Making an Unoccupied Bed

Definition

• Clients spend most of their time in bed, eating, bathing

and using bedpans or urinals, and undergoing numerous
therapeutic procedures. It is essential to keep the bed as
clean and comfortable for the client. This is achieved
through frequent inspection, daily changing and periodic
straightening of bed linens. as much as possible, this is
done is the client is up bathing showering, and if the
client is out of the room for tests or procedures.
Assessment

• Assess your equipment. Check for all the linens

necessary to change the bed. Check for a dirty linen
hamper.
• Assess whether the bed itself needs cleaning prior to
placing clean sheets on it.
• Assess the clien's needs in the bed. Check for profuse
drainage, incontinence, or special needs for comfort or
skin integrity.
• Assess activity orders or restrictions in mobility in
planning if client can get out of bed for procedure.
Nursing Diagnosis

• Impaired bed mobility

• Risk for Impaired Skin Integrity

Planning

• The client will have clean linens on the

bed
• The linens will be appropriate to the
client's needs and condition.
• Bed linens will be clean, dry, wrinkle free.
• Patient will verbalize comfort fter the has
been changed.
• Patient will experience minimal discomfort
while the bed is being made.
Equipment:

• Bottom sheet (fitted if available)

• Mattress cover
• Draw sheet
• Top sheet
• Gloves and gown if there is presence of
bodily fluids or wet bed clothes or if patient
is in isolation
• Pillowcases for each pillow
Implementation
INTERVENTION RATIONALE

1. Wash hands. 1. Reduces transmission of

microorganisms.

2. Explain procedure to client. Assess 2. Encourages client cooperation. Allows

condition of blanket and/or bedspread. for organization of supplies.

3. Assemble equipment and place linen

on a clean, dry surface in reverse order of 3. Organization of materials fecilitates
usage at the cleint's bedside (pillowcases, systematic performance of task.
top sheet, draw sheet, bottom sheet).

4. Decreases risk of infection from soiled,

4. Don gloves.
contaminated linens.
 5. Provides for client comfort and
5. Inquire about the client's toileting
prevents interruptions during
needs and attended as necessary
bedmaking.
6. Assist client to a safe, comfortable 6. Increases client's comfort and
chair. decreases risk for falls.
7. Position bed: flat, side rails down, 7. Promotes good body mechanics and
adjust height to waist level. decreases back strain.
8. Remove and fold blanket and/or
bedspread. if clean and reusable, place on 8. Keeps reusable bed linens clean.
clean work area.
9. Remove soiled pillowcases by grasping
the closed end with one hand and slipping 9. Allows easy removal of the pillowcases
the pillow out with the other. place soiled without contaminantion of uniform by
cases on top of soiled sheet and pillows soiled linens and keeps pillows clean.
on clean work area.
10. remove soiled linens: Start on the side
of the bed closest to you; free the bottom
10. prevents tearing and fanning of linens.
sheet by lifting the mattress and rolling
Linens are folded from cleanest area to
soiled linens to the middle of the bed. Go
most soiled to prevent contamination.
to the other side of the bed, repeat
action.
11. Fold soiled linens: head to middle, 11. Fanning linens increases number of
foot of bed to middle. Place in linen bag microorganisms in air. Folding linens
or hamper, keeping soiled linens away decreases the risk of transmission of
from uniform. infection to others.
12. Check mattress and pad. if the pad is
soiled, replace. if the mattress is soiled, 12. Reduces transmission of
clean with an antiseptic solution and dry microorganisms.
thoroughly.

