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Andrew Pollack-Gray

Nursing Notes

Making an Occupied and Unoccupied Bed

4 min read

When & Why?

Clean, properly fitted linens help maintain hygiene, comfort, skin integrity, and a safe resident environment.
Unoccupied bed: Made while the resident is out of bed.
Occupied bed: Changed while the resident remains in bed.

Before You Start

Supplies

  • Fitted or bottom sheet.
  • Draw or lift sheet when used.
  • Incontinence pad if indicated.
  • Top sheet and blanket.
  • Pillowcase.
  • Bath blanket when appropriate.
  • Gloves and linen bag.

Preparation

  1. Perform hand hygiene.
  2. Explain the procedure and provide privacy.
  3. Gather linens and prepare a clean surface.
  4. Position the bed at a safe working height.
  5. Lock the bed wheels.
  6. Follow the care plan for assistance, positioning, and rails.

Steps

Unoccupied Bed

  1. Remove used linens without shaking them.
  2. Place soiled linens in the appropriate receptacle.
  3. Perform hand hygiene and change gloves as indicated.
  4. Apply the clean bottom sheet.
  5. Add the draw sheet and protective pad if indicated.
  6. Smooth wrinkles from the mattress surface.
  7. Add the top sheet and blanket.
  8. Make appropriate folds, including a toe pleat if required.
  9. Replace the pillowcase.
  10. Lower the bed and complete the safety check.

Occupied Bed

  1. Explain the procedure and assess the resident’s ability to assist.
  2. Provide privacy and cover the resident appropriately.
  3. Position the resident safely on one side, using assistance as required.
  4. Loosen soiled linens on the exposed side.
  5. Roll the soiled linens inward toward the resident.
  6. Place clean bottom linens on the exposed mattress, rolling excess fabric toward the resident.
  7. Assist the resident across to the clean side using safe repositioning techniques.
  8. Remove remaining soiled linens.
  9. Unroll and secure the clean bottom linens.
  10. Smooth wrinkles and position the resident comfortably.
  11. Replace upper bedding and pillowcase.
  12. Return the bed to the appropriate low position.
  13. Ensure the call light and required items are accessible.
  14. Perform hand hygiene and document as indicated.

Safety & Observations

Infection Prevention

  • Keep clean linens separate from used linens.
  • Do not shake or snap soiled linens.
  • Keep linens away from your uniform.
  • Do not place linens on the floor.
  • Follow PPE and hand-hygiene requirements.

Body Mechanics

  • Adjust bed height before working.
  • Avoid excessive bending, twisting, and reaching.
  • Ask for assistance when repositioning exceeds safe handling limits.
  • Use appropriate repositioning equipment.

Skin & Comfort

  • Remove wrinkles beneath the resident.
  • Check for moisture and soiling.
  • Observe pressure areas and report skin changes.
  • Respect pain, mobility restrictions, and positioning instructions.
  • Follow the individualized care plan regarding support surfaces and pads.

What Should I Remember?

Prepare → Protect resident → Remove soiled linens → Apply clean linens → Reposition → Safety check.
Instructor Terms:

  • Closed Bed: A fully made bed with top linens pulled up, prepared when the bed is not currently in use.
  • Open Bed: A bed with the top linens folded down to make it easier for the resident to enter.
  • Mitered Corner: A neat, angled fold that secures bedding around the mattress corner.
  • Toe Pleat: A small fold or loosened area in the top bedding that provides space for the resident’s feet and reduces pressure on the toes.
  • Draw Sheet: A sheet placed across the middle portion of the bed, sometimes used with appropriate assistance and technique for repositioning.
  • Bath Blanket: A lightweight blanket used to maintain warmth and privacy during personal care or linen changes.

Practice

  • Studied
  • Observed
  • Practiced
  • Passed checkoff

Sources

Flashcards

Why should soiled linen never be shaken?03-application / clinical-skills
Answer

It can spread contamination.

What is the main difference between occupied and unoccupied bedmaking?02-mechanisms / clinical-skills
Answer

The resident remains in the bed during occupied bedmaking.

What is an essential final safety check after bedmaking?03-application / clinical-skills
Answer

Bed low as appropriate, resident safe, call light accessible.

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