5.3 Bedmaking Procedures

Tracy M. Christianson, RN, BSN, MN, DHEd, CCNE; Kimberley Morris, RN, BN, MN

5.3 Bedmaking Procedures

Making an Unoccupied Bed

While making a bed may seem like a simple task, in health care settings there specific steps and reasoning for doing so. In this unit you will review these steps for making both an unoccupied and occupied bed.

**Table 5.3.1 Procedure: Making an Unoccupied Bed**
STEP	ACTION	REASON/CONSIDERATIONS
1.	Wash and dry your hands. Apply gloves if linens are soiled with blood or body fluids.	Following routine practices prevents the spread of pathogens.
2.	Assemble equipment and supplies, such as clean linens and pillows. Check the care plan to see what the bed make-up requirements are for the client. Remember to carry linens away from your body.	Promotes organization and efficiency. Carrying linens away from yourself prevents the bacteria on your clothes from getting on the clean linens.
3.	Assemble supplies in the order they will be used: bottom or fitted sheet, slider sheets, soaker pad, top or flat sheet, blanket, bedspread, and pillowcases. Turn the pile of linens upside down and place on a clean surface within your reach.	Promotes organization and efficiency.
4.	Raise the bed to waist level. Work on one side of the bed at a time. Lower the bed rails on the side you are working. Move to the other side of the bed as needed.	Follows principles of body mechanics and reduces the risk of musculoskeletal injury. Completing one side of the bed first promotes efficiency.
5.	Remove and fold any bedding to be reused (such as blankets, comforters, or quilts) and place them on a clean surface.
6.	Remove soiled linens and place in the appropriate receptacle (e.g., hamper). Roll soiled linens away from you inside out. Discard in the appropriate container.	Decreases spread of pathogens. Do not shake linens, as this will release microorganisms into the air.
7.	Discard gloves and wash your hands.	Follows routine practices.
8.	Place the bottom or fitted sheet in the middle of the bed lengthwise. The fold/crease should be in the centre of the bed.	Ensures even placement of bottom sheet.
9.	Unfold half of the sheet on the side you are working, and tuck the corners under the mattress.	Completing one side of the bed first promotes efficiency.
10.	Fanfold (accordion style) the other half of the sheet and leave in the centre of the bed.	Figure 5.3.1 Fanfolded sheets (bottom sheet, slider sheet, and soaker pad)
11.	Place the slider sheet across the bed. Fanfold it to the other side of the bed. The top edge will lay just below the pillow.
12.	Place the soaker pad in the centre of the bed. Open it on the side you are working. Fanfold it to the other side of the bed.
13.	Place top sheet in centre of the bed lengthwise. Fanfold it to the other side of the bed.
14.	Go to the opposite side of the bed.	Completing one side of the bed first promotes efficiency.
15.	Repeat steps 8–11, opening the fitted sheet and tucking it under the edges of the bed. Unfold the remaining half of the top sheet and bed pad.
16.	Add blankets and bedspreads.
17.	Mitre corners of the bedding (See Table 5.3.2 procedure: How to Mitre a Corner, below.)
18.	Bring the top sheet and blankets down over the bedspread, forming a cuff. Smooth out any wrinkles.
19.	Remove the soiled pillowcase by turning it down and placing it inside out.	This step reduces spread of pathogens
20.	Putting a Pillowcase on a Pillow Method 1: Grasp the pillow in one hand and fold it in half so that it makes a V shape. Guide the pillow into the open end of the pillowcase, which is in your other hand. Smooth out the pillow inside the case. Method 2: Grasp the end of a pillowcase at the centre of bottom seams. With your other hand, gather up the pillowcase so it is covering your hand. Grasp the pillow with the hand that is covered by the pillowcase. Pull the pillowcase down and over the pillow.
21.	Lower the bed to its lowest height. Follow the care plan for bed rails.	Reduces risk of injury to the client.
22.	Remove and dispose of your gloves if used. Wash and dry your hands.	Following routine practices reduces spread of pathogens.
23.	Document completion of task if required.

