Making an Occupied Bed

Making an Occupied Bed Purpose The purpose of this procedure is to provide the resident with a clean and comfortable environment and to prevent skin irritation and breakdown. Preparation 1. Review the resident’s care plan to assess for any special needs of the resident. 2. Assemble the linen supplies that will be needed. General Guidelines 1. Take only the linen supplies that you need. Do not take extra supplies with you. Once they are taken into the room they become contaminated (dirty) and cannot be used elsewhere. 2. Do not shake the bed linen. Shaking the linen will spread germs throughout the room. 3. Do not allow soiled linen to come into contact with your clothing. 4. Do not put soiled linen on the floor. As you remove it, place it into the container you are using for soiled laundry/linen. 5. Be sure the bottom sheet is smooth, tight and wrinkle-free. Wrinkles left in the bottom sheet cause skin irritation which results in skin breakdown. 6. If plastic drawsheets/protectors are used, do not let the plastic touch the resident’s skin. Cover it with a cotton sheet. 7. When using a bed sheet for a draw sheet, fold the sheet in half by putting the small and large hems together. Turn the fold toward the HEAD of the bed and place the hems toward the FOOT of the bed. 8. Do not use torn linen. Place it in the torn linen box inside the linen closet. 9. Sheets placed on the occupied bed must be positioned so the rough edges (seams/hems) are kept away from the resident’s skin. 10. Use bed linen only for the purpose for which it was intended. 11. Do not use pins of any type on the linen. 12. The resident’s resistance to pain may be low. Handle the resident as gently as possible. Do not rush the procedure. Allow the resident to take rest breaks as needed. 13. Should the resident become faint, ill or uncooperative while you are making an occupied bed, cease the procedure immediately. Cover the resident and summon your supervisor by using the call system. 14. Should it become necessary for you to leave the resident while you are making an occupied bed, cover the resident. Raise the side rails, if permitted. Tell the resident that you will return shortly to complete the procedure. Equipment and The following equipment and supplies will be necessary when performing this procedure. Supplies 1. One (1) pillowcase; 2. Two (2) sheets; 3. One (1) blanket, if necessary; 4. One (1) bedspread, if necessary; 5. One (1) plastic draw sheet, per facility policy; 6. One (1) cotton draw sheet, if necessary; 7. Disposable bed liners, if necessary; 8. Laundry bag or container for soiled laundry/linen; 9. Soap and water; 10. Paper towels; and 11. Personal protective equipment (e.g., gowns, gloves, mask, etc., as needed). continues on next page Revised: June 2012 Steps in the 1. Wash and dry your hands thoroughly. Procedure 2. Wear clean gloves. 3. Place clean linen on a chair in the order in which the linens will be used. 4. Offer the resident the bedpan or urinal. 5. If the resident’s physical or medical condition permits, lower the headrest and/or the knee rest of the bed. Refer to the resident’s plan of care and/or request information from the nurse supervisor regarding safe positioning for the resident. 6. Remove the pillow from under the resident’s head, if clinically appropriate. Remove the soiled case and put the clean case on the pillow. Put the pillow on the chair. (Note: The soiled pillowcase may be used to put your soiled linen in.) 7. Raise the bed to a comfortable working height and lock in place. Maintain good body mechanics. 8. Loosen all bedding from underneath the mattress. Leave the bedding hanging loose on all sides. 9. If the bedspread is to be put back on the bed, fold the bedspread toward the foot of the bed. Fold again (quarter-fold). Remove the bedspread and place it on the back of the chair. (Note: If the bedspread is being replaced, roll it up and put it in the soiled laundry container.) 10. If the blanket is to be put back on the bed, fold the blanket toward the foot of the bed. Fold again (quarter-fold). Remove the blanket and place it on the back of the chair. (Note: If the blanket is being replaced, roll it up and put it in the soiled laundry container.) 11. Leave the resident covered with the top sheet. 12. If the mattress has slipped out of place, summon assistance to help move it to its proper position. 13. For the protection of the resident, raise the bedside rail on the opposite side of the bed from where you will be working. Lock it in place. 