Types of Hospital Bed and Bed Making

Anatomy of a Typical Hosptal Bed

Key Terms Used In Bed Making

(1)- Striping the Bed

This is a procedure to remove bed linen from a bed which has been previously used. This is required either
to air the bed or put fee bed in sun or making it ready for future.

Procedure
1. When a chair or a stool has been provided with the bed, the chair or stool should be placed at the
foot end of the bed.
2. Place the pillow over the seat of the chair or on stool
3. The bed sheet should be loosened from right side.
4. Fold bed sheet twice, bring top hem to bottom hem, and pick up at the centre.
5. The blanket should be folded in similar way.
6. Soiled sheets should be removed and should not be thrown on floor.
7. Fold the draw sheet in two and place it over the chair.
8. The mackintosh should be folded in similar pattern.
9. The mattress should be turned from top to bottom or from, side to side.

(2)- Bed Mitered Corner means anchoring sheets on mattress of bed.

A tight-fitting triangular fold made by tucking a sheet and blanket securely under a mattress on the
end and on each side at the corners.

Procedure

A. Choose a flat sheet that fits your mattress and allows for several inches of equal overhang on
three sides. Line the head of the mattress with the beginning of your flat sheet and allow the
remainder of the sheet to hang equally on the two long sides and foot of the bed.
B. Tuck under the loose sheet at the foot of the bed being careful to smooth out any wrinkles or
creases that may occur on the bedding.
C. Go to one side of the bed and proceed to create the “45’ Degree Angle” fold by lifting up the
bottom edge of the sheet onto the bed creating a 45’ angle and tucking in the remainder
tightly to the mattress.
D. Fold the sheet back down and tuck into the mattress, again being careful to avoid any wrinkles
and creases. The end result should look similar to a wrapped gift when you angle the edges to
enclose the present.
E. Continue to the other side of the bed and follow the same directions again. Be sure you keep
the sheets very flat, smooth, and wrinkle free.
 Figure: Mitered Corner

(3)- Toe pleat is a fold made in the top bed sheets to provide additional space for patient’s toes.

Figure: Toe Pleat

(4)- Fanfold is a specifically folding the edge of sheet used in the bed 6-8 inches outward horizontally or
diagonally.

Figure: Fanfold top sheet

(5)- Closed Bed has top sheet blankets and bedspreads that are drawn up to the head of the mattress
and under the pillow; this is prepared before a patient is admitted to the room. Closed bed is an empty
bed, waiting for the new patient.

Figure: Close Bed

(6)- Open Bed has top covers that are folded back so that the patient can easily get back into the bed.
It is done when patient is about to be occupied into bed. It is made either for a new or ambulatory
patient.

Figure: Open Bed

(7)- Occupied Bed is made when patient is not able or not permitted to go out of the bed.

Figure: Occupied Bed

 (8)- Unoccupied Bed is made when there is no patient confined in bed, while a patient in the
shower or sitting up in a chair.

Figure: Unoccupied Bed

General Principles of Bed Making

Bed making procedure in nursing is a fundamental of nursing work. The systematic procedures followed in
bed-making are as follows:

1. During bed-making, keep bed position elevated and ensures nursing staff’s good body alignments.
2. During the procedure, the nurse should notice her/his movements so as to avoid waste of time and
energy.
3. After completing, bed should be lower position.

4. During occupied bed making, confirm patient safety and comfort.

5. Wash hands before and after bed making and use gloves during bed-making.
6. Maintain privacy while making bed.
7. Keep soiled linen away from uniform which may have germs.
8. Do not shake dirty linen to prevent germs spread around room.
9. Do not mix soiled and clean linen during bed-making.
10. For bed ridden patient, mattress must be turned air and ensure free of lumps and fold.
11. Keep everything ready on bed side before starting bed-making.
12. Change bed linen frequently to assure cleanliness.
13. It should have a finished appearance.
14. To make bed tight and free from wrinkles, place all linen straight line on the bed.
15. After cleaning bed, dump soap water and disinfectant properly.
16. Try to prevent cross infection of microorganism during bed-making.
17. Ensure all bed-making in a nursing unit alike for uniformity of appearance.
18. Soiled linens should not be thrown on floor.
19. First lift the mattress while loosening the bed-linen or removing the sheets. The sheets should not
be pulled forcefully.
20. The bed linens should be folded from top to bottom or side to side. This applies to fold the mattress
also while making one unoccupied bed.
21. As self precaution while tucking bedding under mattress, the palm of the hand should face
downwards to prevent injury of nails.
22. The open end of the pillow should not face to the entrance of ward.
 Special Types of Hospital Beds

1- Cardiac Bed

This is a special type of bed prepared for a heart patient mostly in intensive care unit (ICU) and high
dependency Unit (HDU).
Purposes
The aim of such bed is mainly to prevent dyspnoea or breathlessness and thereby to provide comfort
to the patient in orthopneic position.

