This document defines different types of bed making including open bed, occupied bed, surgical/post-op bed, and closed bed. It describes the purposes of bed making, components of hospital beds, commonly used bed positions, equipment needed for bed making, asepsis, body mechanics, guidelines, and steps for stripping beds and making open, closed, occupied, and post-op beds. The key information provided includes definitions of different bed types, purposes of providing a suitable environment and comfort for patients, common bed components, positions, necessary equipment, importance of asepsis, body mechanics, and specific steps for each bed making process.

1. BEDMAKING
DEFINITION:
1. Open Bed – the bed making process when the bed is unoccupied or when
the occupant is able to be up while it is made.
2. Occupied Bed – the bed making process in which the bed is made while the
patient is in it.
3. Surgical Bed / Post-Op Bed – the bed making process in which the bed is
prepared to receive a patient with minimum disturbance after his return from
the recovery room.
4. Closed Bed – an empty hospital bed which is made when the occupant has
been discharge in the hospital.
PURPOSES OF BEDMAKING
1. To provide a suitable environment in which the patient will be able to carry on
normal body activities 24 hours a day when he can’t be out of bed.
2. To provide a suitable environment for comfort and rest for the patient who is able
to be out of bed for periods of time.
Hospital beds
- are usually 66cm (26in) high and 0.9 (3ft) wide
- narrower than the usual bed (so that the nurse can reach the client from either side of
the bed without undue stretching
Mattresses
- Usually covered with water repellent material that resists soiling and can be clean
easily.
- It has handles on the sides called lugs by which the mattress can be moved.
Side rails (safety sides)
- They are of various shapes and sizes and are usually made of metal.
- A bed can have two full-length side rails or four half-or-quarter length side rails
(split rails)
- When side rails are being used, it is important that the nurse never leave the

2. bedside while the rail is lowered.
- Positions: Up and down ; high, immediate, and low
- risk clients.
Footboard or Footboot
- These are used to support the immobilized client’s foot in a normal right angle to
the legs to prevent plantar flexion contractures.
Bed cradles
- It is a device designed to keep the top bedclothes off the feet, legs, and even
abdomen of a client
- Most common is a curved metal rod that fits over the bed
Intravenous Rods (poles, stands, standards)
- Usually made of metal, support IV infusion containers while fluid is being
administered to a client.
COMMONLY USED BED POSITIONS
Flat
- Mattress is completely horizontal
- To maintain spinal alignment for clients with spinal injuries
- To assist clients to move and turn in bed-making by nurse
Fowler’s Position
- Semisitting position in which head of bed is raised to angle at least 45 degree.
Knees may be flexed or horizontal.
- Convenient for eating, reading, visiting, watching TV
- Relief from lying positions
- To promote lung expansion for client with respiratory problem
- To assist client a sitting position on the edge of the bed
Semi Fowler’s position
- Head of bed is raised only 30 degree angle
- Relief from lying positions
- To promote lung expansion
Trendelenburg’s position
- Head of bed is lowered and the foot raised in straight incline
- To promote venous circulation in certain clients
- To provide postural drainage of basal lung lobes
Reverse Trendelenburg’s position
- Head of bed is raised and foot lowered. Straight tilt in direction opposite to

