2. Bed Making
Ongoing provision of basic cleanliness,
comfort and safety
Clients may spend long periods of time in
bed, undertaking various activities –
depending on individual health state, and on
situational factors (ie if at home, or in a
health care agency)
3. Principles
Factors to consider with each bedmaking
episode:
Prevention of cross-infection
Safety and comfort for the client
Maintenance of good body mechanics
4. Prevention of cross-infection
Wash hands or use alcohol hand rub before
and after making each bed
If linen is very soiled, wear gloves for
removal
Dirty linen is put immediately into soiled linen
bag (white or brown bag) or as per
organisation – never onto floor !!
5. Don’t shake or flick linen excessively
Linen shouldn’t touch floor, or be held up
against carer’s clothing
Linen should only be put onto a clean
surface prior to bed making
NO interchange of linen between clients
6. Client safety and comfort
Ensure that bed brakes are on, and that bed
is returned to its original position (usually to a
height the resident can easily access), after
bed making is complete
Promote comfort, by having sheets free of
rough areas, wrinkles or creases, food
crumbs and foreign bodies
7. Avoid areas of potential pressure, ie hems of
sheets away from direct contact with client’s
skin
If waterproofing layer is used, must not
come into contact with client’s skin
Need to particularly consider safety and
comfort, if client occupies bed whilst it is
being made
8. Body mechanics of the carer
Maintain good body alignment when bed
making – avoid bending, stretching and
twisting
Use large leg muscles (bend knees), rather
than back muscles
Work smoothly and rhythmically – 2 people
to make beds together is optimal
9. If able, raise bed to a comfortable working
height (usually waist high) – to avoid bending
and back strain
Prepare well – gather all equipment initially,
and avoid legwork
10. Bed features
Many types of beds available, with multiple
modifications possible
In health agencies, most are “hi-lo”, allowing
adjustment of the bed base up and down
Most also allow position changes, ie
head/feet up/down
11.
12. Different types of operation – some have
hand-winding action, others with hydraulic
foot pump mechanism and release button,
some are electric
Bed brakes
Bed heads and feet are detachable, for
emergency access situations, or for transfer
of clients on their beds
13. Bed “attachments”
Trapeze/overhead “monkeybar”
Bedstick
Drainage tube bag hangers
Client call bell
Bed siderails – may constitute restraint!
14. Bed aids
Most bed aids relate to the comfort and
correct positioning of a client
If bed aids used, need to be appropriately
selected and used
Pillows – with waterproof cover
15. Bed aids - Mattress
Many different types
Air alternating
Egg carton
16. Bed cradle
Sheepskin – for under buttocks, or
elbow/heel protectors
Wedges/wedge shaped pillows
Footboards/foot bolsters
Absorbent layers
17. Sheepskins
Medical sheepskins –
green in color
30mm pile (springy),
especially tanned
High density-creates a
cushion that distributes
body weight & pressure
points over a large
area-each fibre acts as
a spring
18. Sheepskins Cont.
Wool can absorb
moisture up to 33% of
its weight without
feeling wet
Reduces friction &
shear
Medical sheepskins are
stamped
19. The steps to making an unoccupied bed
Wash & dry hands
Place clean linen &
soiled linen skip near
the bed
Ensure that there is a
chair on which to
place the bed clothes
Ideally there would be
two people to make
the bed
20. Move the bedside locker &
over bed table if necessary
Adjust the height of the bed
– it should sit about hip
height
Place pillows on the bed.
Place any soiled pillow slips
in the skip
Loosen the upper bed
clothes
21. Remove each item of
upper bed clothes
separately, fold &
place on the chair.
Loosen the bottom
bed clothes, fold &
place on the chair.
