Making an Occupied Bed

Definiton:

If a client is confined to bed, the linens will

be changed with the client still on the bed.
This is termed as "occupied" bed. In this
case, the linens should be changed in a
way that conserves client's time and
energy while keeping the client as
comfortable as possible.
Assessment:

 Assess wether the bed itself needs cleaning prior to

placing clean sheets on it.
 Assess the client's needs in the bed. Check for
profuse drainage, incontinence, or special needs for
comfort or skin integrity.
 Assess the client's ability to assist with the
procedure, including mobility, mental status, and
muscle strength.
 Check for all the linens necessary to change the
bed. check for a dirty linen hamper.
Nursing Diagnosis

• Impaired bed mobility

• Risk for Impaired Skin Integrity
• Risk for Activity intolerance
• Impaired Physical Mobility
• Impaired Bed Mobility
• Impaured Transfer Ability
Planning

• Bed linens will be clean, dry, wrinkle free.

• Patient will verbalize comfort after the bed
has been changed.
• Patient will experience minimal discomfort
while the bed is being made.
Equipment

• Bottom sheet (fitted if available)

• MAttress cover
• Draw Sheet
• Top Sheet
• Gloves and gown if there is presence of
bodily fluids or wet bed clothes or if
patients is in isolation.
• Pillowcases for each pillow.
 Intervention Rationale

1. Explain to the patient how you plan to Patient will know what to expect and can
change the bed. assisst as much as possible

2. Put on gloves and gown if there will be

Reduces transmission of infectious
contact with body fluids or if the patient
organisms.
has been places on contact isolation.
3. Roll the patient to one side, opposite
you. Make sure that if the patient is not Prevents injury to the health care
able to assist in turning, assistance is provider and unnecessary strin and
availbale to help turn the patient safely pressure on the patient.
and efficiently.
4. Once the patient is safely on his side,
loosen the old linen from that side closest
to you.

5. Roll the dirty linen up close to the

patient's back.
 Intervention Rationale

6. Tuck the old linin close to the patient's

body.

7. If the mattress is wet from bodily

Reduces transmission of infectious
excretions, wash the mattress with a
organisms.
germicidal agent.

8. If the bottom sheet is fitted, apply it

smoothly and evenly to that side.

9. If the bottom sheet is a flat sheet, apply

it as evenly as possible, leaving at least 2
in or less hanging over the top and
bottom edge.

10. Place a bed protector 2 feet down Helps protect bottom sheet. allow moving
from the top of the bed, and place a draw the patient up in bed.
sheet over the bed protector, if needed
for patient positioning.
 Intervention Rationale

11. Roll the clean linen lengthwise, and

tuck it under the rolled dirty linen.

12. Raise side rail and move to opposite

side of the bed if making the bed
unassisted.

13. Roll the patient back over the roll of

linen to the opposite side.

14. Loosen the old linen, gather, and

Reduces transmission of infectious
place in pillowcase or linen bag, keeping
organisms.
the soiled linen away from your body.

15. If the mattress is wet from bodily

excretions, wash the mattress with a
germicidal agent.
 Intervention Rationale

16. Remove gown and gloves, and wash Reduces transmission of infectious
your hands. organismss

Ensures tight fit of bottom sheet, thereby

17. Pull clean sheets, and tuck smoothly. preventing skin wrinkling and skin
breakdown.

18. Tuck the sheet at the top, and square Keeps the sheets and blankets secure and
the corners. in place for patient comfort and safety.

19. Move along each side of the bed and

Ensures smooth base free of wrinkles that
tuck in the sheet, pulling it securely so the
could cause patient discomfort and
sheet is tight fitting and there are no
possible skin irritation.
wrinkles.
20. Once the bottom sheet is secure,
place the draw sheet or pull sheet on the
bed 2 feet from the top of the mattress. Assists in repositioning the patient.
Tuck the draw sheet in securely and
tightly.
 Intervention Rationale

21. The top sheet should be placed over

the bed making sure the top of the sheet
is at least 2 in. over the top of the A blanket can be placed on top of the top
mattress. The top sheet can be tucked in sheet if the patient desires.
or left loose, depending on patient or
nursing preference.
22. Tuck in the bottom of the top sheet
and blanket, if used. Square the corners. Prevents too-tight sheets, which can
Allow a 2 in. fold or pleat at the bottom of contribute to foot drop and impaired skin
the top sheet so patient can move feet intergrity.
freely.
23. Place a clean pillowcase on each
Allows the easy use of clean pillows for
pillow in the room, wether the patient is
positioning if needed.
using them or not.
Evaluation

• Bed linens are clean, dry, wrinkle free.

• Patient verbalizes comfort in the clean
bed.
• Patient participated in moving from side to
side.
Documentation

• Document the bed change, how the client

tolerated it, and any unusuqal findings.