3. trendelenburg’s position
- To promote stomach emptying and prevent esophageal reflux in client with hiatal
hernia
ASSESSMENT:
1. Assess the client's health status to determine that the person can safely get out
of bed. In some hospitals it is necessary to have a written order if the client has
been in bed continuously.
2. Assess the client's pulse and respirations if indicated.
3. Note all the tubes and equipment connected to the client because they may
influence the need for additional lines or water-proof pads.
EQUIPMENTS NEEDED (in order of use)
1. Mattress pad 6. Blanket
2. Bottom sheet 7. Spread sheet
3. Rubber or plastic draw sheet 8. Pillowcase for each pillow
4. Cloth draw sheet 9. Pillow
5. Top sheet For Post-Op Bed: 6 – 8 Hot Water Bag
ASEPSIS IN BEDMAKING
1. Wash hands before performing the procedure, to prevent transfer of micro-
organism from the caregivers hand to patient's bed.
2. Soiled linen is not placed on the floor. The floor if one of the most contaminated
area in the hospital. Linen hampers are provided for the disposal of soiled linen.
Handle linen carefully avoid shaking it, or tossing it into the laundry hamper.
3. Use all linen necessary to provide care to the patient but do not excess. Bringing
extra clean linen into the patient’s room may contaminate it, and it cannot be
used for another patient.
4. When the linen change is complete, the room is left in order. Soiled supplies are
promptly removed.
BODY MECHANICS IN BED – MAKING
1. Raise the bed to a comfortable working height (hip level). This will prevent
unnecessary strain on the caregivers back and allows the use of correct body
mechanics by lowering the center of gravity and avoiding stretching of the lower
back muscles.
2. When you must bend, bend your knees not your back, to prevent strain on the
caregivers back.
3. Point your toes and face in the direction that you are moving. Avoid twisting, to
have a proper balance.
4. Conserve steps by making as few trips around the bed as possible. Make the bed
completely on the side before moving to the other side.
PRACTICE GUIDELINES (things to remember)
- Wash hand thoroughly after handling a client’s bed linen. (Linens and equipment
that have been soiled with secretions and excretions harbor microorganisms that
can be transmitted to others directly or by the nurse’s hands or uniform.

4. - Hold soiled linen away from uniform
- Linen for one client is never placed on another client’s bed.
- Place soiled linen directly in a portable linen hamper or tucked into a pillow case
at the end of the bed before it is gathered up for disposal.
- Do not shake soiled linen in the air because shaking can disseminate secretions
and excretions and the microorganisms they contain.
- When stripping and making bed, conserve time and energy by stripping and
making up one side as much as possible before working on the other side.
STRIPPING THE BED
Equipment needed: Laundry hamper or bag
1. Remove attached equipment (ex. Personal items, waste bag). Side rails should be
in down position.
2. Remove cases from pillows and place them on a chair or bedside table.
3. Loosen the top and the bottom linen from the mattress, moving around the bed
from head to foot on one side and from foot on the opposite side.
4. Remove items to be reused (spread, blanket sheet) fold them in, and place them
back of chair.
5. Remove the remaining linen and place them in the laundry hamper.
6. If the mattress is to be turned, do so as to this point by grasping it, pulling it toward
you, and turning it.
7. Move the mattress to the head of the bed.
CLOSED BEDS
1. Gather linens in the order of used. Gathering the equipment will allow you to work
efficiently.
2. Perform hand hygiene.
3. Raise the bed to a comfortable working height, this allows the use of proper body
mechanics.
4. Place a clean bottom linen on the bed, start with the bottom edge even with foot
end of bed with center fold in the middle of the bed , then spread, do the same with
the rubber sheet (the rubber sheet should cover the bed from the clients shoulders
to below the hips) and draw sheet, smooth out the wrinkles as much as possible,
tuck and miter the top edge of the bottom linen (from top to bottom), tuck the
rubber and draw sheet together with the bottom sheet.

5. Top sheet of edge pick sheet on top of mattress lower edge of sheet
tuck up in a triangular fold under mattress
Triangular fold placed over side of mattress linen tuck under mattress
5. Place top linen on bed, using center fold as a guide, then unfold, making sure the
upper hem is at the level of the upper edge of the mattress,. Followed by blanket
which is 6-8 inches below the upper hem of the top sheet, then place the spread
sheet 1-2 inches above the upper hem of the blanket.
6. Make one side of the bed to conserve time, energy and movement and contribute
to the smoothness of the sheets then proceed to the other side of the bed. Pull the
folded sheet from the center of the bed, then straighten.
7. Fan-fold linens to the middle part of bed after bed is made.
8. Make a toe pleat 2-4 inches wide. Tuck in the foot part of the last 3 sheets then
miter. Toe pleat provides additional room for patient's feet
9. Take the pillow and apply the pillow case. Taking care to keep pillow and case
away from the uniform.

