PAMANTASAN NG LUNGSOD NG MAYNILA

(University of the City of Manila)

Intramuros, Manila
COLLEGE OF NURSING

BASIC CONCEPTS OF NURSING

NAME: ____________________________ SCORE: _________________

DATE: _____________________________

Changing An Unoccupied Bed

Purpose

 Promotes comfort
 Promotes cleanliness
 Provides a neat and uniform bed

Assessment

 Assess the client’s health status to determine if he can safely get out
of bed
 Check for presence of surgical wounds or drains
 Check and note all the tubes and equipment connected to the client
 Need, if any, for assistance

Equipment/Materials needed

 Bed sheets – 2 Bottom Sheet – 1 Top Sheet – 1

 Pillow – 1
 Pillow Cover – 1
 Mackintosh sheet/Rubber sheet – 1
 Draw Sheet – 1
 Blanket – 1
 Bedspread – 1
 Laundry bag or portable linen hamper
Principles to observed

 Linens should never come in contact with the uniform or floor

 Maintain good body alignment. Nurse stands facing the direction in
which she is working and work in such a way that she does not twist
her body
 Use large muscles of the body rather than smaller muscles. Flex the
knees rather bending the waist
 When tucking linens under the mattress, separate feet slightly and
flex knees. Flexing the knees shifts the work to the longest and
strongest muscle and keeps the back in good alignment
 When opening and holding linens, place them on the edge of the bed
or bed side chair rather than holding them above shoulder lever and
hyperextending the back
 Do not be wasteful of linen. Discourage hoarding linen in the
patient’s room
 Refrain from using linen for purposes other than that for which it was
originally intended
 Finish one side of the bed first before going to the other side

Implementation of the Procedure:

Procedure/Steps Rationale

1. Introduce self, verify the client’s identity.

Explain the purpose and procedure to the client,
why it is necessary and how he can cooperate.
2. Perform hand hygiene, and observe other
appropriate infection control procedures.
3. Prepare all required equipment and bring the
articles to the bedside.
Mattress cover/Bed sheets – 2 Bottom Sheet – 1
Top Sheet – 1
Pillow – 1-2
Pillow Cover – 1-2
Mackintosh sheet/mattress pad or mat/Rubber
sheet – 1
Draw Sheet – 1
Blanket – 1
Bedspread – 1
Laundry bag or portable linen hamper
4. Provide Privacy for the client
5. Place the fresh linen on the client’s chair or
over bed table. Fold linens and arrange them in
order of use from bottom to top
Note: do not use another client’s bed/chair
 Mattress cover- with right side out, fold
in half crosswise
 Mattress pad-with wrong side out, fold
in half crosswise
 Bottom sheet-with wrong side out, fold
in half crosswise, then quarters. The
finished fold should have the narrow
hem out and the open bottom end
away from the bed
 Rubber sheet-with wrong side out, fold
in half crosswise
 Draw sheet-with wrong side out, fold in
half crosswise
 Top sheet-with right side out, fold in
half crosswise then quarters. The wider
hem should be out and open top ends
towards bed
 Bedspread- with wrong side out, fold in
half crosswise then quarters, wider hem
out
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
position and into the chair
6. Raise the bed to a comfortable working height
7. 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
 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
 Remove the pillowcases, if soiled, and
place the pillows on the bedside chair
near the foot of the bed
 Remove draw sheet & rubber sheet if
any
 Fold reusable linen such as the
bedspread and the top sheet on the
bed, into fourths. First, fold the linen in
half by bringing the top edge even with
 the bottom edge, then grasp it at the
center of the middle fold and bottom
edges
 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
8. 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 contoured 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 of the bed.
 If a rubber sheet is used, place it over
the bottom sheet so that the center fold
is at the center line of the bed and the
top and bottom edge 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 rubber
sheet at the center or far edge of the
bed, and tuck in the near edge
 Lay the draw sheet over the rubber
sheet in the same manner
 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.
9. Move to the other side, and secure the
bottom linens.
 Tuck 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
 Complete this same process for the
draw sheet(s)

10. Apply or complete the top sheet, blanket and

spread.
 Place the top sheet, hem-side up, on
the bed so that its center fold is at the
center of the bed and the top edge is
even with the top edge of the mattress
 Optional: Make a vertical or 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 -10 cm (2 – 4 inches)
perpendicular to the foot of the bed.
Horizontal toe pleat: make a fold in the
sheet 5 – 10 cm (2 – 4 inches) across the
bed near the foot. Loosening the top
covers around the feet of the client 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 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
 Move to the other side of the bed and
secure the bedding in the same manner
11.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
 Place the pillows appropriately at the
head of the bed
12. Provide for client comfort and safety.
 Attach the signal cord so that the client
can use it conveniently
 If the bed currently is being used by a
client, either fold back the top covers at
one side or fanfold them down to the
center of the bed
 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.
13. Document and report pertinent data
Variation: Surgical Bed
 Strip the bed
 Place and leave the pillows on the
bedside chair
 Apply the bottom linens as for an
unoccupied bed. Place a bath blanket
on the foundation of the bed, if this is
agency practice
 Place the top covers 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 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
 Leave the bed in high position with the
side rails down
 Lock the wheels of the bed, if the bed is
not to be moved

Prepared by: Prof. Marilyn Agravante

Modified and Updated by: Prof. Almieda A. Nierves and Dr. Jennifer P. Reyes 2nd Semester 2020-2021

Total score: _____________

I fully understand how I was graded for this skill and it was properly explained to me.

______________________________

Student’s FULLNAME & Signature

Date: ______________

I have explained and discussed how I have graded my student for this particular skill.

___________________________

Clinical Instructor FULLNAME & Signature

Date: _________