Bedmaking
Making an Occupied Bed
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Safety
- Use Standard Precautions to make an occupied bed.
- Assess the environment for safety before caring for a patient. Check the floor for spills, and make sure all equipment is working properly.
- Be aware of the positions in which the patient may be turned while making the bed, so that the patient remains safe at all times.
- If the patient is on aspiration precautions or has a respiratory condition, keep the head of the bed no lower than a 30-degree angle.
- If you are making the bed without assistance, ensure that the side rails on the opposite side of the bed are raised, so that the patient does not roll out of the bed.
- Assess the patient’s ability to reposition himself or herself, and consider making the bed with another person to ensure the patient’s safety.
Equipment
(Roll cursor over items to see labels)
Bottom Sheet (flat or fitted)
Large, quilted waterproof pad (optional)
Top sheet
Bath blanket
Bedspread
Pillowcases
Clean gloves
Antiseptic cleanser or wipes
Towels or washcloth
Linen bag
PrintableDelegation
The skill of making an occupied bed can be delegated to nursing assistive personnel (NAP). Be sure to inform NAP of the following:
- Specify that Standard Precautions are to be used to make an occupied bed.
- Discuss any patient positions to avoid or activity restrictions to observe.
- Explain how to look in the linen for wound drainage, drainage from tubes, or IV tubing.
- Specify when to obtain help with positioning the patient during the linen change, in order to observe good body mechanics and support the patient’s alignment.
- Review the following if the patient is on aspiration precautions:
- Keep the head of the bed no lower than a 30-degree angle.
- Report to you immediately if any excessive coughing or choking occurs during the procedure.
Preparation
- Use Standard Precautions to make an occupied bed. Apply gloves if the linen is soiled or if there is a risk of contact with blood or bodily fluids.
- If prescribed, administer an analgesic to the patient 30 to 60 minutes before the procedure.
- Assess the environment for safety; check the room for spills, make sure equipment is working properly, and ensure that the bed is in the locked, low position.
- Pull the room divider curtain or close the door to provide privacy.
- Determine if the patient has been incontinent or if there is excess drainage on the linen.
- Assess the patient for mobility or positioning restrictions. Explain the procedure to the patient, including that he or she will be asked to roll over layers of linen.
- Assemble all equipment on the bedside table.
Follow-up
- Ask if the patient is comfortable.
- Observe the patient for signs of fatigue, dyspnea, pain, or discomfort.
- Periodically check the linen for cleanliness and tightness.
Documentation
Do not document the making of an occupied bed.
Review Questions
1. The nurse is preparing to make an occupied bed for a patient who is on aspiration precautions. What will the nurse do to ensure the safety of this patient during the bed change?
Keep the head of the bed no lower than a 30-degree angle 
Fold a pillow in half and place it under the patient’s head - Lower the bed to a flat position and place two pillows beneath the patient’s head
- Ask another caregiver to hold the patient’s head during the bed change
CORRECT. For a patient on aspiration precautions, the nurse should keep the head of the bed no lower than a 30-degree angle.
INCORRECT. Folding a pillow in half and placing it under the patient’s head will not prevent aspiration.
INCORRECT. Lowering the bed to a flat position and placing two pillows under the patient’s head will not prevent aspiration.
INCORRECT. Having another caregiver hold the patient’s head while changing the bed will not prevent aspiration.
2. The nurse is directing nursing assistive personnel (NAP) to make an occupied bed. What will the nurse say to minimize the risk of disease transmission to staff and patient during the bed change?
- "You'll need to apply Standard Precautions during this task."
- "Be aware that the bed might be contaminated with blood."
- “Soiled linen should be rolled toward your uniform.”
- "Keep the linen bag at the foot of the bed.”
CORRECT. Telling the NAP to apply Standard Precautions will minimize the risk of disease transmission during the bed change.
INCORRECT. Telling the NAP to be aware of possible contamination does not provide the NAP with instructions on how to remove such blood.
INCORRECT. Soiled linen should be kept away from the NAP's uniform to minimize the risk of disease transmission to the staff.
INCORRECT. Placing the linen hamper at the foot of the bed will not minimize the risk of disease transmission to staff and patient during a bed change.
3. Which action ensures that a patient will not have unnecessary pain during a linen change?
- Discontinue the bed change if the patient expresses or displays physical signs of pain.
- Explain the procedure to the patient before beginning the linen change.
- Administer a prescribed analgesic 30 to 60 minutes before the bed change if needed.
- Postpone the bed change if the patient reports having physical pain before you begin.
INCORRECT. This option does not pertain to pain prevention.
INCORRECT. This option does not pertain to pain prevention.
CORRECT. Administering a prescribed analgesic 30 to 60 minutes before the linen change helps prevent unnecessary pain by giving the medication time to take effect before the patient is moved during the bed change.
INCORRECT. This option does not pertain to pain prevention.
4. The nurse is changing the bed linen of a patient on bed rest. When the nurse is ready to make the other side of the bed, what will the nurse do before having the patient turn onto the side that has already been made?
- Lower the head of the bed
- Raise the side rails
- Apply the top sheet
- Discard the soiled linen in the linen bag
INCORRECT. The head of the bed will have been lowered before the bed change begins unless the patient is on aspiration precautions.
CORRECT. The nurse will raise the side rails to reduce the risk of a fall.
INCORRECT. A clean top sheet is applied only after the entire bottom sheet is in place.
INCORRECT. The soiled linen is not placed in the linen bag until the nurse has finished placing the bottom sheet on the bed.
5. What will the nurse do right after placing a clean top sheet on the patient?
- Make a cuff with the top of the sheet
- Make a horizontal toe pleat
- Tuck the remaining portion of the sheet under the foot of the mattress
- Remove the bath blanket
INCORRECT. After the bath blanket has been removed, the nurse makes a cuff by turning the edge of the top sheet down over the top edge of the blanket.
INCORRECT. The nurse makes a horizontal toe pleat after making a cuff at the top of the sheet.
INCORRECT. The nurse tucks the remaining portion of the sheet and blanket beneath the foot of the mattress.
CORRECT. After applying a clean top sheet, the nurse will ask the patient to hold on to the sheet as the bath blanket is removed.
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