower the side rail nearest you. 7. To prevent the patient from falling out
(Request companion to stay on far side of of bed, lower the siderail only on the side
bed if bed has no side rail). where you are standing.
8. Move individual to the far side of the 8. Placing the patient close to the side rail
bed, making sure that the pillow is moved will allow you to place the clean linen
with him. If possible, the patient should be over a larger area. The pillow gives
on his side, facing away from you and comfort for the patient.
facing the side rail.
9. Loosen the foundation (Cotton draw 9. Making an easier removal of dirty linen
sheet, rubber draw sheet, and bottom on the other side.
sheet) of the bed to the near side. Fanfold
each piece toward the center of the bed,
with the last fold toward the opposite side
of the bed and tuck under the patient’s
back and buttocks.
10. Place clean bottom sheet with 10.Wrinkles under the patient can cause
lengthwise fold on the near side of the skin irritation.
mattress. Tuck the sheet at the head part,
miter the corner, and tuck it in, along the
sides of the mattress to the foot of the bed.
Smooth out all wrinkles.
12. Fanfold the other half of the sheet
toward the center of the bed as you did
with the soiled linen, tucking it under the
soiled bottom sheet.
13. Place the new rubber and cotton draw
sheet on the bed (as in close/open bed).
Tuck them together under the mattress.
Fanfold the other half toward the center of
the bed, tucking it under the patient’s back
and buttocks.
14. Assist patient to turn to the finished
side of the bed rolling him over the clean
and dirty linen. Explain to him/her that
he/she will be rolling over the “lump” and
then gently pull the patient toward you so
that she rolls onto the clean linen. Ask the
help of the other Nurse if possible.
15. Move the pillows to the clean side. 15. Always ensure patient comfort and
Position the patient comfortably on his/her safety before going to the other side of the
side, near the siderails. Raise the siderail bed.
on the clean side of the bed.
16. Walk to the other side of the bed and 16. Never place linen on the floor; cross
lower the siderail. Loosen the foundation contamination can occur.
of the bed. Remove soiled linens from
under the clean linen. Place it in the
pillow case at the back of chair which
served as laundry bag or place it directly
in the linen hamper.
16. Pull clean linens through one after the 16. Ensures that no wrinkles will be under
other: bottom sheet, rubber draw sheet, the patient.
cotton draw sheet from under the patient.
Pull taut starting with the middle section.
 Tuck snugly and smoothly.
17. The patient may now be moved to the 17. Make it easier to place the top linen.
center of the bed in a position of comfort.
18. Place a new top sheet on the bed over
the soiled one. Ask the patient’s
cooperation. Remove the soiled sheet as
you pull the soiled one from the top to the
bottom. Place the soiled linen in laundry
bag.
19. Have the patient point his toes up. 19. Allows room for toes after the bed has
Tuck the top sheet at the foot part, then been made. Secures sheet.
miter corners.
20. Remove the pillow and apply a clean
pillow case. Replace the pillow under the
patient’s head.
21. Position patient as desired and in 21. Promotes comfort and safety for the
proper alignment. Return the bed to the client.
low position and attach call light within
patient’s reach.
22. Evaluate the patient’s tolerance during
the entire procedure.
23. Discard soiled linens. Wash hands

Procedure #3: SURGICAL BED or ANESTHETIC BED

Definition:

* The Surgical bed is also called the anesthetic bed, post operative bed, or the recovery bed.

* A bed prepared for the reception of a patient upon return from surgery.

Purpose:

1. To make the bed with all top bedding folded out of the way so the patient can be transferred from
stretcher to the bed with a minimum of time and movement, and then covered with top bedding.
2. This type of bed can be made for use when the patient undergoes medical treatments or has
severe physical limitations of movement due to his condition or his disease.

A. General or Spinal Anesthetic Bed

Procedure:

1. Prepare the foundation of the bed as described in Closed bed procedure #1 to #10
2. Spread the top sheet on the bed. With the top edge in line with the mattress, unfold
top sheet lengthwise. Then unfold widthwise to cover proximal side of the bed. Do
not tuck in at the foot or sides of the bed.
3. Turn the sheet back even with the mattress at the foot of the bed and 12 inches from
the head part.
 4. Fanfold the beddings halfway across the bed from the side nearest the door.
5. Spread the bath towel at the head part of the bed.

