Module 3 Comfort Measures:

Bed Making

NUPC 104- RELATED LEARNING EXPERIENCE

MODULE III

BED MAKING
OCCUPIED BED
UNOCCUPIED BED

CLINICAL INSTRUCTORS
FRANCES ANNE R. CORPUZ
SHERYLYN KARESSA R. DUCUSIN
JEWELL LLAVORE
JULIE LAGAO
JOAN GAYTERO
DARIO RAGMAC
CHARI RIVO
ROSE ANN TAN

First Semester, SY 2020-2021

1
Module 3 Comfort Measures:
Bed Making

OBJECTIVES

• To be able to know the importance of bed making

• To identify different kinds of beds and its use

• To be able to perform proper procedures for bed making with proper body
mechanics

• To know the principles of bed making in infection control

Bed Making
It is the techniques of preparing different types of bed in making a patients/client comfortable
or his/her position suitable for a particular condition.

Purpose
• To provide the client with a safe & comfortable bed to take
rest & sleep
• To keep the ward neat and tidy and prevent cross infection
• To observe and adapt to the needs of the client and to be ready for any emergency or
critical condition of illness
• To economize time, material & effort.
• To prevent bedsores.
• For treatment of certain conditions.

Types of Bed
A. Open bed/Admission bed -It is a bed, made when it is about to be occupied by either a
new patient or an ambulatory patient. This is the bed prepared to receive a newly admitted
patient.
Purpose
• To welcome the patient

2
Module 3 Comfort Measures:
Bed Making

• To provide immediate care, safety and comfort

• To protect the bed linen while giving bath on admission

B. Closed bed-It is an unoccupied or empty bed made to receive the patient and is fully
covered with counter pane to protect it from dust and dirt. On admission of the patient, the
closed bed is converted in to an open bed.

Purpose
• To keep the bed ready for occupancy.
• To provide a neat and tidy appearance to the unit

C. Occupied bed -This bed is made with the patient in it.

Purpose
• To make a bed with least possible discomfort to the patient.
• To handle the bed clothes skillfully while the patient is on bed, giving least
disturbance to the occupant.
• To provide a neat, clean and tidy appearance.

D. Post-operative bed-It is a bed prepared for a patient who is recovering from the effects of
anesthesia following surgery.

Purpose
• To receive the patient conveniently
• To provide warmth and comfort
• To prevent shock
• To prevent injury
• To prevent soiling of the bed
• To meet any emergency

E. Cardiac bed-A bed prepared for patients with cardiac diseases.

Purpose
• To prepare the bed for the cardiac patients

3
Module 3 Comfort Measures:
Bed Making

• To relieve dyspnea

F. Amputation bed/divided bed-It is a bed in which top linen is divided into two parts to
visualize the amputated part of the lower limbs without disturbing the patient.

Purpose
• To watch the stump for hemorrhage and apply tourniquet instantly
• To take the weight of the bed clothes off the patient.
• To keep the stump in position

G. Fracture bed-It is a bed which is prepared for patients with fracture, bone diseases and
deformity.

Purpose
• To prevent undue sagging of mattress
• To immobilize the fractured part
• To restrict sudden jerky movements
• To keep the traction in position

H. Therapeutic bed (renal bed, rheumatism bed, blanket bed- it is a bed made for patients
suffering from rheumatism or renal disease.
Purpose
• To carry the weight of the bed clothes off the painful joints
• To keep the patient warm
• To induce sweating

4
Module 3 Comfort Measures:
Bed Making

Principles of Infection Control in Bed Making

• Important to limit movement of organisms and spread of
infection while in bed
• Roll the dirty or soiled linen while removing it from bed
• Hold dirty linen away from your body
• Place dirty linen in hamper/cart/bag immediately
• Never place linen on the floor
• Wash your hands after handling dirty linen
• Never bring extra linen into a patient’s room
• Linen is considered contaminated once it is in a room and cannot be used for another
person
• Avoid shaking clean sheets to place them on the bed
• Unfold them gently to inhibit the flow of microorganisms
• Place the open end of pillowcase away from the door 
• This looks neater and also helps prevents the entrance of organisms from the hall
• Observe universal precautions if linen is contaminated by blood or body fluids
• Wash hands frequently and wear gloves while handling linen
• Follow agency policy for proper disposal of linen

