SYSTEMS PLUS COMPUTER COLLEGE

City of San Fernando, Pampanga

BEDMAKING

The health care provider makes a client’s bed with safety and comfort in mind. The
sheets must always be clean, dry, and wrinkle-free. Whenever a client’s bed is soiled,
it must be changed. The sheets should be straightened out and tightened periodically
throughout the day to keep them wrinkle-free.

Definition of Terms:

1. Bed Making: The technique of preparing different types of bed, making

patients/clients comfortable in his/her suitable position for a particular condition.

2. Fanfold: Specifically folding the edge of the sheet used in the bed 6-8 inches
outward.

3. Mitered corner: a means of anchoring sheet on mattresses.

4. Toe pleat: a fold made in the top bed clothes to provide additional space for
patient’s toes.

5. Foot drop: plantar flexion of the foot with permanent contracture of the
gastronomies(calf) muscle and tendon.

6. Bed cradle: is a curved, semi-circular made of metal that

can be placed over a portion of the patient's body.

7. Hospital bed: It's usually about 26-28 inches (60-70) cm above the floor.

The ideal hospital bed should be selected for its impact on patients comfort,
safety, medical condition, and ability to change position

Purpose of Bed Making:

1. To promote client’s comfort.

2. To provide a clean environment for the clients.

3. To provide a smooth, wrinkle-free bed foundation, thus minimizing sources of skin

irritation.
4. To conserve the client’s energy and maintain current healthy status.

5. To prevent or avoid microorganisms to come in contact with the patient which

could cause tribulations.

Common types of bed:

A. Occupied Bed: Is made when the patient is not able or not permitted to get out of
the bed.

B. Unoccupied Bed: Is made when there is no patient confined in bed, while a patient
Is in the shower or sitting up in a chair.

3 Types of Unoccupied Bed:

1. Open bed: the top covers are folded back so the patient can easily get back in to
bed.

2. Closed bed: the top sheet blankets and bedspreads are drawn up to the head of the
mattress and under the pillow; this is prepared in a hospital room before a new
client is admitted to the room.

3. Post-operative bed/ Surgical bed: known as recovery bed or anesthetic bed, and
used for a patient with large cast or other circumstance that would make it difficult
for him to transfer easily into bed.

Kinds of Linens

A. Blanket: a large piece of cloth often soft, woolen and is used for warmth as a bed
cover.

B. Top sheet: used to cover the patient to provide warmth, made of thick cotton,
thermal material.

C. Cotton draw sheet: a piece of cloth that the rubber sheet and is used to absorb
and moisture.

D. Bottom sheet: used to cover the bed after mattress cover.

E. Rubber sheet: used to protect the bottom sheet from soothing due to patient
secretions and prevent the patients from getting bedsore. It's usually placed over
the center of the bottom sheet.
Special Considerations:

1. Before starting the procedure, see to it that all linen are on hand and arranged
according to use.

2. If the bed is of the Hi-Low type, adjust the height accordingly.

3. Finish one side of the bed at a time.

4. Remember that placement of the rubber sheet will depend upon the client’s need.

5. Leave the client’s need in order.

6. Apply the principles of body mechanics while you are making the bed.

Equipment: Assemble at the bedside and arrange according to use the following:

2 Bedsheets 1 Bedspread (optional)

1 Rubber sheet 1 Pillow case
1 Draw sheet 1 Mattress cover (if necessary)
1 hamper

Procedure:

1. Explain to the client what you are going to do, why it is necessary, and how he or
she can cooperate.

2. Wash hands and observe other appropriate infection control procedures.

3. Provide for client privacy.

4. Place the fresh linen on the client’s chair or overbed table; do not use another
client’s bed.
RATIONALE: This prevents cross-contamination (the movement of
microorganisms from one client to another) via soiled linen.

5. Assess and assist the client out of bed.

 Make sure that this is an appropriate and convenient time for the client to be
out of bed.
 Assist the client to a comfortable chair.

6. Strip the bed.

 Check bed linens for any items belonging to the client, and detach the call
bed or any drainage tubes from the bed linen.
  Loosen all bedding systematically, starting at the head of the bed on the far
side and moving around the bed up to the head of the bed on the near side.
RATIONALE: Moving around the bed systematically prevents stretching
and reaching and possible muscle strain.
 Remove the pillowcases, if soiled, and place the pillows on the bedside chair
near the foot of the bed.
 Fold reusable linens, such as the bedspread and top sheet on the bed, into
fourths. First, fold the linen in half by bringing the top edge even with the
bottom edge, and then grasp it at the center of the middle fold and bottom
edges. RATIONALE: Folding linens saves time and energy when
reapplying the linens on the bed.
 Remove the waterproof pad and discard it if soiled.
 Roll all soiled linen inside the bottom sheet, hold it away from your uniform,
and place it directly in the linen hamper. RATIONALE: These actions are
essential to prevent the transmission of microorganisms to the nurse
and others.
 Grasp the mattress securely, using the lugs if present, and move the
mattress up to the head of the bed.

7. Apply the bottom sheet and draw sheet.

 Place the folded bottom sheet with its center fold on the center of the bed.
Make sure the sheet is hem side down for a smooth foundation. Spread the
sheet out over the mattress, and allow a sufficient amount of sheet at the top
to tuck under the mattress.
RATIONALE: The top of the sheet needs to be well tucked under to
remain securely in place, especially when the head of the bed is
elevated. Place the sheet along the edge of the mattress at the foot of
the bed and do not tuck it in (unless it is a contour or fitted sheet).