14. Instruct the resident to turn on his or her side away from you and face the side rail. 15. If the resident cannot turn by himself/herself, assist as needed. 16. Fold/roll the bottom sheet toward the resident (lengthwise from top to bottom). Tuck the sheet against the resident’s back. (Note: The top sheet should keep the soiled linen from coming into contact with the resident’s skin.) The mattress should now be exposed. 17. Check the mattress for any soiling or wetting. Should the mattress be soiled or wet, wash and dry it with a paper towel. Discard the paper towel into the appropriate container located next to the bed. 18. Take one of the clean sheets and fold it in half lengthwise. Be sure the hem seams are turned toward the mattress (facing you). (Note: Do not let the sheet touch your clothing or the floor.) 19. Place the clean sheet on the mattress with the fold running along the middle of the mattress. (Note: The small hem end should be at the foot of the mattress.) 20. Fold the top half of the sheet toward the resident’s back. 21. Beginning at the head of the bed, tuck in the top side and bottom of the sheet under the mattress. Miter the corners. 22. Flatten the roll sheet (the part touching the resident’s back) as much as possible. 23. For safety purposes, raise the bedside rails on your side and lock into position. 24. Go to the opposite side of the bed. Lower the bedside rails. 25. Instruct the resident to turn over to his or her other side. If the resident cannot turn over by himself/herself, assist as needed. 26. Remove the soiled bottom sheet. Roll it up without touching your clothing. Do not let the soiled linen touch the floor. Discard it in the soiled laundry container. (Note: Laundry/linen soiled with visible blood should be discarded in a biohazard container [e.g., red bags].) continues on next page Revised: June 2012 Steps in the 27. Check the mattress for any soiling or wetting. Should the mattress be soiled or wet, Procedure wash and dry it with a paper towel. Discard the paper towel into the appropriate container located next to the bed. (continued) 28. Pull the clean bottom sheet towards you until it is completely unfolded. 29. Beginning at the top of the bed, tuck in the top side and bottom of the sheet under the mattress. Miter the corners. (Note: Be sure the sheet is pulled tightly to prevent wrinkles which can cause skin irritation.) 30. Instruct the resident to roll over on his or her back to the center of the bed. Assist as necessary. 31. Put the pillow back under the resident’s head. (Note: Assist resident as necessary.) 32. Remove the top sheet and put it into the soiled laundry container. 33. Remove gloves and discard into designated container. 34. Wash and dry your hands thoroughly. 35. Spread the clean top sheet over the resident with the wide hem at the head of the bed. 36. Tuck the clean top sheet under the mattress at the foot of the bed leaving enough room for the resident to move his or her feet freely. Miter the corners. 37. Spread the blanket/bedspread over the top sheet. Pull the blanket/bedspread high enough to cover the resident’s shoulders. Tuck the blanket/bedspread under the mattress at the foot of the bed leaving enough room for the resident to move his or her feet freely. Miter the corners. 38. Lower the bed into lowest position and place the siderails in the appropriate position as indicated in the resident’s plan of care. 39. Reposition the head of the bed to a comfortable position for the resident, unless otherwise instructed. 40. Reposition the covers and make the resident comfortable. 41. Place the call light within easy reach of the resident. 42. Discard soiled linen in designated container. 43. Wash and dry your hands thoroughly. 44. Offer the resident a drink. 45. If the resident desires, return the door and curtains to the open position and if visitors are waiting, tell them they may now enter the room. Documentation The following information should be recorded on the resident’s ADL record and/or in the resident’s medical record as necessary. 1. The date and time the procedure was performed. 2. The name and title of the individual(s) who performed the procedure. 3. All assessment data obtained during the procedure. 4. How the resident tolerated the procedure. 5. If the resident refused the procedure, the reason(s) why and the intervention taken.

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