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 Types of Beds

1. Gatch Bed
 Hospital bed that can be manually raised and
lowered by turning cranks located at the bottom of
the bed.
2. Electric Bed
 Similar to the gatch bed, but is operated electrically
and can be managed by most patients/residents.
3. Clinitron
 This is a bed available for the treatment of patients
with multiple or advanced pressure ulcers, grafts,
burns, and intractable pain.
 Bed supports the body evenly
 Filled with a sand-like materialWarm, dry air circulates
through the material to maintain even temperature and
supports the body evenly
IF YOU ENCOUNTER A BED THAT IS UNFAMILIAR,
ALWAYS ASK FOR ASSISTANCE!
PURPOSE OF MAKING A NEAT, CLEAN BED
Helps make residents comfortable.

By keeping beds clean, dry, and wrinkle-

free, making a neat, clean bed
prevents skin breakdown and
decubitus ulcers.
FREQUENCY OF CHANGING BED LINENS

Linens are changed as needed.

Usually a full change of linens occurs on

bath/shower days for residents/patients.
BED MAKING
TYPES OF BED-MAKING
Occupied
Unoccupied
ASSESSMENT
PLANNING
IMPLEMENTATION FOR BED-MAKING
PROCEDURES.
Evaluation and documentation.
 TYPES OF CLIENT BEDS

Closed bed – one with the linens pulled to the top of the
bed.
1. The resident will not use the bed during the day
2. The bed is ready for a new resident

Open bed – one where the linens are folded back so the
resident can climb into the bed during the day as needed.
3. Top linens are folded back
4. The resident uses this bed throughout the day.
 TYPES OF CLIENT BEDS

Occupied bed – a bed made with the

resident in the bed. Toe pleats can
be placed on occupied beds to
reduce the pressure on the
patient’s toes.

Unoccupied bed – a bed made without

the resident in the bed.
 TYPES OF CLIENT BEDS
Surgical bed – made so the
resident/patient can be moved from a
stretcher to the bed without having to
struggle with linens.
1. The bed is left at stretcher height
2. The sheets are folded away from the
side where the patient will enter.
3. Sometimes the pillow is placed on
the nightstand by the bed until the
patient is safely in the bed.
4. This procedure differs from one
facility to another.
A. Follow the rules of medical asepsis
1. Wear gloves when handling soiled linen
2. Wash hands before handling clean linen
3. Because the uniform is considered to be dirty, the
clean linens should never touch the uniform, but
held away from the body.
4. Never shake linens since this causes the spread of
microorganisms.
5. Clean linens are placed on clean surfaces.
6. Dirty linens are never placed on the floor. Place
soiled linen in the proper receptacle.
B. Clean linens are collected in the order that they
will be used
1. pillowcase(s)
2. mattress pad
3. bottom sheet
4. drawsheet
5. bed protector
6. top sheet
7. blanket
8. Bedspread
Linens are not changed every day.
A complete linen change is usually done on the person’s bath day.
This may be once or twice a week.
 Pillowcases, top and bottom sheets, and draw sheets (if used) are
changed twice a week.
Linens are changed if wet, damp, soiled, or very wrinkled or as
necessary.
When handling linens, practice medical asepsis.
Always hold linens away from your body and uniform.
Always hold linens away from your body and uniform.
Never shake linens.
Never shake linens.
Place clean linens on a clean surface.
Place clean linens on a clean surface
 Collect enough linens.
 Do not bring unneeded linens to a person’s room.
 Once in the person’s room, extra linens are
considered contaminated.
 Collect linens in the order you will use them. 
Remove dirty linens one piece at a time.
 Roll each piece away from you.
 The side that touched the person is inside the roll
and away from you.
A DRAWSHEET is a small sheet placed over
the middle of the bottom sheet.
 A cotton drawsheet helps keep the mattress
and bottom linens clean and dry.
 A plastic drawsheet (waterproof drawsheet)
protects the mattress and bottom linens from
dampness and soiling
 A cotton drawsheet is always used when a
plastic drawsheet is used. 
Cotton drawsheets are often used without
plastic drawsheets.
C. Place linens on the bed with the hem
edges away from the patient.
D. Any linen brought into a
resident/patient’s room must stay there
because it is considered to be
contaminated.
E. Other linens can be collected when
collecting the bed linens, i.e. towels,
washcloths, gowns, bath blanket.
F. When removing dirty linens roll them
away from you. The side of the linen
that touched the resident is rolled inside.
G. Linen should always be
stored in an enclosed linen
cart. It should never be left
uncovered on a cart in the
hallway.
H. Never apply the pillowcase
by securing the pillow under
the chin and sliding the
pillow into the case.
GENERAL RULES FOR MAKING THE BED

