Making an unoccupied bed

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• Hospital bed with bedding
  • Mattress
  • Mattress pad
  • Bottom sheet
  • Draw sheet
  • Top sheet
  • Blanket
  • Bedspread
  • Pillow in pillowcase
• Clean linen
  • Mattress pad
  • Bottom sheet
  • Draw sheet
  • Top sheet
  • Pillowcase
• Gloves
• Linen hamper

Clinical situation:

Change linens in an unoccupied bed

Order of the skill performance:

Preparatory stage:

• Introduce yourself
• Identify patient
• Obtain informed consent to the procedure (if the patient's condition allows it)
  • Give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure
  • Explain what you are going to do.
  • Ask the patient to consent to procedure.
  • Explain to the patient how he can help.
• Make sure you have the necessary equipment and put it on the over-bed table (the chair next to the bed)
• Sanitize your hands, put on gloves
• Prepare the patient bed:
• Raise the bed to a comfortable working height.
• Make sure the wheels on the bed are locked

Main stage:

Task 1: Remove the dirty linens

• Lower the head of the bed so that the bed is flat.
• Check the linens for items the person may have left in the bed. If items were left in the bed, move them to a safe place.
• Moving around the bed, loosen all of the bed linens.
• Remove the pillowcase from the pillow, and place it in the linen hamper

• Place the pillow on a clean surface.
• Remove the bedspread. If it is clean and can be reused, fold it and place it on a clean surface.
• Do the same with the blanket, if it can be reused.
• Remove the rest of the linens from the bed, rolling them toward the center of the bed so that any soiled areas are contained inside.

• Place the dirty linens in the linen hamper.
• Check mattress. If the mattress is soiled, clean it with an antiseptic solution and dry it thoroughly.
• Remove and dispose of the gloves. Wash your hands.

Task 2: Place clean linen on the first side of the bed

• Put the clean mattress pad on the bed with the center fold in the center of the bed. Unfold the mattress pad. If you are using a fitted mattress pad, fit the elastic corners over the edges of the mattress. If you are using a flat mattress pad, make sure the top edge is even with the head of the mattress.
• Put the clean bottom sheet on the bed. If you are using a fitted sheet, fit the elastic corners over the edges of the mattress. If you are using a flat sheet:
  • Put the flat sheet on the bed with the center fold in the center of the bed and the bottom edge even with the foot of the mattress. Make sure the sheet is positioned so that when you unfold it, the rough side of the hem stitching at the top of the sheet will be against the mattress. Unfold the sheet.
  • Tuck the top of the sheet underneath the mattress at the head of the bed. 
  • Miter the top corner. With your palms facing up, continue tucking in the sheet on the side, all the way to the foot of the mattress.

• If a draw sheet is to be made into the bed, put the draw sheet across the middle of the mattress with the center fold in the center of the bed. Unfold the draw sheet. With your palms facing up, tuck the draw sheet under the mattress, tucking in the middle third first, then the top third and then the bottom third.
• Put the top sheet on the bed with the center fold in the center of the bed and the top edge even with the head of the mattress. Make sure that the sheet is positioned so that when you unfold it, the rough side of the hem stitching at the top of the sheet will face up. Unfold the sheet.
• Put the blanket on the bed with the center fold in the center of the bed and the top edge about 6 inches (15 cm) below the head of the mattress. Unfold the blanket.
• Put the bedspread on the bed with the center fold in the center of the bed. Unfold the bedspread.
• Together, tuck the top sheet, blanket and bedspread under the foot of the mattress. Miter the corner at the foot of the bed to hold the top sheet, blanket and bedspread in place.

Task 3: Secure the linens on the second side of the bed

• Move to the opposite side of the bed.
• Secure the mattress pad. If you are using a fitted mattress pad, fit the elastic corners over the edges of the mattress. If you are using a fl at mattress pad, unfold it the rest of the way and make sure it is aligned properly.
• Secure the bottom sheet. If you are using a fitted sheet, fi t the elastic corners over the edges of the mattress. If you are using a fl at sheet, tuck the top of the sheet underneath the mattress at the head of the bed, miter the top corner and, with your palms facing up, tuck in the sheet on the side, all the way to the foot of the mattress.
• Secure the draw sheet (if used), tucking in the middle third first, then the top third and then the bottom third.
• Together, tuck the top sheet, blanket and bedspread under the foot of the mattress. Miter the corner at the foot of the bed to hold the top sheet, blanket and bedspread in place.
• Fold the top of the bedspread down far enough to allow room to cover the pillow.
• Fold the top sheet down 6 inches (15 cm) over the blanket’s edge on each side of the bed to form a neat cuff.

Task 4: Change the pillowcase and open or close the bed

• Hold the pillowcase at the center of the bottom seam.
• Turn the pillowcase inside out, back over the hand that is holding the bottom seam.
• With the hand that is holding the pillowcase, pick up the pillow at the center of one of the short ends and bring the pillowcase down over the pillow using your other hand.

• Fit the corners of the pillow into the corners of the pillowcase.
• Place the pillow at the head of the bed, with the open end of the pillowcase facing away from the door.
• If the person will be returning to bed shortly, open the bed by fanfolding the top linens to the foot of the bed. If the person will not be returning to bed soon, close the bed by folding the top of the bedspread back over the pillow.

Final stage:

• Ensure the person’s comfort and good body alignment.
• Adjust equipment for safety: Lower the bed to the level specified in the person’s care plan. Make sure the wheels on the bed are locked. Place the person’s method of calling for help within reach. Lower or raise the side rails according to the person’s care plan.
• Clean up your work area.
• Wash your hands.