NCM 100 SKILLS

BED MAKING

MAKING AN UNOCCUPIED BED

CRITICAL ASPECTS

• Remove all soiled linens without cross contaminating other items in the room.
• Remake the bed with clean linens.
• Do not "shake" or "fan" linens.
• Work efficiently and safely.
• Ensure that there are no wrinkles in the bottom sheet or draw sheet.

EQUIPMENT:
• Bottom and top sheets
• Draw sheet
• Pillowcase for each of the pillows
• Linen bag or hamper
ASSESSMENTS:
• Check to see whether the linen (including the mattress pad, blanket, and bed spread) needs to be
changed.
• Determine what linens are needed.
• Assess whether the patient is able to be out of bed during the linen change.
• Asses for drainage and incontinence to determine whether personal protective equipment such as
procedure gloves and gown, is needed.

PROCEDURAL STEPS:

PROCEDURE
1. Assist the patient to a chair. Provide a robe
and/ or blanket if needed.
2. Position the bed flat, raise to appropriate
working height, and lower side rails.
RATIONALE
Ensures that the patient is comfortable and will
be warm enough during the bed change.
Maintain good body mechanics during the
procedure.

3. Loosen all the bedding.
4. If the blanket or bed spread is clean, fold in
and place it on a clean area (e.g., on the back
of a chair). Do not place on another patient's
bed or furniture.
5. Remove the bottom and top sheet, draw
sheet and pillowcases.
6. From one side of bed:
a. Put the contour bottom sheet on one side of
the bed, and smooth it out over half the
mattress. If you are using a flat bottom sheet,
position it so that approximately 10 inches
hang over at the top and sides, and tuck in the
sheet, mitering the corners.
b. Place the draw sheet in the middle of the
mattress, tuck the side in under the mattress,
and smooth out over half of the mattress.
Reuse the blanket/ or bed spread if it is not
soiled. Placing the item on a clean area
prevents cross - contamination.
Never place linen on the floor because cross -
contamination can occur. Hold dirty linen away
from your uniform to prevent contamination.
Placing the linen on one side of the bed saves
time. When using a flat bottom sheet, having
extra sheet at the top helps keep it in place
when the head of the bed is raised and
lowered.
Ensures that all wrinkles are out of the bottom
sheet and drawsheet.

7. Go to the other side of the bed, straighten

the linen, and finish tucking in the bottom
sheet and draw sheet.
Pulling the draw sheet tight helps prevent
a. Make the draw sheet tight, and smooth any
wrinkles from developing under the patient
wrinkles in the bottom sheet and drawsheet.
when she moves around in bed.
b. If desired, place a waterproof pad or under
the draw sheet.
Placing all linen on one side at a time saves
steps. Center the top sheet and bed spread,
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BEDdocx/
 alongside of the mattress. other side of the bed, they fall equally over
each side of the bed.

Prevents the top covers from placing pressure

on the patient's toes.
9. At the foot of the bed, make a small pleat in
the top sheet and bed spread.

10. Tuck in the top sheet and bed spread at

the same time, mitering the corners.
a. Tuck in the sheet and bed spread at the
bottom of the mattress.
b. Bring the edge of sheet and the bedspread Mittered corners help secure the linen at the
up to make a right angle. foot of the bed.
c. Tuck the lower edge of sheet and
bedspread under the mattress. Prevents the bed spread from rubbing against
the patient's skin.
11. Move to the other side of the bed, smooth
top linens, and repeat step 10. At the head of
the bed, fold the edge of sheet down over the
bed spread. Makes it easier for the patient to get into bed.

12. Fanfold the top sheet and bed spread back

to the foot of the bed.

13. Change pillowcases.

a. Turn the pillowcase wrong side out.
b. Grasp the middle of the closed end of the
pillow case.
c. Reaching through the pillowcase. Grasp the Do not hold the pillow under your arm or chin
end of the pillow. to put on pillowcase because contamination
d. Continuing to grasp the end of the pillow, can occur.
pull the pillowcase down over the pillow.
Provides for client comfort and safety.

14. Assist the client back to bed, return the

bed to the low position, place the call signal
within reach, and place the bedside table and
over bed table so that they are accessible to
the client.

EVALUATION
Evaluate the client's response to activity (e.g., pulse and respirations)

HOME CARE
The only adaptation depends on the type of bed the patient has. If the height of the bed is not adjustable or the
bed is not accessible from both sides, the procedure may be more difficult.