Watch this video for a more complete visual representation of how to make an unoccupied bed:

How To Make An Unoccupied Bed by Kim Morris, RN, BN, MN; Tracy Christianson, RN, BSN, MN, DHEd, CCNE; Lynnette Fleury, RN, BSN, MSN; and Leon Racicot is licensed under a CC BY 4.0 licence.

Mitre the Corners

Table 5.3.2 Procedure: How to Mitre a Corner
STEP	ACTION	EXAMPLE
1.	Begin with the bedspread and sheet tucked at the end of the bed, and the remainder hanging over the side of the bed.	Figure 5.3.2 Step 1
2.	Grasp the edge of the bedding about 45 cm (18 inches) away from the end of the bed.	Figure 5.3.3 Step 2
3.	Bring it up to the top of the bed. Hold it taut (tight) at about a 45-degree angle. It will have a triangular shape.	Figure 5.3.4 Step 3
4.	Lay the triangular shape against the side of the mattress.	Figure 5.3.5 Step 4
5.	Tuck the bedspread and sheet under the mattress. You should end up with a visible diagonal fold in the bedspread.	Figure 5.3.6 Step 5

Making an Occupied Bed

Table 5.3.3 Procedure: Making an Occupied Bed
STEP	ACTION	REASON/CONSIDERATIONS
1.	Identify your client and explain the procedure.	Promotes safety. Communicating with the client promotes co-operation.
2.	Wash and dry your hands. Don gloves if linens are soiled with blood or body fluids.	Following routine practices prevents the spread of pathogens.
3.	Assemble equipment and supplies, such as clean linens and pillows. Assemble supplies in the order they will be used: bottom or fitted sheet, slider sheets, soaker pad, top or flat sheet, then blanket, bedspread, and pillowcases. Turn the pile of linens upside down and place on a clean surface within your reach. Remember to carry linens away from your body.	Promotes organization and efficiency. Carrying linens away from your body prevents the bacteria on your clothes from getting on the clean linens.
4.	Raise the bed to waist level. Remember to use good body mechanics and never lean over the bed. Work on one side of the bed at a time. Move to the other side of the bed as needed. Lower the bed rails on the side you are working.	Follows principles of body mechanics and reduces the risk of musculoskeletal injuries. Completing one side of the bed first promotes efficiency.
5.	Remove and fold any bedding to be reused (such as blankets, comforters or quilts) and place them on a clean surface.	Do not shake linens as this will release microorganisms the air.
6.	Loosen bedding on the side you are working. Loosen top sheet at foot and bottom or flat sheet at the foot and top of the bed. Leave top sheet or a bath blanket on the client.	Leaving the client covered provides warmth and privacy.
7.	Raise the bed to waist level. Never lean over the bed. Work on one side of the bed at a time. Move to the other side of the bed as needed. Lower the bed rails on the side you are working.	Follows principles of body mechanics and reduces risk of musculoskeletal injuries.
8.	Leave the pillow under client’s head for comfort.
9.	Turn the client to the opposite side from which you are working. Ensure the bed rail on the opposite side is raised. Position for safety and comfort.
10.	Roll the soiled bottom sheet and bed pad toward the client. The soiled sheet and mattress pad should be rolled inward, so the soiled part does not touch the client.	Figure 5.3.7 Roll soiled sheets toward the client Prevents spread of pathogens.
11.	Gently tuck the soiled sheets under the client.
12.	Position the clean bottom or fitted sheet lengthwise along the length of the client. Tuck the clean bottom sheet next to and under the soiled sheets underneath the client. Be sure the clean sheet is underneath the soiled sheet. Tuck the bottom sheet in at the head and foot, under the mattress and smooth out any wrinkles.	This will ensure the new sheet stays clean, and that it will be easy to move to the other side after you turn the client onto their opposite side. Smoothing out wrinkles reduces skin irritation.
13.	Open half the slider sheet on your side. Fanfold (fold it up accordion style) the remaining half. Tuck this under the client, over the clean sheet but under the soiled sheet.	Figure 5.3.8 Fanfolded clean sheets
14.	Turn the client to the clean side of the bed. Let them know that they will feel a “bump” as they roll over the linens underneath them. Position the client for safety and comfort. If the bed has rails, ensure the bed rails are positioned up before you move to the opposite side of the bed.	Promotes safety and comfort.
15.	Go to the opposite side of the bed.
16.	Loosen the bottom sheet at the head and foot of the bed. Roll the soiled bottom sheet and bed pad into a ball so that the soiled part of the linen is inside, and away from clean areas. Place soiled linen in the appropriate receptacle.	Reduces the spread of pathogens.
17.	Remove your gloves and wash your hands. If you move away from the bed, ensure the bed rails are up.	Following routine practices reduces spread of pathogens. A raised bed rail promotes safety.
18.	Roll the clean bottom sheet, slider sheet, and soaker pad out from under the client. Tuck in corners and smooth out wrinkles.	Smoothing out wrinkles reduces skin irritation.
19.	Re-position the client back to the centre of the bed.
20.	Remove the soiled top sheet and replace with the clean top sheet. Replace blankets and top bedding over the client.
21.	Bring the top sheet and blanket down over the top bedding to form a cuff.
22.	Remove soiled pillowcases and replace with clean pillowcases, as outlined in the Making an Unoccupied Bed procedure (Table 5.3.1).
23.	At the foot of the bed, make a toe pleat by lifting all linens with pinched fingers.	This allows the client to have room to move their feet and prevents deformities of the feet from pressure made by tight linens.
24.	Position the client for comfort.
25.	Lower the bed to its lowest setting. Ensure side rails are positioned according to care plan.	Ensures safety of client.
26.	Remove gloves, and wash and dry your hands.	Following routine practices reduces spread of pathogens.
27.	Observe, record, and report any changes in condition or behaviour.	Communication with the health care team is an important aspect of the HCA role.

