BED MAKING

Introduction
► A hospital bed is the piece of equipment most
frequently used by the hospitalized patient.
Hospital beds are also found in long-term care
facilities, as well as patient’s homes. The ideal
hospital bed should be selected for its impact on
patient’s comfort, safety, medical condition and
ability to change positions.

Definition:-
• The technique of preparing different types of
patient's comfortable bed in his/ her suitable
position for a particular condition.
• It is the process of making neat and clean bed for
the client in hospital.

Purpose:-
1. To provide clean, safe and comfortable bed for the
patient to promote rest and sleep.
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.
4. To economize time, material and energy.
5. To observe patient and to prevent complications.

► To achieve repositioning more easily.
► To keep it ready for emergency
► To provide active and passive exercises to the patient
► To establish rapport with the patient
► To observe the patient
► To relieve fatigue

Guidelines for Bed Making:-
• Wash hand thoroughly before and after handling clients bed
linen which helps to control nosocomial infection.
• Gather all the required linen and accessories before making the
bed.
• Avoid shaking the linen to prevent the spread of microorganisms
and dust particles.
• Avoid placing linens clean or dirty on another patient’s bed.
• Don’t place dirty linen on floor instead put in linen bag

Guidelines for Bed Making:-
• Do not hold dirty linen against your uniform.
• Always use good body mechanics; raise the bed to its
highest position to make bed making easier
• Stay on one side of the bed until it is completely made;
then move to the other side and finish the bed.
• Observe the patient and document any nursing
observations made.

Kinds of Linens:-
A Blanket: a large piece of cloth often soft, woollen and is
used for warmth as a bed cover.
B Top sheet: used to cover the patient to provide warmth,
made of thick cotton, thermal material
C Cotton draw sheet: a piece of cloth spread over the
rubber sheet and is used to absorb and moisture

Types of bed
► Open bed
► Closed bed
► Occupied bed
► Admission bed
► Post-operative bed
► Cardiac bed
► Amputation bed/Divided bed
► Fracture bed
► Therapeutic bed

Types of Bed Making:-
Common types of bed:
1- Open bed: the top covers are folded back so the patient
can easily get back in to bed. And is prepared for
ambulatory patients.
2- Closed bed: the top sheet blankets and bedspreads are
drawn up to the head of the mattress and under the pillow;
this is prepared in a hospital room before a new client is
admitted to the room. So also called admission bed.

Types of Bed Making:-
► 3- Post-operative bed: known as recovery bed or
anaesthetic or surgical bed, and used for a patient with
large cast or other circumstance that would make it
difficult for him to transfer and make it easy to receive
patient into bed from OT.
► 4- Amputation or Divided bed: This is a bed that is
prepared for a patient having amputed limb.

Types of Bed Making:-
► 5- Fracture bed: This is a hard firm bed designed for the
patient with fracture particularly of spine, pelvis or
femur.
► 6- Cardiac bed: this is prepared for patient with breathing
difficult and make use of cardiac table to relieve their
dyspnoea.
► 7 – Therapeutic bed: are used to treat clients with severe
joint contractures, prolonged immobility or skin wounds
such as pressure ulcers or severe burns. These beds
reduce or relive the effects of pressure against the skin
through various mechanisms. Few examples are blanket
bed or rheumatic/renal bed, burn bed etc.

Making Closed Bed:
Suggested Action :
Assessment
♣Check the room/ward for the need
of disinfection or hygienic level
Planning:
♣Prepare all required equipments:
► Trolley with –
► 1.Mattress (1)
► 2.Bed sheets(2):
Bottom sheet (1)
Top sheet (1)
Rationale
To determine what all type of
disinfection activities are required
Save time and make procedure more
organized

Making Closed Bed:
Suggested Action
4. Pillow cover (1)
5. Mackintosh (1)
6. Draw sheet (1)
7. Blanket (1)
8. A Tray containing:
Savlon water or Dettol water in basin
Sponge cloth (2):
to wipe with solution (1)
to dry (1)
Kidney tray or paper bag (1)
9. Laundry bag or Bucket or hamper bag
Rationale