Body Mechanics
1. Good body mechanisms maintain the body alignment and prevents fatigue. It is also
important to conserve time and energy
2. During bed making use safe patient handling procedures and proper body mechanics.
3. The stability of the body is assured by keeping its center of gravity over its base. When
the base is wide it ensures that the center of gravity will fall through its base. In standing
position, the nurse can have a wide base by separating her feet.
4. The nearer to center of gravity a weight is held, the less is the strain produced. (Eg.
When opening the linen, it should be placed on the edge of the bed rather than holding
it above the shoulder level).
5. Always raise the bed to the appropriate height before changing linen so you do not have
to bend or stretch over the mattress. You move back and forth to opposite sides of the
bed while applying new linen.

5
Module 3 Comfort Measures:
Bed Making

6. Body mechanics and safe handling are also important when turning or repositioning the
patient in bed.
7. When tucking the sheets under the mattress, flexing is done by knees and hips. This
position shifts the work to the long and strong muscles of the thighs and keep the back
in good alignment. This reduces strain on the back.
8. When placing the linen on the bed and tucking them under the mattress face the
direction of work and move with the work rather than twisting the body and over
reaching.
9. Keep linen arranged in order of use. Make bed completely on one side before doing
other side to limit unnecessary movement from one side of bed to the opposite side

Equipment
• Bed sheets
• Bottom Sheet
• Draw mackintosh and/or Draw sheet
• Top Sheet
• Blanket
• Bedspread or counterpane
• Pillow case
• Pillows

*Once you have collected the linen, turn the stack over onto the other hand

ALERT Mittered corner-purpose is to hold linen firmly in place on beds, stretchers,

and exam tables A mitered corner is a special folding technique that secures the linen
under the mattress.

General Instructions for Bed Making

• Wash hand before & after the procedure. Don’t expose the client unnecessarily. Protect
the client from draught. Don’t cover the client’s face while placing the linen. Don’t mix
clean linen with soiled linen. Do not let the linen touch your body or uniform Keep a
reasonable distance from the face of the client to prevent cross infection.

6
Module 3 Comfort Measures:
Bed Making

• All equipment should be collected before starting. Bed should be made in such a way
that patient can be put in it without difficulty. The bed should be free from crumbs and
creases and should give a maximum comfort to the patient. Pillows and other bed
accessories should be well arranged to give support where necessary.
• The patient's face should never be covered by sheets or blankets. Extra assistance
should be available and, if necessary, one should be called upon to help lift the patient.
When pillows are being shaken the nurse should turn away from the patient. The open
side of a pillow case should be away from the main door of the ward.
• Always have a dirty linen bin at hand in which to put dirty linen. Dirty linen should not
be carried across the ward to prevent cross infection. Allow room for the patient feet
for free movement or turning when placing the top sheet over the patient. Any
conversation during bed making should not be on personal matters between the nurses.
Always wash hands before and after bed making

IMAGES FOR MITTERED CORNER

7
Module 3 Comfort Measures:
Bed Making

Things to remember in an 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 linen in the linen bag or linen hamper. Never on the floor.
• Return the bed to the lowest horizontal position when you are finished. To make a
closed bed into an open bed, fanfold the sheets to the foot of the bed. The smooth side
of the hem faces the patient

Things to remember in Occupied bed

• Explain the procedure to the patient before beginning. Protect the patient’s privacy.
Cover the patient with a 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 patient’s toes to prevent the weight of the linen from pressing down
on the toes
Preliminary Assessment
• Check the doctor’s order for specific precautions regarding the movement and
positioning of the client.
• Assess the client’s ability for selfcare
• Check the furniture and linen available in the client’s unit.
• Assess the number of clean linens needed.
• Assess the articles needed for the comfort of the client. Example: blankets, backrests

Communication Tip:

• Use an organized approach and reassuring tone of voice so the client feels safe and
comfortable during bedmaking.
• Encourage the client to report any discomfort or special requests while the bed is being made.
• When making an occupied bed, ask the client to assist as able and to report any discomfort or
the need to rest.
• Interact throughout the entire procedure, even if client is not responsive.