DOCUMENTATION
Linen changes are generally recorded on a checklist. Additional charting would need to be done only if something
abnormal occurred, for example, " The drwasheet had a 20cm circular area of serousanguineous drainage.”

MAKING AN OCCUPIED BED

CRITICAL ASPECTS
ource. was downloaded by 100000^10277011 from CourseHero.com on 10-30-2021 18:32:40 GMT -05:00 Maintain patient
safety during the procedure.

• Position patient laterally near the far siderail, and roll soiled linens under him.
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BEDdocx/
 • Place clean linens on the side nearest you, and then tuck under the soiled linens.
• Roll the patient over the "hump", and position him on his other side, near you. Raise the near siderail.
• Move to other side of bed; pull soiled and clean linens through, and complete the linen change as in
unoccupied bed procedure.
• Place the bed in low position, raise the siderials, and fasten the call light to the pillow.

EQUIPMENT:
• Bottom and top sheets
• Drawsheet
• Pillowcase for each pillows
• Bath blanket (as needed)
• Linen bag or hamper
• Procedure gloves (if exposure to body fluids is possible)

ASSESSMENTS:
• Determine the patient's ability to assist with the procedure and whether additional help is needed.

PROCEDURAL STEPS:
PROCEDURE RATIONALE
Note: If linen change is done at the same time as the
bed bath, some of these steps will vary.

1. Position the bed flat if possible, and raise it to
appropriate working height. Lower the side rail nearest
you.
2. Loosen all the bedding. Disconnect the call device,
and remove the patient's personal items from the bed.
Maintain good body mechanics during the procedure.
To prevent the patient from falling out of bed, lower
the side rail only on the side where you are standing.
Having the head of the bed flat makes it easier to
smooth bottom sheet.
Prevents items from getting lost.

3. Check that no tubes (e.g. IV, nasogastric) are

entangled in the bed linens. Prevents from dislodging tubes accidentally.
4. If the blanket or bed spread is clean, fold it and
place it on a clean area. Cover the patient with a bath Reuse the blanket and or/ bed spread if it is not
blanket, if available, or leave the top sheet over the soiled. Covering the patient ensures that she will not
patient. become chilled and preserves modesty.
5. Slide the patient to the side of bed farthest from
you, and place her in a side - lying position, facing the
siderail.
Place pillow under her head. If needed for support,
place a pillow between the patient and the side rail.
Placing the patient close to the side rail will allow you
to place the clean linen over a larger area, making it
easier to roll the patient back onto the clean linen.
Patients who cannot maintain side- lying position
should have a pillow placed between their chests and
side rail to prevent them from accidentally rolling into
the side rail.
6. Roll or tightly fanfold the soiled linens toward the
patient's back. Tuck the roll slightly under the patient. Cover any moist areas to prevent contact with the
Cover any moist areas with a waterproof pad. clean linen or patient.
7. Place the clean bottom sheet and draw sheet on
the near side of the mattress, with the center vertical Wrinkles under the patient can cause skin irritation.
fold at the center of the bed. Fanfold the half of the
clean linen that is to be used on the far side, folding it
as close to the patient as possible and tucking it under
the dirty linen. Tuck the low edges of clean linen
under the mattress. Smooth out all wrinkles.

8. Roll the patient over the clean and dirty linen.

Explain to her that she will be rolling over a "lump"
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Prevents the patient from falling.

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BEDdocx/
 she rolls onto the clean linen.
Always ensure patient comfort and safety before
9. Raise the side rail on the clean side of the bed. going to the other side of the bed.
10. Move the pillows to the clean side. Position the
patient the patient comfortably on her side, near the Never place linen on the floor; cross contamination
side rail. can occur.
11. Go to the opposite side of bed, and lower the rail.
Pull the soiled linen from under the clean linen, and Ensures that no wrinkles will be under the patient.
place it in laundry bag or hamper.

12. Pull clean linens through, and tuck them in. Pull Makes it easier to place the top linen.
taut, starting with the middle section.

13. Assist the patient to a supine position close to

center of the mattress.

14. Place top sheet and bed spread along one side of
the mattress and continue making the bed as in
unoccupied bed procedures 8 -13, except remove the
bath blanket from under the top linens before tucking
them in.

15. Return the bed to the low position, raise the

siderails, and attach the call light within patient's
reach. Position the bedside table and overbed table
within patient's reach.

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