Figure: Cardiac Bed Figure: Orthopneic Position

Articles Required
 All material required for ordinary bed making.
 Cardiac table.
 Back rest where Fowler’s bed is not available.
 Extra pillow for back.
 Air ring and footrest board.
Procedure
One simple bed is made as already described with foot rest at the foot of the bed.
 The backrest is placed at the back of the patient and for extra comfort one or two pillows are
placed on it.
 The cardiac table is placed in front of the patient with one this is to provide comfortable leaning of
the patient and rest .of the head on it.
 The cardiac bed is also used for patients with respiratory distress.

2- Fracture Bed
The name itself indicates a special bed for a fracture patient in orthopedic ward.

Purposes
 Making the bed firm or hard to provide immobility to the fractured part of the bone.
 Provides better comfort to the patients, promotes better opposition of fractured end and
thereby quick union and prevents complications.
 Figure: Fracture Bed

Articles Required
 Same as for a simple bed.
 Fracture board.
 Fracture bed.
 Sand bag if required.
 Bed cradle if required.

Procedure
The fracture board is placed directly over the bed springs.A thin firm mattress or matting or pad over the
fracture board for comfortable position.

 The inner spring mattress should be removed.

 The other procedures are same as described in ordinary bed making.

3- Cradle Bed
This is a special type of bed with a cradle to carry the weight of the linens.
Purposes

 Protect an affected burn body part from the weight of the upper bedding.
 Protect the upper bedding from moist applications i.e. body lotion, pain killer ointment, creams etc.
 Support heating or warming electrical appliances and cold application by ice bag in cases of
hemorrhage from gastric or pulmonary area.

Figure: Bed Cradle

 Articles Required
This includes simple bed making items:

 Cradle
 Bath blankets
 Roller bandage or tape for tying.
Procedure
1. The foundation of the bed is made.
2. The patient is covered with both blankets and the cradle is adjusted.
3. The cradle is placed over part of the patient where special protection is required.
4. The cradle is secured to the sides and end of the bed.
5. The top sheet is placed over the cradle and it comes over the chest of the patient. The extra portion
of the sheet is tucked evenly at foot and square corner is made under the mattress, but only folded
neatly across the end of the cradle.
6. The first blanket is put up to patient’s shoulder and tucked smoothly at foot with square corner.
7. The top blanket is tucked well under mattress.
8. The spread cover is put and tucked under the mattress at the foot and half square corner is made.
9. The pillow is replaced.

4- Post Operative Bed

This is a special type of bed meant for patient coming from operation theatre either in anesthetized
form or otherwise. Therefore, it is also called post anesthesia recovery bed/surgical bed or
orthopedic bed.

Purposes

The main purposes of postoperative bed making or surgical bed making are pointed below:

1. To protect the patient from immediate comply anesthesia or choking.

2. To lift or transfer the patient easily into bed from stretcher.

3. To provide warmth and comfort for the patient.

4. To observe and prevent patient complications.

5. To save time, effort and materials.

6. To arrange the bed and other furniture in order to facilitate the transfer of the patient from
stretcher to bed.

7. To combat postoperative complication and shock.

8. To protect mattress and other linen from blood, vomits and other discharge.

Articles Required
Equipment’s needed for postoperative bed making or surgical bed making are below:
(B)For Bed Making (C)On the Bedside Table
1. Bed sheet-1 1. Stethoscope
2. Draw sheet-1 2. Sphygmomanometer
3. Woolen blanket-2, 3. Kidney basin
4. Rubber sheet or Mackintosh sheet-1 4. Galipot
5. Pillow case- 1 or 2 5. Padded tongue depressor

5- Blanket Bed (Renal Bed)

 Blanket bed is prepared for a patient with renal diseases or rheumatism.