*Check Videos uploaded in our Google Classroom

8
 Module 3 Comfort Measures:
Bed Making

DON MARIANO MARCOS MEMORIAL STATE UNIVERSITY

South La Union Campus
COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES
Agoo, La Union
Tel. 072.682.0663
Embracing World Class Standards Care to learn, Learn to care

BACHELOR OF SCIENCE IN NURSING

Name: ______________________________ Date: __________ Section/Group: _________

Changing an Unoccupied Bed

CHECKLIST
RUBRICS:
1= Not Done
2= Done with supervision
3= Done without supervision

PROCEDURES 3 2 1
1. Assess:
• The client’s health status, to determine that the person can safely get out
of the bed.
• The client’s pulse and respirations, if indicated
• Note all the tubes and equipment connected to the client.
2. Assemble equipment and supplies:
• Two flat sheets, or one Fitted and one flat sheet, Cloth drawsheet, one
blanket, one bedspread, waterproof drawsheet or waterproof pads
(optional), pillowcases for the head pillows, plastic laundry bag or portable
linen hamper, if available.
Procedure
1. Explain to the client what you are going to do, why it is necessary, and how she
can cooperate
2. Wash hands and observe other appropriate infection control procedures
3. Provide for client privacy
4. Place fresh linen on the client’s chair or over bed table, do not use another
client’s bed.

9
Module 3 Comfort Measures:
Bed Making

5. Assess and assist the client out of bed. Make sure that this is an appropriate
and convenient time for the client to be out of bed. Assist the client to a
comfortable chair.
6. Strip the bed. Check bed linens for any items belonging to the client and detach
the call bell or any drainage tubes from the bed linen. Loosen all bedding
systematically, starting at the head of the bed on the far side and moving around
the bed up to the head of the bed on the near side. Remove the pillowcases, if
soiled, and place the pillows on the bedside chair near the foot of the bed. Fold
the reusable linens, such as the bedspread and top sheet of the bed, into fourths.
First, fold the linen in half by bringing the top edge even with the bottom edge,
then grasp it at the center of the middle fold and bottom edges. Remove the
waterproof pad and discard it, if soiled. Roll all soiled linen inside the bottom
sheet, hold it away from your uniform, and place it directly in the linen hamper.
Grasp the mattress securely, using the lugs, if present, and move the mattress up
to the head of the bed.
7. Apply the bottom sheet and draw sheet. Place the folded bottom sheet with its
center fold on the center of the bed. Make sure the sheet is hem side down for a
smooth foundation. Spread the sheet over the mattress and allow a sufficient
amount of sheet at the top to tuck under the mattress. Miter the sheet at the top
corner on the near side and tuck the sheet under the mattress, working from the
head of the bed to the foot.
• If a waterproof draw sheet is used, place it over the bottom sheet so that
the center fold is at the center line of the bed and the top and bottom
edges extend from the middle of the client’s back to the area of the mid-
thigh or knee. Fanfold the uppermost half of the folded draw sheet at the
center or far edge of the bed, and tuck in the near edge. Lay the cloth
drawsheet over the waterproof sheet in the same manner.
• Optional: Before moving to the other side of the bed, place the top linens
on the bed hem side up, unfold them, tuck them in, and miter the bottom
corners.
8. Move to the other side and secure the bottom linens. Tuck in the bottom sheet
under the head of the mattress, pull the sheet firmly, and miter the corner of the
sheet. Pull the remainder of the sheet firmly so that there are no wrinkles.
Complete this same process for the draw sheet(s).