A. Use good body mechanics

B. Follow rules of medical asepsis –
standard precautions
C. Linens must be tight and wrinkle free
D. Make as much of one side of the bed as
possible before going to the other side. This
saves time and energy.
F. A common element in all bed making is
leaving the unit neat and tidy.
TYPES OF BED-MAKING
(Unoccupied, Obstetrical (OB), Post-
operative/Surgical, Occupied, closed, open)

ASSESSMENT
PLANNING
IMPLEMENTATION FOR BED-MAKING
PROCEDURES.
Evaluation and documentation.
THE STUDENT WILL BE ABLE
TO:
 Demonstrate guidelines to make an
unoccupied and occupied bed.
 Evaluate a peer using skills check.

1-UNOCCUPIED BED, USED WHEN THE
CLIENT IS ABLE TO GET OUT OF BED, IS
LEFT OPEN WITH THE TOP SHEETS FOLDED
DOWN

 2-Occupied bed, used when the client is not

allowed out of bed.
 1-Check the activity order, and assess the

client's ability to get out of bed.
Rationale: This determines whether an
unoccupied or occupied bed should be
made.

 2-Assessthe client's self-toileting ability;

note the pres­ence of any wounds, drainage
tubes.
Rationale: This determines if placement of
waterproof pads should be on the bed.
 EXPECTED OUTCOMES FOCUS ON THE
CLIENT'S SAFETY AND COMFORT.
EXPECTED OUTCOMES
1 Client has a clean, safe environment
throughout hos­pitalization.
2 Client verbalizes a sense of comfort while in
bed.
3 Client's skin remains free of irritation
throughout hospitalization.
To be ready for the next occupant
Prepare the bed for the
client’s return
To provide a clean
environment
To provides a good appearance
To minimize source of infection
 Gloves
 Mattress Pad
 Bottom Sheet
 Cotton draw sheet
 A plastic draw sheet
 Pillow Case
 Top sheet
 Blanket
 Bed spread
 Linen Hamper or bag
 Bed side
PROCEDURE FOR MAKING AN UNOCCUPIED BED:
1. Gather necessary linens in the order to be used.
2. Wash your hands. Put on gloves.
3. Explain what you are going to do.
4.Raise adjustable bed to high position; lower bed
rails.
5.Remove the pillowcase and place the pillow on the
bed side chair.
6. place soiled linen in the linen hamper .
7. Wash and dry plastic covered mattress ,if soiled.
8. Remove gloves, and wash hands
9.Place the folded bottom sheet with its center
fold on the center of the bed. spread the
sheet over the mattress.
10.Place draw sheet in the center of the bed.
11.Place the top sheet, and cover the top sheet
with blanket.
12. FOLD BACK THE CUFF AT THE HEAD OF
THE BED WITH THE SHEET AND BLANKET.
13. But clean billow case on the pillow and
place it in the center at the top of the bed.
15.
THE CLOSED BED: PULL THE COVERS
UP TO THE HEAD OF THE BED.
The open bed: Fanfold the top of the
linens to the bottom third of the bed.
Return the bed to previous position. 16
.and wash your hands
PURPOSE OF OCCUPIED BED MAKING:
To promote the client’s comfort
To provide a clean environment for the