Rationale: This is intended to protect the sheet if the patient should vomit (have an
emesis)

6. Place the pillows on a chair or on top of the fanfolded top covers.

7. Provide a well ventilated room and prepare the items at bedside/unit necessary for
post operative patient.
a. Emesis basin or kidney basin
b. Tissue Paper
c. IV stand
d. Oxygen tank with oxygen catheter
e. Suction Machine
f. Extra patient’s gown
g. Bed pad (preferably for OB-Gyne patients)
h. BP Apparatus, Stethoscope and Thermometer
8. Prepare the unit for the arrival of the patient:
a. Check to see that siderails are attached to the bed, are in working order, and
are in the lowered position.
b. Attach the signal cord to the bed (if necessary)
c. Leave the bed in high position

Rationale: The high level of bed is approximately the same level as a

stretcher, to make it easier to transfer the patient from one another.

d. Lock the brakes of the bed.

Rationale: This prevents the bed from moving when the patient is being
transferred into it.

e. Move furniture away from the bed.

Rationale: Clear space to allow room for the easy passage of the stretcher
and for workers to transfer the patient from the stretcher to the bed.

f. Tidy the unit, remove linen and other items, not needed for the post-operative
care of the patient.

Rationale: Other items that are needed for the care of a patient returning
from surgery will be covered in the unit on post operative care.

Note: The patient should never be left alone until he is fully conscious.

B. Local Anesthetic Bed

1. Perform the steps 1-4 of general anesthetic bed.

2. Do not remove pillow from bed.
3. Provide a well ventilated room and prepare the items at bedside/unit if necessary.

( Refer to General anesthetic nursing action # 7.)

Procedure #4: STRIPPING THE BED

PROCEDURE RATIONALE
 1. Place a chair near the foot of the bed
2. Provide a linen hamper.
3. Check bed linens for the Client’s 3. It is costly and inconvenient when personal
personal items and disconnect call bell or belongings are lost.
any tubes from bed linens.

Note: If the Client is already discharged,

newly find personal items should be
delegated to proper authorities.

(Staff Nurse of Head Nurse)

4. Remove pillow cases by slipping them 4. This will reduce drafts that may spread organisms.
off while pillows lie on bed. Place pillows
on the chair.
5. Strip the bed. Loosen all linen as you 5. Loosening linens helps present tugging and tearing
move around the bed from the head on the on linen. Loosening the linens and moving around the
far side to the near of the bed on the near beds systematically reduce strain caused by reaching
side. across the bed.

Note: Remove items to be reused (if

making an open bed). Fold in quarters
and hang across back of chair.
5. Snugly roll all of the soiled linen inside 6. Rolling soiled linens snugly and placing them
of the bottom sheet and place directly into directly into the hamper helps prevent the spread of
the laundry hamper. Do not place them on organisms. The floor is heavily contaminated. Soiled
the floor or on the furniture. Do not place linen will further contaminate furniture. Soiled linen
soiled linen against Nurse’s uniform. contaminates the Nurse’s uniform and this may spread
organisms to another Client
6. If mattress is to be turned, grasp it and
pull towards you. Then turn it over. Allow
to air.

Note: Refer to procedure Care of the Unit

after Discharge for Discharge Patients

Definition: It is the removal of used linens and the airing of the mattress.

Evaluation:

1. Patient is rested during and after bedmaking procedure (open bed)

2. Bed remains clean, dry, free of wrinkles or other skin irritants, and at a comfortable temperature.
3. Skin remains free of irritations caused by contact with linens.
4. The Nurse feels no stress to back or limbs during the procedure.

SAFETY MEASURES:

 Safety is the responsibility of all Health Care Providers in every environment.