Making Closed Bed:
Suggested Action
Implementation
♣Perform hand hygiene.
♣Prepare all required equipments and
bring the articles to the bedside.
♣Move the chair and bed side locker
♣Clean Bed-side locker:
Wipe with wet and dry.
Rationale
♣To prevent the spread of infection
♣Organization facilitates accurate skill
performance
♣It makes space for bed making and
helps effective action.
♣To maintain the cleanliness

Making Closed Bed:
Suggested Action
Implementation
♣Clean the mattress:
1)Stand in right side.
2)Start wet wiping from top to center and from
center to bottom in right side of mattress.
3)Gather the dust and debris to the bottom.
4)Collect them into kidney tray.
5)Give dry wiping as same as procedure
6)Move to left side and wipe with wet and dry as
same as above.
Rationale
♣To prevent the spread of infection

Making Closed Bed:
Suggested Action :
Implementation
♣Move to right side.
► Bottom sheet:
1)Place and slide the bottom sheet
upward over the top of the bed leaving
the bottom edge of the sheet.
2)Open it lengthwise with the center fold
along the bed center.
3)Fold back the upper layer of the sheet
toward the opposite side of the bed.
Rationale
♣Unfolding the sheet in this manner
allows you to make the bed on one
side.

Making Closed Bed:
Suggested Action
Implementation:
4. Tuck the bottom sheet securely under the head
of the mattress(approximately 20-30cm).
♣Make a mitered corner.
➀Pick up the selvage edge with your hand nearest
the hand of the bed.
➁Lay a triangle over the side of the bed
➂Tuck the hanging part of the sheet under the
mattress.
Rationale
♣A mitered corner has a
neat appearance and
keeps the sheet securely
under the mattress.

Making Closed Bed
Suggested Action
Implementation:
► ➃ Drop the triangle over the side
of the bed.
► ⑤Tuck the sheet under the entire
side of bed.
5) Repeat the same procedure at the
end of the corner of the bed
6) Tuck the remainder in long the side
Rationale
♣Tucking the bottom sheet will be
done by turn, the corner of top firstly
and the corner of the bottom later.
♣To secure the bottom sheet on one
side of the bed.

Making Closed Bed:
Suggested Action
♣Mackintosh and draw sheet:
1)Place a mackintosh at the middle of
the bed
2)Lift the right half and spread it
forward the near Side.
3)Tuck the mackintosh under the
mattress.
4)Place the draw sheet on the
mackintosh. Spread and tuck as same
as above procedure (1-3).
Rationale Implementation:
► ♣Mackintosh and draw sheet are
additional protection for the bed
and serves as a lifting or turning
sheet for an immobile client.

Making Closed Bed:
Suggested Action
♣Move to the left side of the bed.
Spreading Bottom sheet, mackintosh
and draw sheet:
1) Fold and tuck the bottom sheet as
same in the above procedure
2) Fold and tuck both the mackintosh
and the draw sheet under the
mattress as in the above procedure.
Rationale Implementation:
♣Secure the bottom sheet,
mackintosh and draw sheet on one
side of the bed

Making Closed Bed:
Suggested Action
Implementation:
► Return to the right side.
Top sheet and blanket:
1)Place the top sheet evenly on the bed, centering it in the
below 20-30cm from the top of the mattress.
2)Spread it downward.
3)Cover the top sheet with blanket in the below 1 feet from the
top of the mattress and spread downward.
4)Fold the cuff (approximately 1 feet) in the neck part
5)Tuck all these together under the bottom of mattress. Miter
the corner.
6)Tuck the remainder in along the side
Rationale
♣A blanket provides warmth.
♣Making the cuff at the neck part
prevents irritation from blanket edge.
♣Tucking all these pieces together saves
time and provides a neat appearance.

Making Closed Bed:
Suggested Action
Implementation:
♣Repeat the same as in the above
procedure in left side.
♣Return to the right side.
Pillow and pillow cover:
1)Put a clean pillow cover on the
pillow.
2) Place a pillow at the top of the bed
in the center with the open end away
from the door.
Rationale
♣To save time in this manner
♣A pillow is a comfortable measure.
♣Pillow cover keeps cleanliness of the
pillow and neat.
♣The open end may collect dust or
organisms. The open end away from
the door also makes neat.

Making Closed Bed:
Suggested Action
♣Return the bed, the chair and bed-
side table to their proper place.
♣Replace all equipments in proper
place. Discard linen appropriately.
♣Perform hand hygiene.
♣Document:
♣Document on the chart with your
signature and report any findings to
senior staff.
♣Date & time
♣Type of bed
♣Assessment findings observed during
procedure.
Rationale
♣ Bedside necessities will be within
easy reach for the client
♣ It makes well-setting for the
next. Proper line disposal
prevents the spread of infection.
♣ To prevent the spread of
infection
♣ Documentation provides
coordination of care.
♣ Giving signature maintains
professional accountability

Open Bed:
► An unoccupied bed is one that is made for an ambulatory
patient. The open bed has the linens folded down, making
it easier for the client to get into bed. Open a bed for a
new client or leave it open when the client is out of bed
for a short time.
Indication:
► Provide a clean, smooth and comfortable bed to the
patient.

Making Open Bed:
Suggested Action
Assessment:
♣Check the room/ward for the need of
disinfection or hygienic level
♣Explain the purpose and procedure to
the client
Planning:
♣Prepare all required equipments:
Trolley with –
1.Mattress (1)
2.Bed sheets(2):
Bottom sheet (1)
Top sheet (1)
Rationale
♣To determine what all type of
disinfection activities are required
♣Fosters cooperation
♣Save time and make procedure more
organized

Making Open Bed:
Suggested Action
3. Pillow (1)
4. Pillow cover (1)
5. Mackintosh (1)
6. Draw sheet (1)
7. Blanket (1)
8. A Tray containing: Savlon water or
Dettol water in basin Sponge cloth (2):
to wipe with solution (1) to dry (1)
Kidney tray or paper bag (1)
9. Laundry bag or Bucket or hamper bag
(1)
Rationale

Making Open Bed:
Suggested Action
♣Perform hand hygiene.
♣Prepare all required equipments and
bring the articles to the bedside.
♣Assist the patient out of bed
♣Remove the client’s personal belongings
from bed side and keep in locker/safe
place
♣Move the chair and bed side locker
♣Strip the bed clothes, fold them one by
one and place them.
Rationale Implementation:
♣To prevent the spread of
infection
♣Organization facilitates
accurate skill performance
♣To prevent the loss/damage
♣It makes space for bed
making and helps effective
action.
♣To prevent bed clothes
touching the floor

Stripping the Bed:
Removal of used linen and the airing of the mattress.
Procedure:
1- Place chair at the foot of the bed.
2- Locked the bed.
3- Remove pillow case from pillow. Place pillow on chair.
4- Loosen all bed linens starting at center of head of bed, raising the mattress with one hand
and draw out bed clothes with other.
5- Remove sheet separately. Fold each linen with soiled part inside. Wrap them all in a sheet
and place on lower bar of the bed.
6- Roll rubber sheet and place on chair.
7- Remove mattress cover.

Making Open Bed:
Suggested Action
Implementation:
♣Clean Bed-side locker:
Wipe with wet and dry.
♣Clean the mattress:
1)Stand in right side.
2)Start wet wiping from top to center and from center to bottom
in right side of mattress.
3)Gather the dust and debris to the bottom.
4)Collect them into kidney tray.
5)Give dry wiping as same as procedure
6)Move to left side and Wipe with wet and dry as same as above.
Rationale
♣To maintain the cleanliness
♣To prevent the spread of
infection

Making Open Bed:
► Place clean linens on chair in order of use.
► Cover mattress.
► Place bottom sheet with center fold in center in line with rim of
matters at foot part, spread across bed. Make mitered corner of head
part, tuck extra sheet at side from head of foot.
► Put rubber sheet 12-15 inches from the head of mattress. Cover with
draw sheet. Spread a cross bed. Tuck together extra length.
► Place top sheet in line with mattress at head part and spread across
bed. Similarly spread the blanket. Form a toe pleat as in the
procedure of closed bed. Tuck extra length of sheet at foot part,
mitered corner; allow hanging free at sides.