13. Remove gloves, wash hands, and, and 13. reduces transmission of
don second pair of clean gloves. microorganisms.

14. Open clean bottom sheet lengthwise

onto the bed with the seamed side of the 14. Facilitates making bed in an
sheet toward the mattress. Unfold half of organized, time-saving manner by not
the sheet's width to center crease and having to go from one side of the bed to
smooth the sheet flat (refer action 15 for the other.
placing sheet onto mattress).
15. proceed will placing bottom sheet
onto the mattress:
a. Fitted sheet
 Position yourself diagonally toward
the the head of the bed
 Start at the head with seamed side of 15. prevents back strain. Placement of
the fitted sheet toward the mattress. seamed side towrd mattress prevents
 Lift the mattress corner with your irritation to the client's skin. Proper
hand closest to the bed,; with you other placement of linens ensures adequate
hand, pull and tuck the fitted sheet over sheeting for all sides of the bed. Ensures
the mattress corne; secure at the head of proper placemnet of the sheet so that it
the bed sides. can be tightly secured at the top and on
 Repeat action at the foot. both sides of the bed. Prevents straining
b. Flat regular sheet of back muscles; decreases the chance
that the sheet will pull out from under
 Lay the bottom of the sheet on the top
mattress.
edge of the mattress at the foot of the
bed.
allow the sheet to hang 10 inches
(25cm) over the mattress on the side and
at the top of the bed.
•position yourself diagonally toward the
head of the bed. Lift the top of the
mattress corner with the hand closest
bto the bed and smoothly tuck the sheet
under the mattress.
16. Miter the corner et the head of the
bed.
a. Face the side of bed and lift and lay the
top edge of the sheet onto the bed to
form triangular fold.
b. With your palms down, tuck lower 16. Secures sheet tightly to the mattress ,
edge of sheet (hanging free at side of with the triangular fold providing a
mattress) under mattress. smooth tuck to keep the linen in place.
c. Grasp the triangular fold, bring it down
over the side of the mattress and tuck the
sheet smoothly under the mattress.
straighten up the free hanging sheet on
mattress side.
17. Place draw sheet on top of bottom 17. Provides sheet to lift and move the
sheet and fold to middle crease. Both client in bed without having to use the
sheets should hang 10 inches (25cm) over bottom sheet and remake the bed. Helps
the side of the mattress. to keep bottom sheet claen.
18. Face the side of the bed, palms of hands
down. Tuck both the bottom and draw
18. Keeps sheet taut, in place and
sheets under mattress. Ensure that the
wrinkle free, decreasing the risk of
bottom sheet is tucked smoothly under the
skin irritation.
mattress all the way to the foot of the bed.

19. Go to the other side of the bed, Unfold 19. Unfolding decreases air current,
the bottom sheet, repeating steps 14 to 16. which can spraed microorganisms.

20. Unfold the draw sheet and grasp the free

hanging sides of both the bottom and draw
sheets. Pull towards you, keeping your back 20. Uses your body's weight in pulling
straight, and with a frim grasp (sheets tuct) the sheet taut and prevent ts strain
tuck both sheets under the mattress. Use on your back muscles.
your arms and open palms to extend the linen
under the mattress.
21. Place the top sheet on top of bed and
unfold leghtwise, placing the center crease 21. Saves times and movement,
( width) of the sheet in the middle of the bed. making one side of the bed at a time.
Place the top edge of the sheet (seam up) Seam will be folded down to prevent
even with the top of the mattress at the head contact with the client's skin, which
of the bed. Pull the remaining length toward can result in irritation.
the bottom of the bed
22. Unfold and apply the blanket or
22. Provides warmth.
spread; repeat action 21.

23. Miter the bottom corners as described

23. Secures linen at the foot of the bed.
in action 21.

24. Miter the bottom corners as described 24. Allows the client easy access to the
in action 16. bed

25. Apply clean pillowcase on each pillow.

With one hand, grasp the closed end of
the pillowcase. Gather case and turn it
inside out over hand. With same hand,
25. Keeps clean pillowcase away from
grasp the middle of one end of the pillow.
your uniform.
With other hand, pull the case over the
length of the pillow. The corners of the
pillow should fit snugly into the corners of
the case.
26. Return the bed to the lowest position
and elevate the head of the bed 31 to 45
26. Provides for client safety.
degrees. Put side rails up on side, farthest
from client.

27.Promotes client safety and a means to

27. Assist the client back into the bed
call for assistance. Sitting up in chair and
and pull up the side rails; place call light
movement may cause changes in the
in reach; take vital signs.
client's vital signs.

28. Prevents transmission of

28. Remove gloves and wash hands.
microorganisms.
Evaluation:

• The bed linens remain clean, dry, free of

wrinkles.
• Bed linens are changed without any injury
to the client and nurse.
Documentation:

• Document the linen change and client's

tolerance of being out of the bed.