 Purposes

1. Improve perspiration for excretion of waste products in case of nephritis.

2. To carry the weight of the bed clothes off the painful joints.

3. To provide extra warmth to the body.

Articles Required

(1). Bed sheet. (2). Draw sheet (3).Top sheet. (4). Blanket (5). Bed spread. (6). Pillow case. (7).
Duster. (8). Extra pillow. (9). Two old wooden blankets. (10). Narrow mackintosh and sheet.
 
Procedure

1. The bed is prepared as usual.

2. Cover the bed with blanket instead the bottom sheet.

3. Place narrow mackintosh and narrow sheet in the usual manner.

4. Place second bath blanket over the patient.

5. Cradle is used to take off the weight of the top linen off the painful joints.

6. Sand bags are used to immobilize the painful joints.

6- Amputation Bed/Stump Bed/Divided Bed

Amputation bed is prepared for a patient with amputation of the leg to take off the weight of the bed
clothes off site of the operation. In this type of bed the top bed clothes are divided or split.

Figure: Above Knee Amputation (AKA)

Purposes

1.To keep the stump in good position.

2. To be able to watch the stump for hemorrhage and apply tourniquet instantly if necessary.

3. To allow the nurse to do repeated procedures such as bladder irrigation, without exposing the
patient.

4. To allow the nurse to make frequent observations after amputation of the leg without disturbing
the patient.

 Articles Required

1. Set of top extra bedding. 2. Blankets and counter pane. 3. Bed cradle. 4. Tourniquet. 5. Pillow and
plastic cover. 6. Sand bags and draw sheet.

Procedure

1. Prepare the bed as simple open bed.

2. Make bottom half of the bed. Fold sheet crosswise at the center of the bed at bottom tuck in and
make corners. Make upper half of the bed. The other set of the top linen starts from the stump; but
overlapping the first one and the excess is tucked under the mattress at the foot.

3. When the patient is brought back from the operation theatre, make fan fold the two sets of linen
one side of the bed and receive the patient on the bed.
 4. Bed cradle is used to take off the weight of the top linen.

5. Cover the patient and keep him warm and comfortable.

6. Amputation bed is usually used for amputation of the legs; operation bed is used for an
amputation of the hand.

7. The two sections of the top linen should overlap each other at least by 8 to 10 inches. So that
nurse can easily observe the stump and also prevent unnecessary exposure of the patient.

7- Admission Bed

It is a specially made bed for patients who are admitted into the ward. It is made in such a way
that a patient or client is admitted without delay.

Purposes

1. To provide warmth for the patient.

2. To allow immediate admission.

3. To facilitate bathing of patient in bed without undue disturbance.

4. To give prompt treatment.

Articles Required

A trolley with the following items:

 Long mackintosh sheet or mackintosh if necessary.

 One or two blankets if necessary.

 Bed accessories depending on patient's condition e.g. Bed blocks or elevator, bed cradle, back
rest etc.

Procedure

1. Make up bed as for simple unoccupied bed until draw sheet or mackintosh is in position.

2. Cover with a long waterproof sheet or a long mackintosh if necessary.

3. Place second bath blanket over the bed.

4. Put in hot water bottles if necessary.

1. Use one bath blanket or sheet over the waterproof sheet and tuck in all around or fold
5. Put on top bed
under clothes.
itself.
6. Place counterpane loosely over the top bed clothes.
9. Tuck in the bed clothes on other side.

10. Fold the bedclothes over at the side nearest to the door, leaving it open to facilitate quick
admittance.

8- Burn Bed

A burn recovery bed or burn bed is a special type of bed designed for hospital patients who have
suffered severe skin burns across large portions of their body.

Purposes

 Prevent infection to the burn area.

 Help in healing of the burn area.

 Provide comfort to the patient.

 Prevent the patient from sticking to the sheet as a result of exudates oozing from the burn
area.
 

Procedure

 Place three sterile draw sheets (top, middle and bottom) over the sterile bottom sheet and
nicely tuck them under the mattress.
 These are helpful to permit changing by the nurse with minimal discomfort to the patient. In
well established burn unit Microdon (3 M. Co.) sheeting is used over the sterile bottom sheet.
This prevents the patient from sticking to the sheet as a result of the exudates oozing from the
burn area.
 Place the bed cradle over the burn area after receiving the patient in bed. . This prevents the
patient from sticking to the sheets and helps to take the weight of top clothes off the burn
area.
 Discard dirty linen in the dirty linen receptacle.

