The Core Principles of Bed Making
Regardless of the specific type, all bed making shares core principles that prioritize patient safety, comfort, and infection control. These include gathering all necessary supplies beforehand, maintaining proper body mechanics to prevent injury, following facility-specific protocols for handling soiled linens, and ensuring the final bed is smooth and wrinkle-free to prevent skin irritation and pressure ulcers.
Preparing for Unoccupied Bed Making
Before making an empty bed, the caregiver should gather fresh linens, including a fitted sheet, top sheet, and pillowcases. If required, a draw sheet or incontinence pad should also be ready. The process begins with proper hand hygiene and, if the old linens are soiled, the use of personal protective equipment (PPE). The bed should be raised to a comfortable working height to prevent back strain for the caregiver. Soiled linens are carefully removed, rolled inward to contain contaminants, and placed directly into a designated hamper without touching the caregiver's uniform or being shaken, which could spread microorganisms.
Different Types of Unoccupied Beds
There are several configurations for beds that are not currently occupied by a patient.
Closed Bed
A closed bed is prepared for a new admission and is not yet in use. This method keeps the bed clean and tidy until a patient is assigned to it. The top sheet, blanket, and bedspread are pulled up to the head of the mattress, covering the entire bed and preventing dust accumulation. The corners are typically mitered to create a neat, firm appearance.
Open Bed
An open bed is a bed that is currently assigned to a patient who is temporarily out of bed, such as for a shower or physical therapy. To make an open bed, the top covers (top sheet and blanket) are fan-folded or folded back to the foot of the bed. This makes it easy for the patient to get back into bed without the caregiver having to pull back the covers.
Surgical Bed (or Post-operative Bed)
Also known as a recovery or anesthesia bed, a surgical bed is made for a patient returning from surgery or another procedure. This bed is prepared to receive the patient directly from a stretcher. The top linens are fan-folded to one side, or to the middle, to allow for easy patient transfer. A disposable waterproof pad is often placed at the head of the bed to protect against emesis (vomit). The bed is left in a high position with the wheels locked to facilitate the transfer from the stretcher.
Making an Occupied Bed
An occupied bed is made while the patient is still in it, for those who are unable to get out of bed. This is a crucial skill for preventing skin breakdown and maintaining patient hygiene and comfort. The process requires careful coordination to ensure the patient's safety and privacy throughout. The caregiver works on one side of the bed at a time, rolling the patient gently to the far side, then changing the linens on the exposed half of the bed. The process is then repeated on the other side.
Key steps include:
- Explain the procedure: Tell the patient what you are doing and how they can assist. This ensures cooperation and provides comfort.
- Maintain side rails: Keep the side rail up on the opposite side of the bed to prevent the patient from falling.
- Use proper body mechanics: Raise the bed to a working height to prevent back strain.
- Work in sections: Roll the patient to one side, roll soiled linens toward the patient's back, place new bottom linens, and tuck them in. Then, roll the patient over the 'hump' of linens to the clean side.
- Remove soiled linens: Take away the old sheets and immediately place them in the laundry hamper.
- Complete the bed: Pull the clean linens taut, make the final touches, and change the pillowcase.
Specialized Bed Making Techniques
Beyond the primary types, there are specialized techniques used for particular patient needs.
Cradle Bed
A cradle bed uses a frame, typically made of metal, that is placed over the patient's legs. The top covers are draped over this frame, preventing the bedding from touching the patient's feet or legs. This technique is used for patients with burns, skin lesions, or other conditions where pressure from bed linens would cause pain or discomfort. It prevents complications like foot drop by alleviating pressure.
Fanfold Bed
A fanfold is a simple but important technique used for open beds, where the top covers are folded back in a specific, accordion-like manner. The fanfold, which often refers to folding the edges of the sheet 6-8 inches outward, allows a patient to get into bed easily by simply pulling the top covers over them.
Comparison of Bed Making Types
| Feature | Closed Bed | Open Bed | Occupied Bed | Surgical Bed | Cradle Bed |
|---|---|---|---|---|---|
| Purpose | Prepare for new admission | For an existing patient temporarily out of bed | For an immobile patient who cannot get out of bed | For patient returning from surgery or procedure | For patients sensitive to leg/foot pressure |
| Patient Status | Empty/unoccupied | Temporarily unoccupied | Patient is in bed | Empty, awaiting patient transfer from stretcher | Patient is in bed |
| Linens Position | Covers pulled up to head, neat and tidy | Top covers fan-folded to foot | Changed in halves, working around the patient | Top covers fan-folded to one side or middle | Top covers placed over a frame |
| Primary Concern | Cleanliness and readiness | Ease of entry for patient | Safety, comfort, and prevention of pressure sores | Ease of transfer and readiness for patient recovery | Pressure relief and protection from linens |
The Importance of Quality Bed Making for Senior Care
For aging adults, the quality of a made bed has a direct impact on health and well-being. A smooth, clean, and properly made bed can prevent pressure ulcers (bedsores), improve skin integrity, and promote restful sleep. Good sleep hygiene, including a comfortable and tidy bed, is linked to better mental health and a sense of accomplishment and calm. For bedridden seniors, a carefully executed occupied bed change is a critical part of their daily care routine, reducing the risk of complications from prolonged immobility.
Conclusion
Bed making is far more than a simple housekeeping chore in a healthcare setting—it is a skilled procedure with significant implications for patient safety, comfort, and hygiene. From the straightforward preparation of a closed bed for a new resident to the careful maneuver of making an occupied bed for an immobile patient, each type of bed making serves a vital function. Mastering these techniques is essential for any caregiver to provide high-quality, dignified care to those who are most vulnerable.
For more information on best practices in patient care and safety, consult reliable resources such as the National Institutes of Health.