Any soiled items are
placed in the linen
skip
Roll, rather than fold
the waterproof sheet
(if applicable)
22. Pull the mattress well
up to the head of the
bed
Commencing with the
bottom sheet, each
item is replaced
separately
Ensure the hem of the
sheets is facing
outward to protect the
resident’s skin
23. Some facilities
will have fitted
bottom sheets
Note the centre of
the sheet follows
down the middle of
the bed
24. If a draw sheet or Kylie
sheet / Kylie pad is
used it is positioned
approximately 25cm
from the head of the
bed. The bed clothes
should be centred and
unless being made up
as an open bed, tucked
in around the mattress
25. The mitred or military corner
Most hospitals and
residential care facilities
will make their beds
with the sheets having
a mitred corner
26. The steps
Once the sheet is placed on
the bed tuck the bottom end
of the sheet under the end
of the mattress
Pick up, about 20-30cm
from the end of the sheet,
and place it on the top of the
bed – this should make a bit
of a triangle shape
Tuck the sheet that is still
hanging toward the floor
under the bottom of the
matteress
27. The steps continued
Then bring the top part of the
triangle down and tuck into the
mattress for the BOTTOM sheet
Each layer of linen is tucked in the
same way
Often the top sheet and blankets
are left without the step above so
that all of the sheets are not tucked
in along the side of the bed – this
makes it easier to get patients and
residents back into bed
29. At the top end of the bed, fold
the top sheet over the
blanket. The top layer of
blanket is generally tucked
under from the top
Ensure there are no wrinkles
in any layer of the linen
30. Many facilities will have their own policies about using
resident’s own linen, and how the bed should look
Some facilities do not like to have blankets underneath showing
Be aware of your facility’s policy on laundering of personal linen
31. Replace & arrange the pillows to meet the resident’s needs
If a person is to return to bed, the top corner of the upper bed
clothes may be folded back
Ensure the bed is returned back to an appropriate level for the
resident to get back into bed, and place call bells etc in reach
Make sure there is no linen hanging on the floor
32. Replace any furniture
Tidy around the resident’s bed side eg serviettes, tissues etc
Remove linen skip
Wash & dry your hands
33. Now to make the occupied bed
Wash & dry hands
Explain the procedure to the individual &
ensure privacy
Collect clean linen & linen skip before
commencing to make the bed
Move the bedside locker & over bed table if
necessary
34. Ensure there is a nearby chair on which to place
the bed clothes
Adjust the height of the bed
Leaving sufficient pillows to support the individual,
place the reminder on the chair
Remove each item of upper bedclothes separately.
Bed clothes to be replaced are folded and put on
the chair. Cover the person with a procedure
blanket before removing the top sheet. Place
soiled items into the linen skip
Remove accessories such as bed cradle
35. Support the individual & gently turn him onto one side of the
bed. If only one nurse is making the bed, the side rail away
from her should be elevated (if insitu)
Loosen the bottom sheets on the occupied side, and roll
each one towards the centre of the bed. Brush out any debris
eg crumbs. Eliminate any creases from the mattress cover
Working at the unoccupied side of the bed, either:
Unroll, pull the bottom sheets taut, and tuck in around the
mattress OR If
using a fresh sheet, place on the bed and unfold it so that
centre laundry crease lies at the centre of the mattress. Tuck
in at the top, bottom and side. Roll the excess to the centre
of the bed
36. Carefully turn the individual to the other side of the bed,
providing adequate support as he is moved. If appropriate,
elevate side rail
From the opposite side of the bed, either:
Remove any soiled sheets and place in the linen skip
OR
Untuck and roll sheet/s to the centre of the bed
Ensure that side of the mattress is free from debris and
ceases, unroll and tuck the sheet/s in around the mattress
Assist the individual back into the centre of the bed, arrange
the pillows to meet the need and assist him into position
37. Replace any accessories, put on the top sheet and
remove the procedure blanket
Replace the blankets and quilt, ensuring that they
are positioned to cover the individual’s chest and
shoulders. Make foot pleats in the upper bed
clothes and avoid tucking them in to tightly
Adjust the height of the bed – ensure nurse call
bell within reach
Replace any furniture. Remove the linen skip.
Wash and dry hands.