12.9.2: Procedure- Making an Occupied Bed

1. Wash and dry your hands. Don gloves.
2. Assemble equipment and supplies (e.g. clean linens and pillows). Assemble supplies in the order they will be used: Bottom or fitted sheet, bed pad, top or flat sheet, blanket, bedspread, pillow cases(s). Carry linens away from your body to prevent bacteria from your clothes getting on the clean linens. Turn the pile of linens upside down and place on a clean surface which will be within your reach.
3. Raise the bed to waist level. Remember to use good body mechanics. 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.
4. Remove and fold any bedding to be re-used (such as blankets and comforters or quilts). Place them on a clean surface. Do not shake linens as this will release microorganisms in the air.
5. 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 patient for warmth and privacy.
6. Leave the pillow under patient’s head for comfort.
7. Turn the patient to the opposite side from which you are working. Position for safety and comfort.
8. Roll the soiled bottom sheet and bed pad toward patient. The soiled sheet and mattress pad should be rolled inward so the soiled part is not touching the patient.
9. Gently tuck the soiled sheets under the patient.
10. Position the clean bottom or fitted sheet lengthwise along the length of the patient. Tuck the clean bottom sheet next to and under the soiled sheets underneath the patient. Be sure the clean sheet is underneath the soiled sheet. This will ensure the new sheet stays clean and that it will be easy to move to the other side after you turn the patient onto their opposite side. Tuck the bottom sheet in at the head and foot, under the mattress. Smooth out any wrinkles.
11. Open ½ the bed pad on your side. Fanfold (fold it up accordion style) the remaining half. Tuck this under the patient, over the clean sheet but under the soiled sheet.
12. Turn the patient 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 patient 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.
13. Go to the opposite side of the bed.
14. 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.
15. Remove your gloves and wash your hands. If you move away from the bed, ensure that the bed rails are up.
16. Roll the clean bottom sheet and bed pad out from under the patient. Tuck in corners and smooth out wrinkles.
17. Re-position the patient back to the center of the bed.
18. Remove the soiled top sheet and replace with the clean top sheet. Replace blankets and top bedding over the patient.
19. Bring the top sheet and blanket down over the top bedding to form a cuff.
20. Remove soiled pillow cases and replace with clean pillow cases as outlined in the procedure, “Making an Unoccupied Bed.”.
21. At the foot of the bed, make a toe pleat by lifting all linens with pinched fingers. This allows the patient to have room to move their feet and prevents deformities of the feet from pressure made by tight linens.
22. Position the patient for comfort.
23. Lower the bed to its lowest setting. Ensure side rails are up.
24. Remove gloves, wash and dry your hands.
25. Observe, record, and report any changes in condition or behavior.