 Falls are the major safety problem in hospitals as well as the leading cause of accidental death
for elderly.
 Those clients at high risk of falling include the elderly and those clients who have previously
fallen.
 Careless smoking in bed and faulty elective equipment are frequently implicated as causes in
hospital fires.
 Restraints that are correctly applied limit the client’s mobility but do not interfere with his
circulation and respiration.
 Orientation to new surroundings, introduction to staff members, and explanation about
equipment and procedures facilitate the client’s transfer to a new health care setting.
 “Pray with the patient” as in Psalm 23.
 Competency Performance Checklist

BEDMAKING

Name___________________________________________ Date _____________________

Essential/ Element Competency

critical Demonstrated?
element?
OPEN BED YES NO

1 0

1. Introduced self and verified client’s identity.

2. Explained procedure to client.
3. Gathered appropriate equipment.
4. Performed hand hygiene and observed other appropriate infection

prevention procedures.
5. Provided for client privacy.
6. Placed fresh linen on client’s chair or overbed table.
7. Assessed and assisted client out of bed using assistance devices, if
needed.
8. Raised the bed to a comfortable working height.
9. Applied clean gloves if linens and equipment were soiled with
secretions and/or excretions.
10. Stripped the bed.
- Loosened all bedding systematically, starting at head of bed on
- far side and moving around bed up to head of bed on near side.
- Removed pillowcases, if soiled, and placed pillows on bedside
- chair.
- Rolled all soiled linen inside bottom sheet, held it away from
- uniform, and placed directly into linen hamper.
- Grasped mattress securely and moved mattress to head of bed.
- Removed and discarded gloves if used. Performed hand hygiene.
11. Applied the bottom sheet and draw sheet.
12. Moved to the other side and secured the bottom linens.
13. Applied or completed the top sheet.
14. Mitered the corner where the bottom sheet and top sheet has been
tucked under the mattress

a. Made a vertical or horizontal toe pleat.

14. Put clean pillowcases on the pillows and placed pillow(s) at head of
bed.
15. Provided for client comfort and safety.
- Folded back top covers to make it easier for client to return to
- bed.
- Placed bedside table and overbed table so they were available to
o the client.
- Left the bed in appropriate position, depending on the situation
o of the client.
TOTAL:

CLOSED BED YES NO

1 0

- Folded the linens in sequence from top to bottom.

- Placed and linens and pillows on bedside chair.
- Applied bottom linens.
- Placed top covers on bed. Miter the corner where the sheet has
been tucked under the mattress.

- Made a cuff at top of bed. Folded top linens up from bottom.

- On side of bed where client is to be transferred, folded up two
outer corners of the top linens so they met in the middle of bed,
forming a triangle.
- Picked up apex of triangle and fan-folded top linens lengthwise to
side of bed opposite from where client is to enter the bed.
- Bedspread applied. Mitered bottom corners.

- Left bed in high position with side rails down.

- Locked wheels of bed if bed is not to be moved.

- Used effective body mechanics throughout procedure.

- Communicated appropriately with the client.

TOTAL
OCCUPIED BED YES NO

1 0

- Wash hands. Gather and arrange equipment in order of use.

- .Explained procedure to the patient
- Loosen all the beddings
- Move individual to the far side of the bed,
- Loosen the foundation

- Fanfold each piece toward the center of the bed, with the last
fold toward the opposite side of the bed and tuck under the
patient’s back and buttocks.
 - Place clean sheets with lengthwise fold on the near side of the
mattress. Tuck the sheet at the head part, miter the corner, and
tuck it in, along the sides of the mattress to the foot of the bed.
Smooth out all wrinkles.
- Assist patient to turn to the finished side of the bed rolling him
over the clean and dirty linen.
- Walk to the other side of the bed and lower the side rails.

- Loosen the foundation of the bed. Remove soiled linens from

under the clean linen. Place it in the pillow case at the back of
chair which served as laundry bag or place it directly in the linen
hamper.

- Pull clean linens through one after the other: bottom sheet, rubber
draw sheet, cotton draw sheet from under the patient. Pull taut
starting with the middle section. Tuck snugly and smoothly.
- Moved patient to the center of the bed in a position of comfort.
- Place a new top sheet on the bed over the soiled one.
- Tuck the top sheet at the foot part, then miter corners.
- Provide newly changed pillow case
- Position patient as desired and in proper alignment

- Ensured the patients safety all throughout the procedure.

- Discard linens properly in the hamper.
TOTAL _______
CRITERIA:

Performance (Checklist) 70% ----------

Ability to Answer Questions 30% ----------

Total 100% FINAL GRADE

Com
ments:

Ove
rall Performance: ____ Satisfactory ____ Unsatisfactory

Evaluator: