Bed making

Introduction- The primary aims of bed making is to be provide comfort and safety of the patient,
e.g. using pillows for support; preventing bed-sores by means of clean smooth sheets. The morale of
the patient is greatly helped by good bed making. It makes economy of time, effort and equipment,
e.g. being prepared for an emergency admission; using rubber sheeting to prevent soiling of linen,
mattress and pillow. It also gives cleanliness, order and pleasing appearance to patient’s unit.

DEFINITION OF BEDD MAKING:-

“Bed making is a process of keeping the bed clean neat and tidy also keep ready for admission,
transfer, examination, treatment, and to promote comfort the patient.”

PURPOSE OF BED MAKING:-

 To provide clean and comfortable bed for the patient

 To give neat tidy appearance to the unit
 To keep it ready for any emergency
 To receive patient comfortably
 To establish inter-personal relationship
 To economize the time, material and energy
 To prevent bed sore

PRINCIPALS OF BEDMAKING:-

 Systematic way of doing save time., energy and material.

 Good body mechanics maintains the body alignment and prevents fatigue.
 A safe and comfortable bed will ensure rest , sleep and Prevents several complications in
bed ridden patient , e.g. pressure sore, foot drop, etc.
 Microorganism are found everywhere on bed, bed sheets, blanket, pillow cover and the
articles used by the Patient and in the environment.
 Keep the bed and environment clean and neat. It helps to provide physical and mental
health.

GENERAL INSTRUCTIONS/RULES TO BE OBSERVED IN BED MAKING:-

 Wash hand before and after procedure.

 Do not expose the patient unnecessarily.
 Do not cover the patients face while placing the linen.
 Does not mix clean linen with soiled linen.
 Maintain good body mechanics.
 Make the bed firm, smooth and unwrinkled.
 Practice economy of time, energy and material.
 Nursing principles such as individuality,, comfort, safety and good workmanship should
be kept in mind during the bed making.
 Inspect the cot, mattress and pillows daily for the purpose of vermin’s and destroy them
if found on the bed.
 Always get extra help to make a bed for helpless patient and prevent from falling.
 Make adaptations according to climatic differences, individual needs, customs and
habits of the patient.
 The cotton mattress must be turned, aired and made free from lumps and creases.
PRELIMINARY ASSESSMENT:-
 The doctor’s order for specific precautions regarding movement and positioning of the
patient.
 Assess the patient’s ability for self- care.
 The furniture and linen available in the patient unit.
 The number of the clean linen needed.
 Assess the articles needed for the comfort f the patient ,e.g. blankets, etc.

PREPARATION OF ARTICLES WITH RATIONAL:-

ARTICLES RATIONAL
1.Damp duster and dry duster –to clean the metal To prevent spread of infection.
bed

2.Kidney tray To receive wastes.

3.Matress ( size 190 cm width ) with cover To protect mattress.

4.Bed sheets-2 ( top sheet and bottom sheet) To use as bottom and top sheet.
Size (108 inch long and 76 inch wide )
5.Draw sheet ( size 15o cm long and 110 cm wide ) To cover mackintosh

6. Draw mackintosh -1 6. to protect bed linen

7.Pillow -1 (60 cm long, 45 cm wide and 10 cm To protect pillow, to provide comfort.

thick ) and pillow cover -1 ( average size 65 cm long
and 50 cm wide)
8.Counter pane To protect top linen

9. Blanket (3 m long and 3 m wide ) To provide warmth

10. Stool/chair To keep articles.

11.Dirty linen trolley/basket/hampers To discard dirty linen

Types of bed making:-

1. Routine beds
 Occupied bed
  Simple unoccupied

2. Special beds

 Cardiac
 Orthopedic
 Admission
 Divided
 Amputation
 Plaster of paris

1.OPEN BED –

DEFINITION-
Preparing a bed that is
comfortable and
suitable for a hospitalized
patient. an open bed is a bed
to which a client is already
assigned.

Purpose-
 To provide comfort
and rest
 To maintain a clean
environment and neat appearance to the unit
 To reduce transmission of microorganisms
 To economized time , material and effort
 To promote cleanliness
 To observe patient and to prevent complication
 To ambulate the patient
 To provide smooth , wrinkle free bed thus minimizing sources of skin irritation

GENERAL INSTRCTION-
 Unnecessary exposure of the patient should be avoided
 Appropriate measures should be ensured to protect patient from drought
 Clean linen should not be mixed with soiled linen
 Good body mechanic should be employed all through the procedure
 Ensure that patient `s body is not in direct contact with woolen blanket and mackintosh
 While making the bed ensure that the soiled or clean linen do not touch the uniform the
nurse
 The bed should be firm , smooth , clean and wrinkle free
 Necessary modification should be done according to change in weather and individual need ,
comfort , safety

ARTICLES-
1. A tray for carbonizations containing-
 a) Duster-2
b) A bowl/with this disinfectant solution (1;20savlon)
c) Kidney tray
2. Bed proper functioning
3. Mattress and pillows
4. Chair or stool – to keep the clean linen
5. Bedside locker
6. Set of clean linen- bottom sheet , top sheet , draw sheets , pillow case ,counter pane/ bed
spread (optional) ,blanket (optional)
7. Mackintosh
8. Linen bag/bucket hamper for soiled linen.

PROCEDURE –

S.NO NURSING ACTION RATIONAL

.
BEFORE PROCEDURE- Determines if patient can be mad to sit
1. Assess patient’s general condition and out of bed
check doctor`s order for any specific
instruction movement restriction
2. Explain to patient the need of purpose Wins the patient`s cooperation and
of making bed confident
3. Assess whether there is need for Ensures an organized approach towards
change of linen and collect fresh linen as caring out procedure
needed
4. Move furniture away from the bed Provides adequate space for nurse to
move
5. Place the tray on bedside locker. Keep Arranging articles at the bedside saves
linen basket at the bed side. time and energy.
6. Place stool at foot end of bed and place Keeping articles at convenient place and
fresh linen on it the reverse order of within reach promotes ease of work and
use. saves time.
7. Assist patient to get out of bed and sit
comfortably on a stool or chair near the
bed
8. Lower head end of bed. keep bed in flat -working with bed in lowered position
position and lower side rails promotes good and body mechanics.
-keeping the bed in flat position enables
the nurse to make a wrinkle free bed.s
Remove wrist watch and wash hands Prevents chances of cross-infection
9.
DURING PROCEDURE-
10. Switch off fan Prevent spread of dust and
microorganism
11. Wash hands and take articles to Prevent cross infection
patient’s bed.

12 Loosen the top linen starting from Allow easy removal of linen.
head end and proceed to foot end.
13 Remove the sheets one by one after It prevent sheet from touching the
making 4 folds .if re used; arrange floor.
them on back of chair after shaking
them gently.
14 Roll the mackintosh and place it over Mackintosh is not folded to avoid
the chair. creases.

15 Remove the bottom sheet, folding it Prevent sheet from touching the floor.
into four or six.

16 Remove the mattress cover if soiled damp dusting prevents spread of dust
and dust the mattress and the cot with
damp duster while cleaning, start
from cleaner area to less clean area
and replace cover of mattress.
17 Place the folded bottom sheet on the To cover mattress and to spread
head and corner of the mattress on evenly on all sides.
your side and spread it straight.
18 Tuck 12-18 inches under the mattress
on head end when tucking linen,
keep the feet slightly apart and flex
the knees while bending.
19 Make mitered corners while tucking. Keeps bed neat and tidy.

20 Tuck at foot end and secure mitered

corner on your side.

21 Spread the draw mackintosh at the to protect the mattress and keep it dry
center of the bed and tuck from your from spilling of water etc
side.
22 Place draw sheet over the To prevent chilling and direct contact
mackintosh about 3.5 inches above of rubber sheet with the patient.
mackintosh and tuck it along the
right side.
23 Go to the other side and tuck in each To maintain good body mechanism.
of bottom linens as done before.
24 Come back to previous side and
spread the top sheet over the bottom
linen in the same manner as with the
bottom sheet. Make toe pleat at the
foot end of the bed, if required.
25 If a blanket is used, spread it over the To provide warmth to patient..
top sheet.
26 Spread counter pan over the blanket To provides extra warmth.
placing its centre at the centre of the
bed such that it covers the blanket
tuck top edge of the counter pan over
and under the top edge of the blanket.
27 Tuck at the foot end altogether and tucking foot end keeps linen fixed on
 make mitered corners on the sides. the bed

28 Place pillow with cover, keeping the

open end away from the entrance.

29. The top covers with /or blanket are The patent can easily get back in to bed.
folded back so the patient.
30 AFTER PROCEDURE-
Help patient to get into bed.

31 Replace articles
Wash hands Reduce risk of transmission of
microorganism.

2. CLOSED BED:
DEFINITION - IT is an unoccupied /empty bed to receive the patient and fully covered with
counter pane to protect it from dust and dirt on admission of the patient, the closed bed is
converted into open bed. To ma a close bed , the top covers are pulled up to the head of the
bed over the bottom covers.

PURPOSES:-
1) To keep the bed ready for occupancy/admission.
2) To provide a neat and tidy appearance to the unit.
3) To give a clean comfortable of bed.
4) To keep it ready for any emergency.
5) To protect the bed from dust and dirt.
ARTICLES-
1. A tray for carbonizations containing-
d) Duster-2
e) A bowl/with this disinfectant solution (1;20savlon)
f) Kidney tray
2. Bed proper functioning
3. Mattress and pillows
4. Chair or stool – to keep the clean linen
5. Bedside locker
6. Set of clean linen- bottom sheet , top sheet , draw sheets , pillow case ,counter pane
(optional) ,blanket (optional)
7. Mackintosh
8. Linen bag/bucket for soiled linen.

PROCEDURE-
S.NO NURSING ACTION RATIONAL
.
BEFORE PROCEDURE- Determines if patient can be mad to sit
1. Assess patient’s general condition and out of bed
check doctor`s order for any specific
instruction movement restriction
2. Explain to patient the need of purpose Wins the patient`s cooperation and
of making bed confident
3. Assess whether there is need for Ensures an organized approach towards
change of linen and collect fresh linen as caring out procedure
needed
4. Move furniture away from the bed Provides adequate space for nurse to
move
5. Place the tray on bedside locker. Keep Arranging articles at the bedside saves
linen basket at the bed side. time and energy.
6. Place stool at foot end of bed and place Keeping articles at convenient place and
fresh linen on it the reverse order of within reach promotes ease of work and
use. saves time.
7. Assist patient to get out of bed and sit
comfortably on a stool or chair near the
bed
8. Lower head end of bed. keep bed in flat -working with bed in lowered position
position and lower side rails promotes good and body mechanics.
-keeping the bed in flat position enables
the nurse to make a wrinkle free bed.s
Remove wrist watch and wash hands Prevents chances of cross-infection
9.
 DURING PROCEDURE-
10. Switch off fan Prevent spread of dust and
microorganism
11. Wash hands and take articles to Prevent cross infection
patient’s bed.

12 Loosen the top linen starting from Allow easy removal of linen.
head end and proceed to foot end.
13 Remove the sheets one by one after It prevent sheet from touching the
making 4 folds .if re used; arrange floor.
them on back of chair after shaking
them gently.
14 Roll the mackintosh and place it over Mackintosh is not folded to avoid
the chair. creases.

15 Remove the bottom sheet, folding it Prevent sheet from touching the floor.
into four or six.

16 Remove the mattress cover if soiled damp dusting prevents spread of dust
and dust the mattress and the cot with
damp duster while cleaning, start
from cleaner area to less clean area
and replace cover of mattress.
17 Place the folded bottom sheet on the To cover mattress and to spread
head and corner of the mattress on evenly on all sides.
your side and spread it straight.
18 Tuck 12-18 inches under the mattress
on head end when tucking linen, keep
the feet slightly apart and flex the
knees while bending.
19 Make mitered corners while tucking. Keeps bed neat and tidy.

20 Tuck at foot end and secure mitered

corner on your side.

21 Spread the draw mackintosh at the to protect the mattress and keep it dry
center of the bed and tuck from your from spilling of water etc
side. To protect the mattress and keep
it dries from spilling of water etc.
22 Place draw sheet over the To prevent chilling and direct contact
mackintosh about 3.5 inches above of rubber sheet with the patient.
mackintosh and tuck it along the right
side.
23 Go to the other side and tuck in each To maintain good body mechanism.
of bottom linens as done before.
24 Come back to previous side and
spread the top sheet over the bottom
linen in the same manner as with the
bottom sheet. Make toe pleat at the
foot end of the bed, if required.
 25 If a blanket is used, spread it over the To provide warmth to patient
top sheet,15-20 cm below from the Smooth cuff protects patient`s skin
top of the mattress . cuff the top of from irritatiom caused by blanket.
the sheet over the blanket.
26 Spread counter pan over the blanket To provides extra warmth.
placing its centre at the centre of the
bed such that it covers the blanket
tuck top edge of the counter pan over
and under the top edge of the blanket.
27 Make a toe fold about 15 cm from the Ensure adequate space for the toes
bottom of mattress. under the sheet.
28 Tuck at the foot end altogether and tucking foot end keeps linen fixed on
make mitered corners on the sides. the bed

Place pillow with cover, keeping the

29 open end away from the entrance.

30 The top sheet, blankets and This is prepared in a hospital room

bedspreads(counter pane) are drawn up before a new patient is admitted to the
to the head of the mattress and under room
the pillow
31 AFTER PROCEDURE-
Help patient to get into bed.

32 Replace articles.
Wash hands Reduce risk of transmission of
microorganism.

OCCUPIED BED-

DEFINITION-Occupied the bed is making a comfortable bed when patient is unable to get out of the
bed. It is usually done by two persons.

Purpose-

 To provide a neat and clean bed.

 To refresh the patient who is confined to
the bed.
 To change the linen with the least possible
disturbance to the patient.
 To draw or fix the sheets under the
patients very firmly so that it would not
wrinkle.
 To remove crumbs from the bed.
 To make the patient feel comfortable.