6. 10.Place half of the pillow with case under the top sheet making sure that the opening
of the pillow case is away from the door opening.
11.Replace call light within patients reach, and other items attached to bed.
OPEN BEDS
1. Step 1 to 6 same with closed bed.
2. Fan-fold linens to the middle part of bed after bed is made.
POST-OP BEDS
1. Follow steps 1 to 9 in closed bed.
2. Fan-fold the first 3 top linen to far side on foot part of the bed.
3. Place 6 to 8 Hot Water Bag (same number on each side).
4. Unfold the first 3 linens to the head part to cover the HWB and to warm bed linens.
5. Leave the bed in high position.
6. Change the pillowcase and leave the pillow on a chair or at the foot of the bed to
be accessible for placement under the clients head.
7. Arrange appropriate items (emesis basin, tissue, IV stands) at bedside.
8. Move all object away from the other side of the bed area to leave room for the
stretcher.
9. Fold back the first 3 top linen to far side on foot part of the bed, when you’re about
to transfer the patient from the recovery room on a stretcher to the bed made.
10.Position patient flat on bed (as per doctor’s order), unfold the first 3 linens to cover
the patient. Leave the patient with both side rails up to protect patient from fall.
OCCUPIED BEDS
1. Explain to the patient what is to be done.
2. Perform hand hygiene.
3. Close the door or curtain for privacy.
4. Gather linens in the order to be used. Gathering the equipment will allow you to
work efficiently.
5. Raise bed to convenient working level. Move client toward the near side of the bed.
Having the bed at waist height and the client at the side of the bed allows the use
of correct body mechanics by lowering the center of gravity and avoiding stretching
of the lower back muscles.
6. Strip off all top 3 linen. Position bath blanket and remove spread, top sheet and
blanket in one movement. If the top linens are to be reused, fold and place them
in a chair. Linens should be folded & not fluffed in the air, to prevent spread of
micro-org.
7. Place linens not to be reused in a laundry hamper or linen bag. Avoid contact with
your uniform. The spread of micro-organism from soiled linen to uniform to other
clients is prevented by avoiding contact with linen.
8. Roll patient too far /opposite side of bed, making sure side rail (far side) is up.

7. Adjust the pillow under the head.
9. Loosen bottom, rubber and draw sheet on near side of bed and fan fold it toward
center of bed. Fan-fold other half of clean bottom linen, rubber and draw sheet and
tuck under patient back and buttocks. Do the same for the rubber sheet and draw
sheet. This allows space for you to place clean linens, and it moves dirty linen
close to the other side of the bed for easy removal.
10.Place a clean bottom linen on the bed, start with the bottom edge even with foot
end of bed with center fold in the middle of the bed , then spread, do the same with
the rubber sheet (the rubber sheet should cover the bed from the clients shoulders
to below the hips) and draw sheet, smooth out the wrinkles as much as possible,
tuck and miter the top edge of the bottom linen (from top to bottom), tuck the
rubber and draw sheet together with the bottom sheet.
11.Help patient roll over folded linen. Raise the side rail and move to opposite side of
the bed. Lower the side rail on that side of bed.
12.Loosen soiled linen, remove from bed by folding toward the center or one end of
the bed (hold the linens away from your body) and place them in a laundry hamper.
13.Pull the fan fold linen under patients body, then spread, do the same with the
rubber sheet and draw sheet, smooth out the wrinkles as much as possible, tuck
and miter the top edge of the bottom linen (from top to bottom), tuck the rubber
and draw sheet together with the bottom sheet.
14.Place the top sheet over the patient with the seam side up, the center crease
should be at the center of bed. Unfold the sheet from head to toe without covering
patients face.
15.Have the client grasp the top sheet while you pull the soiled sheet or bath blanket
from under the clean sheet.
16.Followed by blanket which is 6-8 inches below the upper hem of the top sheet,

8. then place the spread sheet 1-2 inches above the upper hem of the blanket.
17.Proceed to the other side of the bed. Pull the folded sheet from the center of the
bed, then straighten.
18.Tuck the upper hem of the spread sheet under the blanket then fold back the top
sheet over the spread sheet.
19.Make a toe pleat 2-4 inches wide. Pleating removes pressure of bed covers on
clients toes. Tuck in the foot part of the last 3 sheets then miter.
20.Change pillowcase.
20.1 grasp the close end of a clean pillowcase at the center point.
20.2 with the other hand. Hold the open end of the case.
20.3 invert the case over your hand and forearm (at the closed end) by pulling the
open end of case back toward the closed end. Maintain your grasp at the closed
end.
21.Reattach call light within the clients reach and arrange unit. Place bed in low
position.
22.Assist patient to position of comfort. Perform hand hygiene and document your
care.