AKLAN STATE UNIVERSITY

School of Arts and Sciences

Bachelor of Science in Nursing
Banga, Aklan

NAME DATE
COURSE & SEC RLE GROUP

CHANGING AN OCCUPIED BED

DEFINITION:
● Making an occupied bed refers to changing beddings while the customer is still in bed.

PURPOSES:
• To conserve the client's energy.
• To promote client comfort.
• To provide a clean, neat environment for the client.
• To provide a smooth, wrinkle-free bed foundation, thus minimizing sources of skin irritation.

PROCEDURE RATIONALE

ASSESSMENT
1. Assess the client’s skin condition. • To assess the need for a special mattress (e.g.,
an egg-crate mattress), footboard, or heel
protectors.
2. Assess client's ability to reposition self. • This will determine if additional assistance is
needed.

3. Determine presence of incontinence or • To assess the need for protective waterproof

excessive drainage from other sources pads.
4. Determine what linens the client may already • This avoids stockpiling unnecessary extra linens.
have in the room.
PLANNING
Prepare the needed equipment
• Two flat sheets or one fitted and one flat sheet
• Cloth drawsheet (optional)
• One blanket
• One bedspread
• Incontinent pads (optional)
• Pillowcase(s) for the head pillow(s)
• Plastic laundry bag or portable linen hamper, if available
• Three pair of gloves
Alcohol-based handrub
IMPLEMENTATION
5. Assemble equipment and arrange on bedside • Organization facilitates systematic performance
chair in the order the items will be used. of the task
6. Prior to performing the procedure introduce • Patient identification validates the correct
self and verify the client's identity using patient and correct procedure. Also to ally
agency protocol. Explain to the client what you anxiety and gain participation
are going to do, why it is necessary, and how
•
he or she can participate.
7. Perform hand hygiene and observe other • To prevent the spread of infection
appropriate infection control procedures.
Apply clean gloves if the linen is soiled with
body fluids.
8. Close curtains around the bed and close the • To provide privacy.
door to the room, if possible.
9. Adjust bed to safe working level, usually waist • Having the bed at he proper height prevents
high. Lower head of bed. Lock bed wheels. back and muscle strain
•
10. Remove the top bedding.
• Remove any equipment attached to the bed • Disconnecting tubes from linens prevents
linen, such as a signal light. discomfort and accidental dislodging of the
• Loosen all top linen at the foot of the bed, and tubes.
remove the spread and the blanket.
• Leave the top sheet over the client, or replace
it with a bath blanket as follows: • The top sheet can remain over the client if it is
a. Spread the bath blanket over the top being changed and if it will provide sufficient
sheet. warmth.
b. Ask the client to hold the top edge of the
blanket.
c. 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.
d. Remove the sheet from the bed and
place it in the soiled linen hamper.

11. Change the bottom sheet and draw sheet.

• Raise the side rail that the client will turn • This protects clients from falling and allows
toward. them to support themselves in the side-lying
• Assist the client to turn on the side away from position. If there is no side rail, have another
the nurse and toward the raised side rail. nurse support the client at the edge of the bed.
• Loosen the bottom linens on the side of the
bed near the nurse.
• Fanfold the dirty linen (i.e., drawsheet and • Doing this leaves the near half of the bed free to
the bottom sheet) toward the center of the be changed.
bed as close to and under the client as
possible.
• Remove your gloves, do hand hygiene and • To prevent contaminating the new linens.
put on new set of clean gloves.
• Place the new bottom sheet on the bed, and
vertically fan-fold the half to be used on the
far side of the bed as close to the client as
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 on 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, over
the fanfolded bed linens at the center of the
bed, onto the clean side of the bed.
• Move the pillows to the clean side for the
client'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.
• To prevent contaminating the new linens.
• Remove your gloves, do hand hygiene and
put on new set of clean gloves.
• Unfold the fanfolded 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 the 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 divisions:
a) Face the side of the bed to pull the
middle division,
b) face the far top corner to pull the bottom
division, and
c) face the far bottom corner to pull the top
division.
• Tuck the excess drawsheet under the side of
the mattress.

12. 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.
13. Apply or complete the top bedding. • The sheet should remain over the client when
• Spread the top sheet over the client and the bath blanket or used sheet is removed.
either ask the client to hold the top edge of
the sheet or tuck it under the shoulders.
• Complete the top of the bed.

14. Ensure continued safety of the client.

• Raise the side rails. Place the bed in the low
position before leaving the bedside.

• Attach the call light to the bed linen within the

client's reach.
• Put items used by the client within easy
reach.