Making Open Bed:
▪ Go to opposite side and repeat same procedure.
▪ Grasp one corner of top sheet, fanfold at foot part or diagonally to
one side.

Making an Occupied Bed:
Some clients are unable to get out of bed as a result of their specific
condition or generalized weakness. Changing bed linens with the client in
the bed is known as making an occupied bed.
Indications: Provide clean and comfortable bed with least
disturbance to the patient in it.

Making Occupied Bed:
Suggested Action
Assessment:
♣Check the room/ward for the need of disinfection or
hygienic level
♣Explain the purpose and procedure to the client
♣To determine what all type of disinfection activities
are required
Planning:
♣Prepare all required equipments:
Trolley with –
1.Mattress (1)
2.Bed sheets(2):
Bottom sheet (1)
Rationale
♣Fosters cooperation
♣Save time and make procedure
more organized

Making Occupied Bed:
Suggested Action
3. Pillow (1)
4. Pillow cover (1)
5. Mackintosh (1)
6. Draw sheet (1)
7. Blanket (1)
8. A Tray containing:
Savlon water or Dettol water in basin
Sponge cloth (2): to wipe with solution (1)
to dry (1)
Kidney tray or paper bag (1)
9. Laundry bag or Bucket or hamper bag (1)
Rationale

Making Occupied Bed:
Suggested Action
Implementation:
♣Perform hand hygiene.
♣Prepare all required equipments and
bring the articles to the bedside.
♣Close the curtain/door
♣Remove the client’s personal belongings
from bed side and keep in locker/safe
place
♣Move the chair and bed side locker
♣Lift the client’s head and move pillow
from center to the left side.
Rationale
♣To prevent the spread of infection
♣Organization facilitates accurate skill
performance
♣To maintain privacy
♣To prevent the loss/damage
♣It makes space for bed making and
helps effective action.
♣The pillow is comfortable measure for
the client.

Making Occupied Bed:
Suggested Action
Implementation
♣Assist the client to turn toward
left side of the bed. Adjust the
pillow. Leaves top sheet in place.
♣Stand in right side: Loose
bottom bed linens. Fanfold (or
roll) soiled linens from the side of
the bed and wedge them close to
the client.
♣Wipe the surface of mattress by
sponge cloth with wet and dry.
Rationale
♣Moving the client as close to the
other side of the bed as possible
gives you more room to make the
bed. Top sheet keeps the client
warm and protect his or her privacy.
♣Placing folded (or rolled) soiled
linen close to the client allows more
space to place the clean bottom
sheets.
♣To prevent the spread of infection.

Making Occupied Bed:
Suggested Action
Implementation:
♣Bottom sheet, mackintosh and draw sheet:
1)Place the clean bottom sheet evenly on the bed folded lengthwise with
the center fold as close to the client’s back as possible.
2)Adjust and tuck the sheet tightly under the head of the mattress,
making mitered the upper corner.
3)Tighten the sheet under the end of the mattress and make mitered the
lower corner.
4)Tuck in along side.
5)Place the mackintosh and the draw sheet on the bottom sheet and tuck
in them together.
Rationale
♣Soiled linens can
easily be removed
and clean linens are
positioned to make
the other side of the
bed.

Making Occupied Bed:
Suggested Action
Implementation:
♣Assist the client to roll over the folded (rolled)
linen to right side of the bed. Adjust the pillow and
top sheet.
♣Move to left side: Discard the soiled linens
appropriately. Hold them away from your uniform.
Place them in the laundry bag (or bucket).
♣Wipe the surface of the mattress by sponge cloth
with wet and dry.
Rationale
♣Moving the client to the
bed’s other side allows you
to make the bed on that
side.
♣Soiled linens can
contaminate your uniform,
which may come into
contact with other clients.
♣To prevent the spread of
infection.

