Republic of the Philippines

NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY

General Tinio, Cabanatuan City, Nueva Ecija

Clinical Learning Skills Laboratory

FUNDAMENTALS OF NURSING (NCM 103)
CHECKLIST:
CHANGING AN UNOCCUPIED BED

Name: ______________________________________________________________ Score:

Block: ________________________ Date:____________________________

PROCEDURE
Changing an Unoccupied Bed Performed Comments
YES NO
ASSESSMENT
1. Assess:
 Client’s health status to determine that
the person can safely get out of bed. In
some hospitals it is necessary to have a
written order to get out of bed if the
client has been in bed continuously
 Client’s BP, pulse and respirations if
indicated
 Client’s mobility status
 Tubes and equipment connected to the
client.
PLANNING
1. Assemble equipment and supplies:
 Clean gloves, if needed
 Two flats sheets or one fitted and one
flat sheet
 Cloth drawsheet (optional)
 One blanket
 One bedspread
 Incontinent pads (optional)
 Pillowcase (s) for the head pillow (s)
 Plastic laundry bag or portable linen
hamper, if available
IMPLEMENTATION

Preparation
1. Determine what linens the client may already
have in the room to avoid stockpiling of
unnecessary extra linens
IMPLEMENTATION

Performance
1. If the client is in bed, Prior to performing the
procedure, introduce self and verify the client’s
identify using agency protocol. Explain to the

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 client what you are going to do and why it is
necessary, and how he or she can participate.
2. Perform hand Hygiene and observe other
appropriate infection control procedure
3. Provide for client privacy.
4. Place the fresh linen on the client’s chair or
overbed table, as do not use another client’s
bed.
5. Assess and assist the client out of the bed using
assistive devices as appropriate.
 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. 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
 Check bed linens for any items
belonging to the client, and detach the
call bell 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 bed on the near side.
 Remove the pillow cases, if soiled, and
place the pillow 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 bottom
edge, and then grasp it at the center of
the middle fold and bottom edges.
 Remove the incontinent 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,
not on the floor.
 Grasp the mattress securely, using the
lugs if present, and move the mattress
up to the head of the bed.
 Remove and discard gloves if used.
Perform hand Hygiene
9. Apply the bottom sheet and drawsheet
 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. 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 drawsheet is used, place it over the
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 bottom sheet so that the centerfold is at
the centerline of the bed and the top and
bottom edges extend from the middle of
where the client’s back would be on the
bed to the area where the midthigh or
knee would be Fanfold the uppermost
half of the folded drawsheet at the
center or far edge of the bed and tuck in
the near edge.
 Optional: Before moving to the other
side of the bed, place the top linens on
the bed hem side up, unfold them, tuck
them in, and miter the bottom corners.
10. 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.
11. Apply or complete the top sheet, blanket, and
spread
 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.
 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
 Vertical toe pleat: Make a fold in
the sheet 5 to 10cm
perpendicular to the foot of the
bed
 Horizontal toe pleat: Make a fold
in the sheet 5 to 10 cm 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 15cm 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 the 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.
 Move to the other side of the bed and
secure the top bedding in the same
manner.
12. Put clean pillowcases on the pillows as
requested
 Grasp the closed end to the pillowcase
at the center with one hand.
 Gather up the sides of the pillowcase
and place them over the hand grasping
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 the case. The grasp the center of one
short side of the pillow through the
pillowcase
 With the free hand, the pillowcase over
the pillow
 Adjust the pillowcase so that the pillow
fits into the corners of the case and the
seams are straight.
13. Provide for client comfort and safety
 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 a
safety pin. Most beds now have a call
light button on the side rail.
 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.
 Place the bedside table and the overbed
table so that they are available to the
client.
 Leave the bed in the high position if the
client is returning by stretcher, or place
it in the low position if the client is
returning to bed after being up.
EVALUATION AND DOCUMENTATION
Document all relevant information.
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
Evaluation
 Make sure the call light is accessible to
the client
 Relate client parameters of activity to
previous assessment data particularly if
the client has been on bed rest for an
extended period of time or it is the first
time that the client is getting out of bed
after surgery.
TOTAL:

Remarks:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________

Rating Scale:

