Changing an Occupied Bed
Some clients may be too weak to get out of bed. Either the nature of their illness may
contraindicate their sitting out of bed, or they may be restricted in bed by the presence
of traction or other therapies. When changing an occupied bed, the nurse works quickly
and disturbs the client as little as possible to conserve client’s energy.
Guidelines in changing an occupied Bed:
 Maintain the client in good body alignment. Never move or position the client in
a manner that is contraindicated by the client’s health. Obtain help if necessary to
ensure safety.
 Move the client gently and smoothly. Rough handling can cause the client
discomfort and abrade the skin.
 Explain what you plan to do throughout the procedure before you do it. Use
terms that are easy to understand.
 Use the bed-making time, like the bath time, to assess and meet the client’s
needs.
PURPOSE:
1. To conserve the client’s energy and maintain current healthy status.
2. To promote client comfort
3. To provide a clean, neat environment for the client
4. To provide a smooth, wrinkle-free bed foundation, thus minimizing sources of
skin irritation.
ASSESSMENT
1. Note specific orders or precautions for moving and positioning the client
2. Determine presence of incontinence or excessive drainage from other sources
indicating the need to protective waterproof pads.
3. Assess skin condition and need for special mattress, footboard or heel protectors
DELEGATION
Bed-making is usually delegated to UAP. Inform the UAP to what extent the
client can assist or if another person will be needed to assist the UAP. Instruct the UAP
about handling of any dressings and tubes of the client and also the need for special
equipment (footboard or heel protectors), if appropriate.
Commented [adelfamae1]: Patient: Bale ano po, ang
sabi lang naman po ng doktor, ay... na..hilo lang po ako kaya
nahulog sa upuan. Student Nurse: Nahilo po ba talaga kayo?
Patient: Opo. Student Nurse: Ahh, kasasayaw. Ano po ba
yon? Activity sa school? Patient:Ah, hindi po. Laro-laro po.
Studeny Nurse: Ah, nagkaroon po ba ng mga bali caused by
that accident? Patient: Hindi, wala naman po. Student
Nurse: Ilang taon po kayo non? Patient: Hindi ko na
matandaan, I think, grade 1 or grade 2? Student Nurse:
Grade 1 or grade 2... so mga 7 or 8 years old po? Patient:
Oo. Student Nurse: Nagkaroon po ba ng complications after
that? May naapektuhan po bang ibang parts ng body?
Patient: Wala naman. Student Nurse: Naospital na po ba
kayo because of some serious illness? Patient: Ah, naospital
ako dahil don. Student Nurse: Dahil don sa, sa aksidente?
Nahulog kayo. Patient: Oo. Dun lang.
Commented [adelfamae2]: Patient: Ah, napansin ko na
namamayat ako. Tumataas blood sugar level. Mga 2014
yon. Student nurse: yung onset po ba ng symptoms ay
biglaan? O paunti unti po yung paglabas? Patient: Ah, unti
unti. Student nurse: so ah nabanggit niyo po na isa po sa
napansin niyong sintomas ay yung biglaang pagjaroon ng
weight loss. How about for the last three months po?
Patient: Meron, minsan bumababa minsan tumataas.
Student: Ah so nagffluctuate po no? Uh.. intentional po ba
to or not? Patient: Unintentional po. Student nurse: Ah, so
unintentional po... sa tingin niyo po if not because of a
special diet, bakit po may fluctuations sa weight? Patient:
ah.. nag eexercise ako. Uhmm gumagawa ng mga gawaing
bahay, nagwwalking. Student nurse: Gaano kadalas naman
po kayo mag exercise? Patient: Ah, yung walking ko kung
minsan hindi ko ginagawa pag umuulan. Yung exercise
naman every other day. Student nurse: ah.. every other
day.. pag nag eexercise po
Commented [adelfamae3]: Student Nurse: Ah, surgeries
po? Wala naman? Patient: Wala. Student Nurse: Vitamins
po, nagtatake po ba? Supplements? Patient: Opo vitamins.
Yung pang ah.. for vitamin c.. ah para sumigla.. for immunity
ganon. Student nurse: vitamin c... okay so.. medications po?
For a certain illness? Currently? Patient: Meron. Metformin
for my diabetes milletus, type 2. Student nurse: Ahh for
diabetes. Gano na po katagal kayong may diabetes? Patient:
Pagpalagay po natin since 2014. Student nurse: so four
years na rin po, ano. Ah, may family members po ba na may
diabetes din? And ilan po? Patient: Meron po, mga dalawa
po. Ah, tatlo pala bale yung tatay ko at yung dalawa kong
kapatid na lalake. Student nurse: Ayon po. So nasa pamilya
niyo po ba, sa lahi ang pagiging diabetic? Patient: Yes.
Student: So.. pano niyo po nalama,na may diabetes kayo? At
kailan po?
EQUIPMENTS
1. Two flat sheets or one fitted and one flat sheet
2. Cloth drawsheet (optional)
3. One blanket
4. One bedspread
5. Waterproof drawsheet/ Waterproof pads (optional)
6. Pillowcases
7. Plastic laundry bag/Portable linen hamper

IMPLEMENTATION
1. Explain to the client what you are going to do, why is it necessary, and how he
or she can cooperate
2. Wash hands and observe other appropriate infection control procedure. Put on
disposable gloves if linen is soiled with body fluids.
3. Provide for client’s privacy
4. Remove the top bedding
 Remove any equipment attached to the bed linen, such as 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 (the top sheet can remain over the client if it
is being changed and if it will provide sufficient warmth) or replace it with bath blanket
as follows:
a. Ask the client to hold the top edge of the blanket
b. 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.
c. Remove the sheet from the bed and place it in the soiled linen hamper
5. Change the bottom sheet and draw sheet
 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. This protects the client from falling. 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
thec client as possible. Doing this leaves the near half of the bed free to be changed.
 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 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 onto the clean side of the bed. The client
rolls over the fanfolded linen at the center 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
 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 into three sections;
a. Face the side of the bed to pull the middle section
b. Face the far top corner to pull the bottom section
c. 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 shoulder. The sheet should remain over the client
when the bath blanket or used sheet is removed.
 Complete the top of the bed

8. Ensure continue safety of the client

 Raise the side rails. Place the bed in the low position before leaving the bed side.
 Attach the signal cord to the bed linen within the client’s reach
 Put items used by the client within easy reach

9. Bed-making is not normally recorded.

EVALUATION
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.