client
To minimize source of skin irritation
SAME SUPPLIES AND EQUIPMENT USED
DURING THE UNOCCUPIED BED MAKING
1. Assemble equipment and supplies
2. Explain to the client what you are going to do
3. Wash hands
4. Provide for clients privacy
5. Loosen all the top linens at the foot of the
bed and remove the spread and the blanket.
6.leave the top sheet over the client.
7.Change the bottom sheet and draw sheet
8.Assist the client to turn on the side facing.
Raise the side rail nearest the client.
9. Loosen the foundation of the linen on the side of the
bed.
10. Fanfold the bottom sheet and the draw sheet at the
center of the bed.
11. Place the new bottom sheet and draw sheet
on the bed , and vertically fanfold the half to be
used on the far side of the bed.
12. Tuck the sheet under the near half of the
bed and miter the corner.
13. Assist the client to roll over toward you onto
the clean side and move the side rail before leaving
the side of the bed.
14. Remove the used linen and place it in the
portable hamper.
15. Unfold the fan folded bottom sheet and the draw
sheet from the center of the bed.
16. Use both hands to pull the bottom and draw sheet
then tuck the excess under the side of the mattress.

17. Reposition the client on the center of the bed.

18. Reposition the pillows at the center of the bed.
19.Spread the top sheet and the blanket over
the client .
20.Complete the top of the bed. And Raise the
side rails.
21.Return the bed to previous position and
wash your hands.
EVALUATION
 Observe client's linens for cleanliness and
tightness.
 Ask if client is comfortable after bed is
made.
 Observe client's skin for signs of
irritation.
Documentation
 UNOCCUPIED BED
DEFINITION
A bed prepared to receive a new patient

PURPOSE
1.To provide clean and comfortable bed for the patient
2. To reduce the risk of infection by maintaining a clean
environment.
3. To prevent bed sores by ensuring there are no
wrinkles to cause pressure points
THINGS TO REMEMBER
(UNOCCUPIED BED)

 Raise the bed to a comfortable working height.

 Wash your hands before and after every patient
contact
 Gather all the equipment needed
 Roll the soiled linen away from your body
 Place the soiled lined away from your body
 Place the soiled linen in the lined bag/linen
hamper NEVER ON THE FLOOR!!!!
 Return the bed to the lowest horizontal
position when you are finished
 To make a closed bed to an open bed fan fold
the sheets to the foot of the bed
 The smooth side of the hem faces the client
 THINGS TO REMEMBER
(OCCUPIED BED)
 Explain the procedure to the client before
beginning
 Protect the client’s Privacy
 Cover the client with bath blanket
Make sure the side rail is up on the side you are not
working on
When finished make a toe pleat over the clients toes to
prevent the weight of the linen from pressing down on
the toes
 MAKING A CLOSED BED
Equipment: clean linen—mattress pad, fitted or flat bottom sheet,
waterproof bed protector if needed, cotton draw sheet, flat top
sheet, blanket(s), bedspread (if used), pillowcase(s), gloves

1. Wash your hands.

2. If client/patient is in the room, identify yourself by name.
Identify the client. Greet the client by name.
3. Explain procedure to the client. Speak clearly, slowly, and
directly. Maintain face-to-face contact whenever possible.
 MAKING A CLOSED BED

4. Place clean linen on clean surface within reach (e.g., bedside

stand, overbed table, or chair).
5. Adjust bed to safe working level, usually waist high. Put bed in
flattest position. Lock bed wheels.
6. Put on gloves.
7. Loosen soiled linen and roll soiled linen (soiled side inside) from
head to foot of bed. Avoid contact with your skin or clothes. Place it
in a hamper or linen bag. Do not place on overbed table, chair, or
floor.
 MAKING A CLOSED BED
8. Remove and discard gloves. Wash your hands.
9.Remake the bed. Place the mattress pad (if used) on the bed,
attaching elastic at corners as necessary.
10.Place bottom sheet on bed without shaking linen. If using a flat
sheet with seams, this sheet must be placed with the crease in the
center of the mattress. The seams on both ends must be placed
down. If using a fitted bottom sheet, place right-side up and
tightly pull over all four corners of the bed.
 MAKING A CLOSED BED
11. Make hospital, or mitered, corners to
keep bottom sheet wrinkle-free.
12. Put on waterproof bed protector and
then the draw sheet, if used. Place them in
the center of the bed on the bottom sheet.
Smooth, and tightly tuck the bottom sheet
and draw sheet together under the sides of
bed. Move from the head of the bed to the
foot of the bed.
13. Place the top sheet over the bed and
center it. The seam must be up.
MAKING A CLOSED BED
14. Place blanket over the bed and center it.
15. Place the bedspread over the bed and center it.
16. Tuck top sheet and blanket under the foot of the bed
and make hospital corners.
17. Fold down the top sheet to make a cuff of about six
inches over the blanket.
 MAKING A CLOSED BED
18. Take a pillow, and with one
hand, grasp the clean pillowcase
at the closed end. Turn it inside
out over your arm. Next, using
the hand that has the pillowcase
over it, grasp the one narrow
edge of the pillow. Pull the
pillowcase over it with your free
hand. Do the same for any other
pillows. Place them at the head
of the bed with open end away
from the door. Make sure
zippers or tags are on the inside.
MAKING A CLOSED BED