 .

 
9- Clinitron Bed provides an ideal healing environment for compromised skin by minimizing
the forces that cause tissue breakdown: pressure, shear, friction, heat and moisture.
Clinitron Bed uses unique air fluidized therapy system which minimizes interface pressure,
while maximizing the surface’s immersion and envelopment properties to support healing.

Figure: Clinitron Bed Figure: Air Fluidized Therapy

Purposes

 Provides the highest level of wound care for patients with complex, advanced wounds that
are difficult to heal and expensive to manage.
 Medical grade, silicone-coated bead fluidization improves patient comfort.
 Electric head of bed articulation accommodates patients with respiratory complications.
 Bed height adjustment aids in patient positioning and egress and improves working height
for caregivers.
10- Rotokinetic bed is used primarily for severely immobilized patients or patients
with spinal cord injuries. The bed can rotate a patient up to 270°. The Rotokinetic bed helps
maintain skeletal alignment while providing constant rotation. This bed improves skeletal
alignment with constant side-to-side rotation up to 90 degrees.

Figure: Rotokinetic Bed

 11- Specialized Bariatric Bed is a heavy duty bed, featuring sturdy and strong frames that
can hold as much as 1000 lbs of obese patients.

Purposes

 Bariatric beds provide more comfort for obese patients than standard-size beds.

 They help preserve self-esteem by providing these patients with a bed that easily fits their
larger body size as well as special side rails that help them turn and reposition themselves.

 Bariatric beds allow caregivers to perform such routine care as boosting, turning, and
transferring in and out of bed with greater ease and less risk of injury.

 Most bariatric beds have a built-in scale that allows the nurse to more easily weigh the patient.
Some bariatric beds also convert to a cardiac chair.

Figure: Bariatric Bed

 Manual Standard Bed

The simplest bed with limited functions, economically cheapest, used usually in general wards
for stable patients.

(A) - Gatch Bed is also called simple crank bed, a hospital bed with a frame in three
movable sections equipped with mechanical spring parts that permit raising the head
end, foot end, or middle manually or electrically. It has main three types:

1- Single Gatch bed has an adjustable head section which will elevate only the head rest
of a patient by manipulating single crank up and down to adjust the comfortable
positions for patient i.e., supine, fowler positions etc..

Figure: Single Crank Gatch Bed

2- Double Gatch Bed will elevate the head rest and the feet rest of a patient
independently by manipulating double cranks up and down to adjust different
comfortable positions for the patient i.e., fowler positions, dorsal recumbent etc.

Figure: Double Crank Gatch Bed

 3- Triple Gatch bed has three cranks at foot side of bed with additional adjustable
height option. All three cranks operate independently.

Figure: Three Crank Gatch Bed

Purposes

o It is used to relieve of symptoms caused by respiratory infections like pneumonia or

asthma.
o Easily raising individuals into a sitting position allows fluid to be more easily liberated
from the lungs and chest in a comfortable manner.
o They usually don’t need electricity so can be handled manually.

(B)- Low Bed

Low beds are exactly that - medical beds that are low to the ground.

Purposes

 Prevents patients and individuals who are at risk of falling from the height of a
typical medical bed. 

 Provides easy access to bed especially old aged patient suffering from
neurological diseases i.e., Alzheimer’s and Parkinson’s diseases.
 Figure: Low Bed

(c)- Electric Bed

Electric beds may be semi electric or full electric type and operated by digital remote
control panel either by patients or nurses.

Purposes

They are used in highly intensive care units like ICU, CCU, and HDU where patients need
critical care, sophisticated instruments.

Figure: Digital Remote Panel in Electric Bed

Figure: High Tech Electric Bed
APPENDIX

Characteristic Features of Full Electric Bed

Types of Air Mattress

There are 4 main types of air mattress (pressure relieving mattresses) and the right one for the
patient depends on their risk level for bed sores. This is determined by assessments such as the
Braden or Norton scales.

(1)-Therapeutic Static Foam mattresses are made of single or multi-layer memory foam that
contours to the body to redistribute pressure and promote comfort. Their surface remains
static, which means the patient’s weight is evenly distributed over a large surface at a
continuous low pressure. That being said, memory foam does respond to a patient’s body
shape, weight and level of movement.
Nursing Alert:
Static t foam mattresses are intended more for the prevention of pressure sores rather than
the treatment of them. Patients still must be repositioned by their car provider regularly,
otherwise sores can still develop.