EVALUATION
15. Conduct appropriate follow-up, such as
determining client's comfort and safety,
patency of all drainage tubes, and client's
access to call light to summon help when
needed.
• Reassess all tubing, oxygen apparatus, IV • This prevents errors in supportive devices
pumps, and so forth. resulting from procedure.
 AKLAN STATE UNIVERSITY
School of Arts and Sciences
Bachelor of Science in Nursing
Banga, Aklan

NAME DATE
COURSE & SEC RLE GROUP

CHECKLIST ON CHANGING AN OCCUPIED BED

PROCEDURE PERFORMED PERFORMED UNABLE TO

COMPLETELY INCOMPLETELY PERFORMED
(2) (1) (0)
ASSESSMENT
1. Assess skin condition and need for a special
mattress (e.g., an egg-crate mattress),
footboard, or heel protectors.
2. Assess client's ability to reposition self.
3. Determine presence of incontinence or
excessive drainage from other sources
indicating the need for protective waterproof
pads.
4. Determine what linens the client may already
have in the room.
PLANNING
5. Assemble equipment and arrange on bedside
chair in the order the items will be used.
IMPLEMENTATION
6. Prior to performing the procedure introduce self
and verify the client's identity using agency
protocol. Explain to the client what you are
going to do, why it is necessary, and how he or
she can participate.
7. Perform hand hygiene and observe other
appropriate infection control procedures. Apply
clean gloves if the linen is soiled with body
fluids.
8. Close curtains around the bed and close the door
to the room, if possible.
9. Adjust bed to safe working level, usually waist
high. Lower head of bed. Lock bed wheels.
10. Remove any equipment attached to the bed
linen, such as a signal light.
11. Remove the top bedding by loosening all top
linen at the foot of the bed, and remove the
spread and the blanket.
12. Leave the top sheet over the client, or replace it
with a bath blanket as follows:
a. Spread the bath blanket over the top
sheet.
b. Ask the client to hold the top edge of
the blanket.
c. 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
d. Remove the sheet from the bed and
place it in the soiled linen hamper.
Changing the bottom sheet and draw sheet.
13. Raise the side rail that the client will turn
toward.
14. Assist the client to turn on the side away from
the nurse and toward the raised side rail.
15. Loosen the bottom linens on the side of the bed
near the nurse.
16. Fanfold the dirty linen (i.e., drawsheet and the
bottom sheet) toward the center of the bed as
close to and under the client as possible.
17. Remove your gloves, do hand hygiene and put
on new set of clean gloves.
18. Place the new bottom sheet on the bed, and
vertically fan-fold the half to be used on the far
side of the bed as close to the client as
possible. Tuck the sheet under the near half of
the bed and miter the corner if a contour sheet
is not being used.
19. Place the clean drawsheet on 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.
20. Assist the client to roll over toward you, over the
fan-folded bed linens at the center of the bed,
onto the clean side of the bed.
21. Move the pillows to the clean side for the
client's use. Raise the side rail before leaving
the side of the bed.
22. Move to the other side of the bed and lower the
side rail.
23. Remove the used linen and place it in the
portable hamper. Remove gloves, do proper
hand hygiene and wear new set of clean
gloves.
24. Unfold the fan-folded bottom sheet from the
center of the bed.
25. Facing the side of the bed, use both hands to
pull the bottom sheet so that it is smooth and
tuck the excess under the side of the mattress
26. Unfold the drawsheet fan-folded at the center of
the bed and pull it tightly with both hands. Pull
the sheet in three divisions:
a) Face the side of the bed to pull the middle
division,
b) face the far top corner to pull the bottom
division, and
c) face the far bottom corner to pull the top
division.
27. Tuck the excess drawsheet under the side of
the mattress.
28. 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.
29. 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.
30. Ensure continued safety of the client.
• Raise the side rails. Place the bed in the low
position before leaving the bedside.

• Attach the call light to the bed linen within the

client's reach.
• Put items used by the client within easy reach.
EVALUATION
31. Conduct appropriate follow-up, such as
determining client's comfort and safety, patency
of all drainage tubes, and client's access to call
light to summon help when needed.
• Reassess all tubing, oxygen apparatus, IV
pumps, and so forth.
DOCUMENTATION
32. Document all what have been done from the
start up to the end of changing the patient’s
bed.
TOTAL

Remarks:

_____________________________________________________________________________________________
_____________________________________________________________________________________________

Grade: __________________

Rating Scale:

Excellent : 96 - 100%
Very Satisfactory : 90 - 95%
Very Good : 85 - 89%
Good : 80 - 84%
Fair : 75 - 79%
Poor : 74 & below

Clinical Instructor Student’s Signature