Making Occupied Bed:
Suggested Action
Implementation:
♣Bottom sheet, mackintosh and draw sheet:
1)Grasp clean linens and gently pull them out from under the client.
2)Spread them over the bed’s unmade side. Pull the linen.
3)Tuck the bottom sheet tightly under the head of the mattress and
miter the corner.
4)Tighten the sheet under the end of the mattress and make mitered
the lower corner.
5)Tuck in along side.
6)Tuck the mackintosh and the draw sheet under the mattress.
Rationale
♣Wrinkled linens
can cause skin
irritation.

Making Occupied Bed:
Suggested Action
Implementation:
♣Assist the client back to the center of the bed. Adjust the
pillow
♣Return to right side:
♣Clean top sheet, blanket:
1)Place the clean top sheet at the top side of the soiled top
sheet.
2)Ask the client to hold the upper edge of the clean top
sheet.
3)Hold both the top of the soiled sheet and the end of the
clean sheet with right hand and withdraw to downward.
Remove the soiled top sheet and put it into a laundry bag.
Rationale
♣The pillow is comfort
measure for the client.
♣Tucking these pieces
together saves time and
provides neat, tight corners.

Making Occupied Bed:
Suggested Action
Implementation:
3) Place the blanket over the top sheet. Fold top sheet
back over the blanket over the client.
4) Tuck the lower ends securely under the mattress.
miter corners.
5) After finishing the right side, repeat the left side.
♣Remove the pillow and replace the pillow cover with
clean one and reposition the pillow to the bed under
the client’s head.
Rationale
♣The pillow is a
comfortable
measures for a
client

Making Closed Bed:
Suggested Action
Evaluation
► Return the bed, the chair and bed-side table to their proper
place.
► Replace all equipments in proper place. Discard linen
appropriately.
► Perform hand hygiene.
Document:
► Document on the chart with your signature and report any
findings to senior staff.
► Date & time
► Type of bed
► Assessment findings observed during procedure.
Rationale
► Bedside necessities will be within easy
reach for the client
► It makes well-setting for the next.
Proper line disposal prevents the spread
of infection.
► To prevent the spread of infection
► Documentation provides coordination of
care.
► Giving signature maintains professional
accountability

Purpose
• To provide warmth and comfort for the patient.
• To provide protection for the bed from vomiting,
bleeding, drainage and discharge.
• To arrange the bed and other furniture in order to
facilitate the transfer of the patient from stretcher
to bed.

Making Post Operative Bed:
Suggested Action
Assessment:
♣Check the room/ward for the need of
disinfection or hygienic level
♣Explain the purpose and procedure
Planning:
♣Prepare all required equipments:
The same linen as those used for making on
occupied bed plus the following –
Bath towel
Rationale
♣To determine what all type
of disinfection activities are
required
♣Fosters cooperation
♣Save time and make
procedure more organized

Making Post Operative Bed:
Suggested Action
Small rubber sheet
Woollen blanket
3 hot water bags w/cover
On the Bedside Table:
► Stethoscope
► Sphygmomanometer
► Kidney basin
► Swipes
► Padded tongue depressor
► Observation Sheet
In the Room
► Oxygen cylinder with complete tubings
Rationale

Making Post Operative Bed:
Suggested Action
► Humidifier and nasal catheter
► Suction apparatus
► Stand
► Drainage bottles
► Shock blocks
► Iv stand
Rationale

Making Post Operative Bed:
Suggested Action
Implementation:
♣Perform hand hygiene.
♣Prepare all required equipments and
bring the articles to the bedside.
♣Move the chair and bed side locker
♣Strip bed. Make foundation bed as
usual with a large mackintosh, and
cotton draw sheet.
Rationale
♣To prevent the spread of infection
♣Organization facilitates accurate skill
performance
♣It makes space for bed making and
helps effective action.
♣Mackintosh prevents bottom sheet from
wetting or soiled by sweat, drain or
excrement. Cotton draw sheet makes the
client felt dry or comfortable without
touching the mackintosh directly.