19. Return bed to lowest position.

20. Leave call light within client’s reach.
21. Wash your hands.
22. Take laundry bag or hamper to proper area.
23. Document procedure using facility guidelines.
 MAKING AN OPEN BED
Equipment: clean linen—mattress pad,
fitted or flat bottom sheet, waterproof
bed protector if needed, cotton draw
sheet, flat top sheet, blanket(s),
bedspread (if used), pillowcase(s), gloves
1. Wash your hands.
2. Make a closed bed, as described in
previous procedure.
3. Stand at the head of the bed. Grasp the
top sheet and blanket, and bedspread, and
fold them down to the foot of the bed. Then
bring them back up the bed to form a large
cuff.
MAKING AN OPEN BED
4. Bring the cuff on the top linens to a point where it is
one hand-width above the linen underneath. This way,
when the client gets into bed, he will not pull all the linen
out at the foot of the bed.
5. Make sure all linen is wrinkle-free.
6. Wash your hands.
7. Document procedure using facility guidelines.
 MAKING AN OCCUPIED BED

Equipment: clean linen—mattress pad,

fitted or flat bottom sheet,
waterproof bed protector if needed,
cotton draw sheet, flat top sheet,
blanket(s), bedspread (if used), bath
blanket, pillowcase(s), gloves
1. Wash your hands.
2. Identify yourself by name. Identify
the client. Greet the client by name.
3. Explain procedure to the client. Speak
clearly, slowly, and directly. Maintain
face-to-face contact whenever
possible.
MAKING AN OCCUPIED BED
4. Provide for the client’s privacy with a curtain, screen, or
door.
5. Place clean linen on clean surface within reach (e.g.,
bedside stand, overbed table, or chair).
6. Adjust bed to safe working level, usually waist high.
Lower head of bed. Lock bed wheels.
7. Put on gloves.
8. Loosen top linen from the end of the bed on the working
side.
 MAKING AN OCCUPIED BED

9. Unfold the bath blanket over

the top sheet and remove the
top sheet. Keep client covered
at all times with the bath
blanket.
10. You will make the bed one
side at a time. Raise side rail
(if bed has them) on far side
of bed. After raising side rail,
go to the other side of the bed.
Gently help client to turn onto
her side slowly, moving away
from you, toward raised side
rail
MAKING AN OCCUPIED BED
11. Loosen bottom soiled linen, mattress pad, and protector,
if present, on the working side.
12. Roll bottom soiled linen toward client and center of
bed, soiled side inside. Tuck it snugly against client’s
back.
13. Place the mattress pad (if used) on the bed, attaching
elastic at corners on working side.
MAKING AN OCCUPIED BED

14.Place clean bottom linen or fitted bottom sheet

with the center crease in the center. If flat sheet is
used, tuck in at top and on working side. Make
hospital corners to keep bottom sheet wrinkle-
free. If fitted sheet is used, tightly pull two fitted
corners on working side.
 MAKING AN OCCUPIED BED
15. Smooth the bottom sheet
out toward the client. Be sure
there are no wrinkles in the
mattress pad. Roll the extra
material toward the client.
Tuck it under the client’s
body.
MAKING AN OCCUPIED BED
16. If using a waterproof bed protector, unfold it and center
it on the bed. Smooth it out toward the client.
17. If using a draw sheet, place it on the bed. Tuck in on
your side, smooth, and tuck as you did with the other
bedding.
 MAKING AN OCCUPIED BED

