Assessment:
Assess client’s health status to determine that the person can safely get out of bed and the client’s pulse and respirations, if indicated. Note all the tubes and equipment connected to the client.
Planning:
Assemble all equipments and supplies: Two flat sheets, or one fitted and one flat sheet. Cloth drawsheet (optional), One blanket, One bedspread, Waterproof drawsheet or waterproof draw pads (optional), Pillowcases for the head pillows and Plastic laundry bag or portable linen hamper, if available.
Implementation:
Explain to the client what you are going to do, why it is necessary, and how she can cooperate. Wash hands and observe other appropriate infection control procedures. Provide for client privacy. Place the fresh linen on the client’s chair or overbed table; do not use another client’s bed. Assess and assist the client out of bed. Make sure that this is an appropriate and convenient time for the client to be out of bed. Assist the client to a comfortable chair. Strip the bed.
Check bed linen for any items belonging to the client, and detach the call bell or any drainage tubes from the bed linen. Loosen all bedding systemically, starting at the head of the bed on the far side and moving around the bed up to the head of the bed on the near side. Remove the pillowcases, if soiled and place the pillows on the bedside near the foot of the bed. Fold reusable linens, such as the bedspread and top sheet on the bed, into fourths. First, fold the linen in half by bringing the top edge even with the bottom edge, and then grasp it at the center of the middle fold and bottom edges. Remove the waterproof pad and discard it, if soiled. Roll all soiled linen inside the bottom sheet, hold it away from your uniform, and place it directly in the linen hamper. Grasp the mattress securely, using the lugs, if present, and move the mattress up to the head of the bed.
Apply the bottom sheet and drawsheet. Place the folded bottom sheet with its center fold on the center of the bed. Make sure the sheet is hem-side down for a smooth foundation. Spread the sheet out over the mattress, and allow a sufficient amount of sheet at the top to tuck under the mattress. Miter the sheet at the top comer on the near side and tuck the sheet under the mattress, working from the head of the bed to the foot. If a waterproof drawsheet is used, place it over the bottom sheet so that the center fold is a the center line of the bed and the top and bottom edges extend from the middle of the client’s back to the area of the mid-thigh or knee. Fanfold the uppermost half of the folded drawsheet at the center or far edge of the bed, and tuck in the near edge.
Lay the cloth drawsheet over the waterproof sheet in the same manner. Before moving to the other side of the bed, place the top linens on the bed hem-side up, unfold them, tuck them in, and miter the bottom corners. Move to the other side and secure the bottom. Move to the other side and secure the bottom linens. Tuck in the bottom sheet under the head of the mattress, pull the sheet firmly, and miter the corner of the sheet. Pull the remainder of the sheet firmly so that there are no wrinkles. Complete this same process for the drawsheets(s). Apply or complete the top sheet, blanket and spread. Place the top sheet, hem side-up, on the bed so that its center fold is at the center of the bed and the top edge is even with the top edge of the mattress.
Unfold the sheet over the bed. Make a vertical or a horizontal toe pleat in the sheet to provide additional room for the client’s feet. Vertical toe pleat- Make a fold in the sheet 5-10 cm (2-4 in) perpendicular to the foot of the bed. Horizontal toe pleat -Make a fold in the sheet 5-10 cm (2-4 in) across the bed near the foot. Follow the same procedure for the blanket and the spread, but place the top edges about 15 cm (6 in) from the head of the bed to allow cuff of sheet to be folded over them Tuck in the sheet, blanket and spread at the foot of the bed, and miter the corner, using all three layers of linen. Leave the sides of the top sheet, blanket, and spread hanging freely, unless toe pleats were provided. Fold the top of the top sheet down over the spread, providing a cuff. Move to the other side of the bed, and secure the top bedding in the same manner.
Put clean pillowcases on the pillows as required. Grasp the closed end of the pillowcase at the center with one hand. Gather up the sides of the pillowcase, and place them over the hand grasping the case. Then grasp the center of the one short side of the pillow through the pillowcase. With the freehand, pull the pillowcase over the pillow. Adjust the pillowcase so that the pillow fits into the corners of the case and the seams are straight. Place the pillows appropriately at the head of the bed.
Provide for client comfort and safety. Attach the signal cord so that the client can conveniently use it. If the bed is currently being used by a client, either fold back the top covers at one side or fanfold them down to the center of the bed. Place the bedside table and the overbed table so that they are available to the client. Leave the bed in the high position if the client is returning by stretcher, or place in the low position if the client is returning to bed after being up. Document and report pertinent data.