Making Post Operative Bed:
Suggested Action
♣Place top bedding as for closed bed
but do not tuck at foot
♣Fold back top bedding at the foot of
bed.
♣Tuck the top bedding on one side
only.
♣On the other side, do not tuck the
top sheet. 1)Bring head and foot
corners of it at the center of bed and
form right angles.
Rationale Implementation:
♣Tuck at foot may hamper the client
to enter the bed from a stretcher
♣To make the client’s transfer smooth
♣Tucking the top bedding on one side
stops the bed linens from slipping out
of place
♣The open side of bed is more
convenient for receiving client than
the other closed side.

Making Post Operative Bed:
Suggested Action
Implementation:
2) Fold back suspending portion in 1/3
and repeat folding top bedding twice
to opposite side of bed
♣Remove the pillow.
♣Place a kidney-tray on bed- side.
♣Place IV stand near the bed.
♣Check locked wheel of the bed.
Rationale
♣To maintain the airway
♣To receive secretion
♣To prepare it to hang I/V soon
♣To prevent moving the bed
accidentally when the client is shifted
from a stretcher to the bed.

Making Post Operative Bed:
Suggested Action
Implementation:
♣Put the hot water bags at the foot
and center of the bed if the weather
is cold.
♣Place the necessary articles on the
bedside table and the irrigating stand,
suction machine and oxygen set-up
adjacent to the bed.
♣Arrange unit.
Rationale
► Hot water bags (or hot bottles)
prevent the client from taking
hypothermia & remove it before
receiving the patient.

Making Post Operative Bed:
Suggested Action
Evaluation:
► Return the bed, the chair and bed-side table to their proper
place.
► Replace all equipments in proper place.
► Perform hand hygiene.
Document:
► Document on the chart with your signature and report any
findings to senior staff.
► Date & time
► Type of bed
► Assessment findings observed during procedure.
Rationale
► Bedside necessities will be
within easy reach for the client
► It makes well-setting for the
next.
► To prevent the spread of
infection
► Documentation provides
coordination of care.
► Giving signature maintains
professional accountability

Purpose
► This bed is made to facilitates the dressing of the stump
► To ensure that the stump is visible to the staff moving
about the ward, so that at a glance any haemorrhage may
be observed.
► Keep the stump in good position.

Articles Required:-
► All the article as per unoccupied bed
EXTRA REQUIREMENT
⮚ A bed cradle
⮚ Two sand bags
⮚ Pillow with water proof cover
⮚ A bed linen

Procedure:
• Gather all the needed supplies.
• Make the bed as though you are making an unoccupied bed.
• The foot end side of the top linen is folded back to the head
end at the level of the part to be observed. (if below knee
amputation).
• Spread the second set of linen starting from the level of stump.
• The second set of top linen should overlap the first by 8 to 12
inches.
• Receive the patient and elevate the stump on a small pillow
and place the sand bag on either side to support the stump.
• Place the bed cradle in position & cover the patient.

Fracture bed
► This is a hard firm bed designed for the patient with
fracture particularly of spine, pelvis or femur.

Fracture Bed
Indications:
► Aid in immobilizing the fracture
► Prevent unnecessary pain
► Provide warmth and comfort to the patient
► Prevent undue sagging of the mattress

Articles Required:

Procedure:
• Gather all needed supplies. Place the fracture board
directly over the bed/cot.
• Make the bed as an open bed and spread cover sheet
between the bottom and top sheet. Place hot water bottles
in between to warm the bed. (Optional)
• Place the sand bags to support the part in order to
maintain the position.
• When the patient is received in bed, place the cradle over
the fractured part and cover it.

Cardiac Bed:
Cardiac bed is made with special arrangements,
which are required by a cardiac patient. Cardiac patient’s
bed is made in a manner to ease the respiration of patient.
Bed is provided with extra pillows to be kept on head side of
patient to keep the patient in prop up position for better
airflow.
There is special cardiac table provided with the
patient’s bed with all equipment available for emergency
cardiovascular support, like oxygen masks, nasogastric tubes
etc.