10
Module 3 Comfort Measures:
Bed Making

9. Apply or complete the top sheet, blanket, and spread. Place the top sheet,
hem-side up, on the bed so that its center fold is at the center of the bed and the
top edge is even with the top edge of the mattress.
• Unfold the sheet over the bed. Optional: Make a fold in the sheet to
provide additional room for the client’s feet.
• Vertical toe pleat: Make a fold in the sheet 5-10 cm (2-4in) perpendicular
to the foot of the bed.
• Horizontal toe pleat: Make a fold in the sheet 5-10 cm (2-4in) across the
bed near the foot.
• Follow the same procedure for blanket and the spread, but place the top
edges about 15cm (16in) from the head of the bed to allow a cuff of sheet
to be folded over them. Tuck in the sheet, blanket, and spread at the foot
of the bed, and miter the corner using all three layers of linen. Leave the
sides of the top sheet, blanket, and spread hanging freely, unless toe
pleats were provided.
• Fold the top of the top sheet down over the spread, providing a cuff. Move
the other side of the bed, and secure the top bedding in the same manner.
10. Put clean pillowcases on the pillows as required. Grasp the closed end of the
pillowcase at the center with one hand. Gather up sides of the pillowcase and
place them over the hand grasping the case. Then grasp the center of one short
of the pillow through the pillowcase. With the free hand, pull the pillowcase over
the pillow. Adjust the pillowcases so that the pillow fits into the corners of the case
and the seams are straight. Place the pillows appropriately at the head of the bed.
11. Provide for the client comfort and safety. Attach the signal cord so that the
client can conveniently use it. If the bed is currently being used by a client, either
fold back the top covers at one side or fanfold them down to the center of the bed.
• Place the bedside table and the overbed table so that they are available to
the patient. Leave the bed in the high position if the client is returning by
stretcher, or place in the low position if the client is returning to bed after
being up.
12. Document and report pertinent data.
Variation: Surgical Bed
Strip the bed.
Place and leave the pillows on the bedside chair.
Apply the bottom linens as for an unoccupied bed. Place a bath blanket on the
foundation of the bed, if this is agency practice.

11
Module 3 Comfort Measures:
Bed Making

Place the top covers on the bed as you would for an unoccupied bed. Do not tuck
them in, miter the corners, or make a toe pleat.
Make a cuff at the top of the bed as you would for an unoccupied bed. Fold the
top linens up from the bottom.
On the side of the bed where the client will be transferred, fold up the two outer
corners of the top linens so they meet in the middle of the bed forming a triangle.
Pick up the apex of the triangle, and fanfold the top linens lengthwise to other side
of the bed.
Leave the bed in high position with side rails down.
Lock the wheels of the bed if the bed is not to be moved.
For the next items, evaluate the students in general according to the criteria. (5 as the
highest score)
5 4 3 2 1
Mastery
Orderliness
Proper attitude in assessing the client followed.
Ability to answer questions.
Proper reporting observed.

Student’s Signature: ____________________

Evaluator’s Signature:____________________

Comments:________________________________________________________________
_________________________________________________________________________.

12
 Module 3 Comfort Measures:
Bed Making

DON MARIANO MARCOS MEMORIAL STATE UNIVERSITY

South La Union Campus
COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES
Agoo, La Union
Tel. 072.682.0663
Embracing World Class Standards Care to learn, Learn to care

BACHELOR OF SCIENCE IN NURSING

Name: ______________________________ Date: __________ Section/Group: _________

Changing an Occupied Bed

CHECKLIST
RUBRICS:
1= Not Done
2= Done with supervision
3= Done without supervision