 Miter the sheet at the top corner on the near side and tuck the sheet under
the mattress, working from the head of the bed to the foot.

 If a waterproof draw sheet is used, place it over the bottom sheet so that the
centrefold is at the center line of the bed and the top and bottom edges
extend from the middle of the client’s back to the area of the midthigh or
knee. Fanfold the uppermost half of the folded drawsheet at the center or far
edge of the bed and tuck in the near edge.

 Lay the cloth drawsheet over the waterproof sheet in the same manner.

 Optional: Before moving to the other side of the bed, place the top linens on
the bed hemside up, unfold them, tuck them in, and miter the bottom
corners. RATIONALE: Completing one entire side of the bed at a time
saves time and energy.

8. Move to the other side and secure the bottom linens.

  Tuck in the bottom sheet under the head of the mattress, pull the sheet
firmly, and miter the corner of the sheet.

 Pull the remainder of the sheet firmly so that there are no wrinkles.
RATIONALE: Wrinkles can cause discomfort for the client. Tuck the
sheet in at the side.

 Complete this same process for the drawsheet(s).

9. Apply or complete the top sheet, blanket, and spread.

 Place the top sheet, hemside up, on the bed so that its centrefold is at the
center of the bed and the top edge is even with the top edge of the mattress.

 Unfold the sheet over the bed.

 Optional: Make a vertical or a horizontal toe pleat in the sheet to provide

additional room for the client’s feet.

a. Vertical toe pleat: Make a fold in the sheet 5 to 10 cm (2 to 4 in.)

perpendicular to the foot
of the bed.

b. Horizontal toe pleat: Make a fold in the sheet 5 to 10 cm (2 to 4 in.)across

the bed near the
foot.

Loosening the top covers around the feet after the client is in bed is another way to
provide additional space.

 Follow the same procedure for the blanket and the spread, but place the top
edges about 15 cm (6 in.) from the head of the bed to allow a cuff of sheet to
be folded over them.

 Tuck in the sheet, blanket, and spread at the foot of the bed, and miter the
corner, using all three layers of linen. Leave the sides of the top sheet,
blanket, and spread hanging freely unless toe pleats were provided.

 Fold the top of the top sheet down over the spread, providing a cuff.
RATIONALE: The cuff of sheet makes it easier for the client to pull the
covers up.

 Move to the other side of the bed and secure the top bedding in the same
manner.

10. Put clean pillowcases on the pillows as required.

  Grasp the closed end of the pillowcase at the center with one hand.

 Gather up the sides of the pillowcase and place them over the hand grasping
the case. Then grasp the center of one short side of the pillow through the
pillowcase.

 With the free hand, pull the pillowcase over the pillow.

 Adjust the pillowcase so that the pillow fits into the corners of the case and
the seams are straight. RATIONALE: A smoothly fitting pillowcase is more
comfortable than a wrinkled one.

 Place the pillows appropriately at the head of the bed.

11. Provide for client comfort and safety.

 Attach the signal cord so that the client can conveniently use it. Some cords
have clamps that attach to the sheet or pillowcase. Others are attached by a
safety pin.

 If the bed is currently being used by a client, either fold back the top covers
at one side or fanfold them down to the center of the bed. RATIONALE: This
makes it easier for the client to get into bed.

 Place the bedside table and the overbed table so that they are available to
the client.

 Leave the bed in a high position if the client is returning by stretcher, or

place in the low position if the client is returning to bed after being up.

12. Document and report pertinent data.

 Bed-making is not normally recorded.

 Record any nursing assessments, such as the client’s physical status and
pulse and respiratory rates before and after being out of bed, as indicated.
VARIATION: SURGICAL BED

While the client is in the operating room, the client’s bed is prepared for the post-
operative phase. In some agencies, the client is brought back to the unit on a stretcher
and transferred to the bed in the room. In other agencies, the client’s bed is brought to
the surgery suite and the client is transferred there. In the latter situation, the bed
needs to be made with clean linens as soon as the client goes to surgery so that it can
be taken to the operating room when needed.

 Strip the bed.

 Place and leave the pillows on the bedside chair. RATIONALE: Pillows are left
on a chair to facilitate transferring the client into the bed.

 Apply the bottom linens as for an unoccupied bed. Place a bath blanket on the
foundation of the bed if this is agency practice. RATIONALE: A flannel bath
blanket provides additional warmth.

 Place the top covers (sheet, blanket, and bedspread) on the bed as you would
for an unoccupied bed. Do not tuck them in, miter the corners or make a toe
pleat.

 Make a cuff at the top of the bed as you would for an unoccupied bed. Fold the
top linens up from the bottom.

 On the side of the bed where the client will be transferred, fold up the two outer
corners of the top linens so they meet in the middle of the bed forming a
triangle.

 Pick up the apex of the triangle and fanfold the top linens lengthwise to the
other side of the bed to facilitate the client’s transfer into the bed.

 Leave the bed in high position with the side rails down. RATIONALE: The high
position facilitates the transfer of the client.

 Lock the wheels of the bed if the bed is not to be moved. RATIONALE: Locking
the wheels keeps the bed from rolling when the client is transferred from
the stretcher to the bed.

Prepared by: Jennifer B. Garcia, RN

Instructor