(2) Low Air Loss Mattresses have tiny holes in the surface that  ‘leak’ air through the fabric with
the intention of wicking away moisture build-up and providing a more comfortable overall
position by reducing the contact pressure between the mattress and the user. 

Figure
: Low Air Loss Mattress
(3) Dynamic (Alternating Therapy) Mattresses powered by pumps, have a system of
long air tubes or bladders that  inflate and deflate intermittently with the intent of changing
the pressure points on the user’s body to avoid pressure build-up leading to skin breakdown.

Figure: Dynamic Alternate Pressure Mattress

(4) Hybrid Mattresses combine both foam and dynamic therapies and can be used either as
static mattresses or as dynamic therapy surfaces to mitigate the risk of pressure ulcers.
This gives the added advantages that ‘stepping up’ from a static mattress to a dynamic therapy
mattress can be achieved quickly and easily without needing to move the patient from the bed
and without waiting for equipment to be delivered.

Figure: Hybrid Mattress

 CHANGINGAN OCCUPIED BED

Purpose:

1. To conserve the client’s energy

2. To promote client comfort.
3. To provide a clean, neat environment for the client.
4. To provide a smooth, wrinkle-free bed foundation, thus minimizing sources of skin irritation.
ASSESSMENT RATIONALES
Assess
1 Skin condition and need for a special mattress (e.g., an egg-
crate mattress), footboard, bed cradle, or heel protectors.
2 Client’s ability to reposition self. This will determine if additional
assistance is needed.
3 Determine presence of incontinence or excessive drainage
from other sources indicating the need for protective
waterproof pads.
4 Note specific orders or precautions for moving and
positioning the client.
Equipment:
1. Two flat or one fitted and one flat sheet
2. Cloth draw sheet(optional)
3. One blanket
4. One bedspread
5. Pillowcase(s) for the head pillow(s)
6. Waterproof draw sheet or waterproof pads(optional)
7. Plastic laundry bag or portable lines hamper, if available
Implementation:
Preparation: This avoids stockpiling of unnecessary
Determine what linens the client may already have in the room extra linens.
to avoid stockpiling of the unnecessary extra linens.
Performance Rationale
1 Prior to performing the procedure, introduce self and verify
the client’s identity using agency protocol. Explain to the
client what you are going to do, why it is necessary, and
how he or she can cooperate.
2 Perform hand hygiene and observe other appropriate
infection control procedures .Apply clean gloves if linens is
soiled with body fluids.

3 Provide for client privacy.

4 Remove the top bedding.
a Remove any equipment attached to the linen, such as
signal light.
b Loosen all top linen at the foot of the bed, and remove
the spread and the blanket.
c Leave the top sheet over the client (the top sheet can
remain over the client if it is being changed and if it will
provide sufficient
warmth), or replace it with a bath blanket as follows:
a Spread the bath blanket over the top sheet.
b Ask the client to hold the top edge of the
blanket.
c Reaching under the blanket from the side, grasp the (1)Removing top linens under a bath
top edge of the sheet and draw it down to the foot of blanket.
the bed. Leaving the blanket in place. ( 1 )
d Remove the sheet from the bed and place it in the
soiled linen hamper.
5 Change the bottom sheet and draw sheet.
a Raise the side rail that the client will turn toward. If This protects clients from falling and
there is no side rail, have another nurse support the allows them to support themselves in the
client at the edge of the bed. side-lying position.
b Assist the client to turn on the side away from the nurse
and toward the raised side rail.
c Loosen the bottom linens on the side of the bed near the
nurse.
d (1) Fanfold the dirty linen (e.g., draw sheet and the
bottom sheet toward the center of the bed.
(2) As close to and under the client as
possible.
(2) Moving soiled linen as close to the
client as possible.
Doing this leaves the near half of the bed
free to be changed.
e Place the new bottom sheet on the bed, and vertically
fanfold the half to be used on the far side of the bed as
close to the client as possible.
(3) Tuck the sheet under the near half of the bed and
miter the corner if a contour sheet is not being used.