PROCEDURES 3 2 1
1. Assess:
• Note specific orders or precautions for moving and positioning the
client.
• Determine presence of incontinence or excessive drainage from
other sources indicating the need for protective waterproof pad.
• Assess skin condition and need for special mattress, footboard, or
heel protectors.
2. Assemble equipment and supplies:
• Two flat sheets, or one fitted and one flat sheet.
• Cloth drawsheet (optional)
• One blanket
• One bedspread
• Waterproof drawsheet or waterproof pads (optional)

13
Module 3 Comfort Measures:
Bed Making

• Pillowcases for the head pillows

• Plastic laundry bag or portable linen hamper, if available.
Procedure
1. Explain to the client what you are going to do, why is it necessary and
how she/he can cooperate.
2. Wash hands and observe other appropriate infection control procedures.
3. Provide for client privacy.
4. Remove the top bedding.
• Remove any equipment attached to the bed linen, such as a signal
light.
• Loosen all the top linen at the foot of the bed, and remove the
spread and the blanket.
• Leave the top sheet over the client, or replace it with a bath blanket
as follows:
• Spread the bath blanket over the top sheet.
• Ask the client to hold the top edge of the blanket.
• Reaching under the blanket from the side, grasp the top edge
of the sheet and draw it down to the foot of the bed, leaving
the blanket in place.
• }Remove the sheet from the bed and place it in the soiled
linen hamper.
5. Change the bottom sheet and drawsheet.
• Assist the client to turn on the side facing away from the side where
the clean linen is.
• Raise the side rail nearest the client. If there is no side rail, have
another nurse support the client at the edge of the bed.
• Loosen the foundation of the linen on the side of the bed near the
linen supply.
• Fanfold the drawsheet and the bottom sheet at the center of the
bed, as close to the patient as possible.
• Place the new bottom sheet on the bed, and vertically fanfold the
half to be used on the far side of the bed as close to the patient as

14
Module 3 Comfort Measures:
Bed Making

possible. Tuck the sheet under the near half of the bed, and miter
the corner if a contour sheet is not being used.
• Place the clean drawsheet in the bed with the center fold at the
center of the bed. Fanfold the uppermost half vertically at the center
of the bed, and tuck the near side edge under the side of the
mattress.
• Assist the client to roll over toward you onto the clean side of the
bed. Have the client roll over the fanfolded linen at the center of the
bed.
• Move the pillows to the clean side for the patient’s use. Raise the
side rail before leaving the side of the bed.
• Move to the other side of the bed, and lower the side rail.
• Remove the used linen and place it in the portable hamper.
• Unfold and fanfold bottom sheet from the center of the bed.
• Facing the side of the bed, use both hands to pull the bottom sheet
so that it is smooth, and tuck excess under the side of the mattress.
• Unfold the drawsheet fanfolded at the center of the bed and pull it
tightly with both hands. Pull the sheet in three sections:
• Face the side of the bed to pull the middle section.
• Face the far top corner to pull the bottom section.
• Face the far bottom corner to pull the top section.
• Tuck the excess drawsheet under the side of the mattress.
6. Reposition the client in the center of the bed.
• Reposition the pillows at the center of the bed.
• Assist the client to the center of the bed. Determine what position
the client requires or prefers, and assist the client to that position.
7. Apply or complete the top bedding.
• Spread the top sheet over the client, and either ask the client to hold
the top edge of the sheet or tuck it under the shoulders, the sheet
should remain over the client when the bath blanket or used sheet is
removed.
• Complete the top of the bed.

15
Module 3 Comfort Measures:
Bed Making

8. Ensure the continued safety of the client.

• Raise the side rails. Place the bed in the low position before leaving
the bedside.
• Attach the signal cord to the bed linen within the client’s reach.
• Put items used by the client within easy reach.
❖ Bed making is not normally recorded.

For the next items, evaluate the students in general according to the criteria. (5
as the highest score)
5 4 3 2 1
Mastery
Orderliness
Proper attitude in assessing the client followed.
Ability to answer questions.
Proper reporting observed.

Student’s Signature: ____________________

Evaluator’s Signature: ____________________

Comments:__________________________________________________________
___________________________________________________________________

16