Excellent : 96 – 100%

Very Satisfactory : 90 – 95%

Very Good : 85 – 89%

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Good : 80 – 84%

Fair : 75 – 79%

Poor : 74 and below

__________________________________________________

Student’s Printed Name and Signature

__________________________________________________

Skills Laboratory Instructor

Printed Name and Signatures

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 Republic of the Philippines
NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY
General Tinio, Cabanatuan City, Nueva Ecija

Clinical Learning Skills Laboratory

FUNDAMENTALS OF NURSING (NCM 103)
CHECKLIST:
CHANGING AN OCCUPIED BED

Name: ______________________________________________________________ Score:

Block: ________________________ Date:____________________________

PROCEDURE
Changing an Occupied Bed Performed Comments
YES NO
ASSESSMENT
1. Assess:
 Skin condition and need for a special
mattress, footboard, bed cradles, or heel
protectors
 Client’s ability to reposition self.

DETERMINE
1.  Presence of incontinence or excessive
drainage from other sources indicating
the need for protective waterproof
pads.
 Note specific orders or precautions for
moving and positioning the client.
PLANNING
1. Assemble equipment and supplies:
 Two flat sheets or one fitted and one flat
sheet
 Cloth drawsheet (optional)
 One blanket
 One bedspread
 Incontinent pads (optional)
 Pillowcase for the head pillow
 Plastic laundry bag or portable linen
hamper, if available
IMPLEMENTATION

Preparation
1. Determine what linens the client may already
have in the room to avoid stockpiling of
unnecessary extra linens
IMPLEMENTATION

Performance
1. Prior to performing the procedure, introduce
self and verify the client’s identify using agency

Page 6 of 9
 protocol. Explain to the client what you are
going to do and why it is necessary, and how he
or she can participate.
2. Perform hand Hygiene and observe other
appropriate infection control procedures. Apply
clean gloves if linens are soiled with body fluids.
3. Provide for client privacy.
4. Remove the top bedding
 Remove any equipment attached to the
bed linen, such as a signal light.
 Loosen all top linen at the foot of the
bed, and remove the spread and the
blanket.
 Leave the top sheet over the client or
replace it with a bath blanket as follows:
 Spread the bath blanket over the
top sheet
 Ask the client to hold the top
edge of the blanket
 Reaching under the blanket from
the side, grasp the top edge of
the sheet and draw it down to
the foot of the bed, leaving the
blanket in place.
 Remove the sheet from the bed
and place it in the soiled linen
hamper.
5. Change the bottom sheet and drawsheet
 Raise the side rail that the client will
turn toward
 Assist the client to turn on the side away
from the nurse and toward the raised
side rail.
 Loosen the bottom linens on the side of
the bed near the nurse.
 Fanfold the dirty linen toward the center
of the bed as close to and under the
client as possible.
 Place the new bottom sheet on the 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. Tuck the
sheet under the near half of the bed and
miter the corner if a contour sheet is not
being used.
 Place the clean drawsheet 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 thennear side edge under the side
of the mattress.
 Assist the client to roll over toward you,
over the fanfolded bed linens at the
center of the bed, onto the clean side of
the bed.
 Move the pillows to the clean side for
the client’s use. Raise the side rail before
leaving the side of the bed.
 Move to the other side of the bed and
lower the side rail.
 Remove the used linen and place it in
the portable hamper.

Page 7 of 9
 Unfold the fanfolded bottom sheet from
the center of the bed.
 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.
 Unfold the drawsheet fanfolded at the
center of the bed and pull 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 the
top division.
 Tuck the excess drawsheet under the
side of the mattress.
6. Reposition the client in the center of the bed.
 Reposition the pillows at the center of
the bed
 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
 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.
 Complete the top of the bed.
8. Ensure continued safety of the client.
 Raise the side rails. Place the bed in the
low position before leaving the bedside.
 Attach the call light to the bed linen
within the client’s reach.
 Put items used by the client within easy
reach
9. Bed-making is not normally recorded.
EVALUATION AND DOCUMENTATION
Evaluation
 Conduct appropriate follow-up, such as
determining client’s 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.
TOTAL:

Remarks:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
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Rating Scale:

Excellent : 96 – 100%

Very Satisfactory : 90 – 95%

Very Good : 85 – 89%

Good : 80 – 84%

Fair : 75 – 79%

Poor : 74 and below

__________________________________________________

Student’s Printed Name and Signature

__________________________________________________

Skills Laboratory Instructor

Printed Name and Signature

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