(3) Placing new bottom sheet on half of

the bed.
f (4)Place the clean draw sheet on the bed with the
center fold at the center of the bed. Fanfold the
uppermost half vertically at the center of the bed and
tuck the near side edge under the side of the mattress.

(4) Placing clean drawsheet on the bed.

 g Assist the client to roll over toward you, over the
fanfold bed linens at the center of the bed, onto the
clean side of the bed.
h Move the pillows to the clean side for the client’s use.
Raise the side rail before leaving the side of the bed.
i Move to the other side of the bed and lower the side
rail.
j Remove the used linen and place it in the portable
hamper.
k Unfold the fanfold bottom sheet from the center of the
bed.
l Facing the side of the bed, use both hands to pull the
bottom sheet so that it is smooth and tuck the excess
under the side of the mattress.
m Unfold the draw sheet fanfold at the center of the bed
and full it tightly with both hands. Pull the sheet in
three divisions: (a) face the side of the bed to pull the
middle division, (b) face the far top corner to pull the
bottom division, and
(c) face the far bottom corner to pull top division.
n Tuck the excess draw sheet under the side of the
mattress.
6 Reposition the client in the center of the bed.
a Reposition the pillows at the center of the bed.
b Assist the client to the center of the bed.
Determine what position the client requires or prefers
and assist the client to that position.
7 Apply or complete the top bedding.
a (5) Spread the top sheet over the client and either ask
the client to hold the top edge of the sheet or tuck it
under the shoulders. The sheet should remain over the
client when the bath blanket or used sheet is removed.

(5)Client holds top edge of sheet while

nurse removes bath blanket.
b Complete the top of the bed.
8 Ensure continued safety of the client.
a Raise the de rails. Place the bed in the low position
before leaving the bedside.

b Attach the call light bed linen within the client’s

reach
 c Put items used by the client within easy reach.
9 Bed-making is not normally recorded.
Evaluation:
This prevents errors in supportive
 Conduct appropriate follow up, such as determining client’s
devices resulting from procedure.
comfort and safety. Patency of all drainage tubes, and
client’s access to call light to summon help when needed.
 Reassess all tubing, oxygen apparatus, IV pumps, and so
forth.

CHANGHING AN UNOCCUPIED BED

PURPOSES:
1. To promote the client comfort
2. To provide a clean neat environment for the client
3. To provide a smooth, wrinkle-free bed foundation, thus minimizing sources of skin irritation
STEPS RATIONALE
 Assess In some hospital it is necessary to have a
1 Client’s health status to determine that the person can written order to get out of bed if the
safely get out of bed. client has been in bed continuously.

Client may experience postural

2 Client’s BP, pulse and respirations if indicated. hypotension when moved from a lying
position to standing to sitting, particularly if
it is the first time out of bed for awhile.

3 Client’s mobility status. This may influence the need for additional
assistance with transferring the client from
the bed to a chair.

4 Tubes and equipment connected to the client. This may influence the need for additional
linens or water proof pads.

EQUIPMENT:
1. Clean gloves, if needed
2. Two flat or one fitted and one flat sheet
3. Cloth draw sheet(optional)
4. One blanket
5. One bedspread
6. Pillowcase(s) for the head pillow(s)
7. Waterproof draw sheet or waterproof pads(optional)
8. Plastic laundry bag or portable lines hamper, if available
Preparation
Determine what lines the client may already have in the room to avoid stockpiling of the
unnecessary extra linens.
STEPS RATIONALE
1 If the client is in bed, prior to performing the procedure,
introduce self and verify the client’s identity using agency
protocol. Explain to the client what you are going to do,
why it is necessary, and how he or she can cooperate.
2 Perform hand hygiene and observe other appropriate
infection control procedures.
3 Provide for client privacy.
4 Place the fresh linen on the client’s chair or over bed table; This prevents cross- contamination
do not use another client’s bed. (the movement of microorganisms
from one client to another) via soiled
linen.
5 Assess and assist the client out of bed. This ensures client safety.
a Make sure that this is an appropriate and convenient
time for the client to be out of bed.
 b Assist the client to a comfortable chair.
6 Raise the bed to a comfortable working height.
7 Apply clean gloves if linens and equipment have been
soiled with secretions and/or excretions.
8 Strip the bed.
a Check bed lines for any items belonging to the client,
and detach the call bell or any drainage tubes from the
linen.
b Loosen all bedding systematically, starting at the head Moving around the bed systematically
of the bed on the far side and moving around the bed prevents stretching and reaching and
up to the head of the bed on the near side. possible muscle strain.
c Remove the pillowcases, if soiled, and place the pillows
on the bed-side near the foot of the bed.

d Fold reusable lines, such as the bedspread and top sheet Folding linens saves time and energy
on the bed, into fourths, First, fold the linen in half by when reapplying the linens on the bed
bringing he top edge even with the bottom edge, and and keeps them clean.
then grasp itat the center of the middle fold and bottom
edges (1).