18. Raise side rail nearest you.

Go to the other side of the bed.
Lower side rail on the working
side. Help client roll or turn
onto clean bottom sheet.
Explain that he will be moving
over a roll of linen. Protect the
client from any soiled matter
on the old linens.
MAKING AN OCCUPIED BED

19. Loosen soiled linen. Look for personal items.

Roll linen from head to foot of bed, avoiding
contact with your skin or clothes. Do not shake
soiled linen. Place it in a hamper or linen bag. Do
not place on overbed table, chair, or floor.
MAKING AN OCCUPIED BED
20. Pull the clean linen through as quickly as possible.
Start with the mattress pad and wrap around corners.
Pull and tuck in clean bottom linen, just like the other
side. Pull and tuck in waterproof bed protector and
draw sheet, if used. Make hospital corners with bottom
sheet. Finish with bottom sheet free of wrinkles.
21. Place client on his back. Keep client covered and
comfortable, with a pillow under his head.
22. MAKING AN OCCUPIED BED
Unfold the top sheet. Place it over the
client and center it. Ask the client to hold the
top sheet and pull the bath blanket out from
underneath. Put it in the hamper/bag.
23. Place the blanket over the top sheet and
center it. Place the bedspread over the blanket
and center it. Tuck the top sheet, blanket and
bedspread under the foot of the bed and make
hospital corners on each side. Loosen the top
linens over the client’s feet.
MAKING AN OCCUPIED BED

24. At the top of the bed, fold down the top sheet to
make a cuff of about six inches over the blanket.
25. Gently hold and lift client’s head and remove
pillow. Do not hold it near your face. Remove the
soiled pillowcase by turning it inside out. Place it
in the hamper/bag.
26. Remove and discard gloves. Wash your hands.
MAKING AN OCCUPIED BED
27. With one hand, grasp the clean pillowcase at the closed
end. Turn it inside out over your arm. Next, using the
hand that has the pillowcase over it, grasp the center of
the end of the pillow. Pull the pillowcase over it with your
free hand. Do the same for any other pillows. Place them
gently under client’s head with open end away from the
door. Make sure zippers or tags are on the inside.
MAKING AN OCCUPIED BED
28. Make sure bed is wrinkle-free. Make client
comfortable.
29. Return bed to lowest position. Return side rails to
ordered position. Remove privacy measures.
30. Leave call light within client’s reach.
31. Be courteous and respectful at all times.
32. Wash your hands.
MAKING AN OCCUPIED BED

33. Take laundry bag or hamper to proper area.

34. Report any changes in the client to the nurse.
Document procedure using facility guidelines.
MAKING A SURGICAL BED

Equipment: clean linen (see Procedure: Making

a closed bed), gloves
1. Wash your hands.
2. Place clean linen on clean surface within reach
(e.g., bedside stand, overbed table, or chair).
3. Adjust bed to safe working level, usually waist
high. Lock bed wheels.
4. Put on gloves.
 MAKING A SURGICAL BED
5. Remove all soiled linen, rolling it (soiled side inside)
from head to foot of bed. Avoid contact with your skin or
clothes. Place it in a hamper or linen bag.
6. Remove and discard gloves.
7. Wash your hands.
8. Make a closed bed. Do not tuck top linens under the
mattress.
9. Fold top linens down from the head of the bed and up
from the foot of the bed.
MAKING A SURGICAL BED
10. Form a triangle with the linen.
Fanfold the linen triangle into
pleated layers and position opposite
the stretcher side of the bed.
Fanfolding means folding several
times into pleats. After fanfolding,
form a tiny tip with the end of the
linen triangle. The tip can be grasped
quickly and pulled over the
returning client. This step quickly
provides much-needed warmth to
the client.
MAKING A SURGICAL BED
11. Put on clean pillowcases. Place the clean pillows on a
clean surface off the bed, such as on the bedside stand or
chair.
12. Leave bed in its locked position. Leave both side rails
down.
13. Move all furniture to make room for the stretcher.
14. Do not place call light on bed. That is placed after the
client returns to bed.
15. Wash your hands.
MAKING A SURGICAL BED

16. Take laundry bag or hamper to proper area.

17. Document procedure using facility guidelines.