Equipment of Occupied Bed Making:

The below equipment is very important for occupied bed making:

1. Bed or cot,
2. Mattress with cover,
3. Bed sheet -2,
4. Pillowcase -1 or 2,
5. 1 Protective sheet and cotton draw sheet,
6. Mackintosh-1,
7. Paper bag,
8. Chair-1,
9. Bucket-1.

PROCEDURE-

S. NO. NURSING ACTION RATIONAL

1. Assess patient`s general condition and Determines level of activity and ensure
check for any limitation in physical patent`s septic during the procedure
activity
2. Explained to patient the need for bed Facilitates patient cooperation.
making .
3. Wash hand Prevents spread of microorganisms
4. Assemble all equipment and arrange on Organized efforts facilitate easy of
the bed side chair in the order use performance oh task
5. Close door/ curtain Provides privacy
6. Loosen the top bedding from head end Makes removal of blanket easier.
foot end. Remove blanket living the top
sheet over the patients.
7. If blanket and bed spread are to be re- Facilitate replacement and prevents
used ,fold length wise and keep on the wrinkling .
chair. Length wise folding prevents
contamination of head end of sheet.
8. Position the patient on side on the far side Provides space for placement of fresh bed
of the bed facing away. lines . side rails ensure safety .
Adjust the pillow under the head. Be sure
that the farthest side rails are up .
9. Loosen bottom lines from end to foot end
on both side
10. Fan-fold the draw sheet towards the
patient and push it as closed to the patient
as possible .
11. Clean and roll the mackintosh toward the Provides maximum works space for
patient placing clean linen .
12. Fan-fold the bottom sheet toward the When the patient turns to the other side
patient. these soiled linen can be early removed.
13. Dust the mattress with dry duster . Dusting minimized the number of
microorganisms.
14. Apply clean bottom linen , which in fan- Applying linen over bed in successive
folded length wise to the exposed half the layers minimizes expenditure of time and
bed, keeping the center fold in center of energy.
the bed.
15. Fan-fold the bottom sheet towards the Keeping seam edges down eliminates
 patient .smoothen the bottom layer over irritation to patient`s skin. Mattress corner
the mattress and bring edge over near will secure the sheet on the bed .
side .
Allow the sheets to hang about 25 cm over
the mattress edge, make mitered corner at
the head end of the bed. Tuck hanging
sheets on the side till the foot end .the
lover hem of the bottom should be events
with the bottom edge of mattress .
16. Bring the mackintosh back into place it Protects bed linen from soiling.
using and it clean using dry dusters .place
the draw sheet over the mackintosh and
tuck both mackintosh and draw sheets
under the mattress.
17. Raise the side rails on working side and go Maintain safety.
to the other side
18. Remove the draw sheet by folding into a
bundle and place in the linen bad.
Remove the bottom sheet and put it in
linen bad. Clean and roll mackintosh
towards the patients
19. Pull taut and secure the bottom sheet Removes wrinkles and creases in linen ,
under the head of the mattress . miter which are uncomfortable to lie on .
corner .pull the side of the sheet taut and
tuck under the side of the mattress .
20. Assists the patient in rolling back to Maintains patient`s comfort.
supine position and reposition the pillow
21. Tuck the mackintosh and draw sheet in the Tucking will keep the bed firm.
same manner.
22. Place top sheet over the patient with Sheets should be equally distributed over
center-fold lengthwise down the middle of bed by correctly positioning the center fold.
the bed. Open the sheet from head to foot
and unfold it over the patient.
23. Asked the patient to hold the top linen and Top sheet prevent exposure of body part .
tuck around the shoulders . having patient the sheet encourage
Remove the used top sheet by pulling participation in care.
from down and place it in the linen bag.
24. Place the blanket over sheet as in an open Provide warmth for the patient .
bed
25. Make a horizontal toe pleat and modified Tucking the linen together gives neat
mitered corner in the foot end allowing appearance and toed pleat provides
the side to hang free adequate room for the legs under the sheets
.
26. Place the upper edge of blanket 5-6 inches Provides warmth for the patients. This type
lower than the top sheet as in open bed of fold, covering the upper edge of blanket
fold it the blanket`s upper border to from avoids irritation from direct contact of
a cuff patient`s skin with blanket .
27. Chang the pillow case and replace Maintains neat appearance
pillow/pillows with open end facing away
from door entrance to room
28. Place the call signal and all other tubing’s Ensures safety comfort
back and place the patient in comfortable
position.
29. Discard the dirty linen in the linen bag and Prevents and transmission of
 wash hands. microorganism
30 Record the observations made on the Provide accurate documentation .
patient in the nurses notes

CONCLUSION- Adequate supply and cleanliness of bedding linen and furniture is necessary
to provides an environment favorable to the recovery of the patient . provision of neat clean
linen is essential for assuring and protecting patient form cross infection .