(1) Fold reusable linens into fourths

when removing them from the bed.
e Remove the waterproof pad and discard it if soiled.
f Roll all soiled linen inside the bottom sheet, hold it away These actions are essential to prevent
from your uniform, and place it directly in the linen the transmission of microorganism to
hamper (2). the nurse and others.

(2) Roll soiled linen inside bottom sheet

and hold away from body.
g Grasp the mattress securely. Using the lugs if present,
and move the mattress up to the head of the bed.

h Remove and discard gloves if used. Perform hand

hygiene.
9 Apply the bottom sheet and draw sheet.
 a Place the folded bottom sheet with its center fold on the The top of the sheet needs to be well
center of the bed. Make sure the sheet is hem side down tucked under to remain securely in
for a smooth foundation. Spread the sheet out over the place, especially when the head of the
mattress, and allow a sufficient amount of sheet at the bed is elevated.
top to tuck under the mattress. 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 (3).

(3) Placing bottom sheet on bed.

b Miter the sheet at the top corner on the near side (see
figure 33-20) and tuck the sheet under the mattress,
working from the head of the bed to the foot.

c If a waterproof drawsheet is used, place it over the

bottom sheet so that the centerfold is at the centerline
of the bed and the top and bottom edges extend from
the middle of the client’s back to the area of the mid
thigh or knee.
Fanfold the uppermost half of the folded draw sheet at
the center or far edges of the bed and tuck in the edge
(4). (4) Placing clean drawsheet on bed.

d OPTIONAL: before moving to the other side of the bed, Completing one entire side of the bed
place the top linens on the hemside up, unfold them, at a time saves time and energy.
tuck them in, and miter the bottom corners.
10 Move to the other side and secure the bottom linens.
a Tuck in the bottom sheet under the head of the
mattress, pull the sheet firmly, and miter the corner of
the sheet.
b Pull the remainder of the sheet firmly so that there are Wrinkles can cause discomfort for the
no wrinkles. Tuck the sheet in at the side. client and breakdown of skin. Tuck the
sheet in at the side.
c Tuck in the drawsheets, if appropriate.
11 Apply or complete the top sheet, blanket, and spread.
a Place the top sheet, hem side up; on the bed so that its
centerfold is at the center of the bed and the top edge is
even with the top edge of the mattress.
b Unfold the sheet over the bed.
c 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.
d 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.
e Fold the top of the top sheet down over the spread, The cuff of a sheet makes it easier for
providing a cuff (7). the client to pull the covers up.

(7) Making a cuff of the top linens.

f Move to the other side of the bed and secure the
bedding in the same manner.
12 Put clean pillowcases on the pillows as required.

a Grasp the closed end of the pillowcase at the center with

one hand.
b 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.(8)

(8) Method for putting a clean pillowcase

on a pillow.
c With the free hand, pull the pillowcase over the pillow.

d Adjust the pillowcase so that the pillow fits into the A smoothly fitting pillowcase is more
corners of the case and the seams are straight. comfortable than a wrinkled one.
e Place the pillows appropriately at the head of the bed.

13 Provide for client comfort and safety.

 a Attach the signal cord so that the client can conveniently
reach it. Some cords have clamps that attach to the sheet
or pillowcase. Others are attached by safety pin. Most
bed now have call light bottom on the side rail.

b If the bed is currently being used by a client, either fold This makes it easier for the client to get
back the top covers at one side or fanfold them down to into the bed.
the center of the bed.
c Place the bedside table and the over bed table so that
they are available to the client.
d Leave the bed in the 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.
14 Document and report pertinent data.
a Bed-making is not normally recorded.
b Recording any nursing assessments, such as the client’s
physical status and pulse and respiratory rates before
and after being out of bed, as indicated.