Watch the video for a more complete visual representation of how to make an occupied bed:

Video coming soon.

Summary

The simple task of making a well-made bed contributes to a client’s well-being. A comfortable and tidy made bed can also prevent future health issues.

Review Questions

A well made bed contributes to the client’s comfort and safety.
1. True
2. False
Standard precautions are not required for bedmaking procedures.
1. True
2. False
The Fowler’s position
1. has the head of the bed higher than the feet
2. has the feet higher than the client’s head
3. is used for sleeping only
4. is used when the client is eating

Chapter 5 Attributions and References

Unit 5.2 Image Attributions

5.2.1 Fowler’s Position by Doyle and McCutcheon (2015), via Wikimedia Commons, is used under a CC BY SA-4.0 licence.
5.2.2 Semi-Fowler’s Position by Doyle and McCutcheon (2015), via Wikimedia Commons, is used under a CC BY SA-4.0 licence.
5.2.3 Trendelenberg Position by Doyle and McCutcheon (2015), via BCcampus, is used under a CC BY SA-4.0 licence.
5.2.3 Reverse Trendelenberg by Saltanat ebli, via Wikimedia Commons, is used under a CC0 1.0 Public Domain licence.

Unit 5.3 Image Attributions

5.3.1 Fanfolded sheets by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.
5.3.2 Step 1 by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.
5.3.3 Step 2 by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.
5.3.4 Step 3 by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.
5.3.5 Step 4 by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.
5.3.6 Step 5 by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.
5.3.7 Roll soiled sheets toward the client by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY licence.
5.3.8 Fanfolded clean sheets by Kim Morris, HCA Program/ Thompson Rivers University, is used under a CC BY 2.0 licence.

Videos

B 301 Unoccupied Bed by Skills Lab (2017) is licensed under a Standard YouTube License.
B 302 Occupied Care video by Skills Lab (2017) is licensed under a Standard YouTube License.

References

Doyle, G. R. & McCutcheon, J. A. (2015, November 23). 3.5 Positioning patients in bed [Digital Images]. In Clinical procedures for safer patient care. British Columbia Institute of Technology (BCIT)/ BCcampus. https://opentextbc.ca/clinicalskills/chapter/3-4-positioning-a-patient-in-bed/

License

Icon for the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License

Personal Care Skills for Health Care Assistants - 2nd Edition Copyright © 2023 by Tracy Christianson and Kimberly Morris, Thompson Rivers University is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.