Goal: The bed linens are changed without injury to the patient or nurse.
1. Assemble equipment and arrange on a bedside chair in the order in which items will be used.
2. Perform hand hygiene. Put on PPE, as indicated.
3. Adjust the bed to a comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009). Drop the side rails.
4. Disconnect call bell or any tubes from bed linens.
5. Put on gloves. Loosen all linen as you move around the bed, from the head of the bed on the far side to the head of the bed on the near side.
6. Fold reusable linens, such as sheets, blankets, or spread, in place on the bed in fourths and hang them over a clean chair.
7. Snugly roll all the soiled linen inside the bottom sheet and place directly into the laundry hamper. Do not place on floor or furniture. Do not hold soiled linens against your uniform.
8. If possible, shift mattress up to head of bed. If mattress is soiled, clean and dry according to facility policy before applying new sheets.
9. Remove your gloves, unless indicated for transmission precautions. Place the bottom sheet with its center fold in the center of the bed. Open the sheet and fan-fold to the center.
10. If using, place the drawsheet with its center fold in the center of the bed and positioned so it will be located under the patient’s midsection. Open the drawsheet and fan-fold to the center of the mattress. If a protective pad is used, place it over the drawsheet in the proper area and open to the centerfold. Not all agencies use drawsheets routinely. The nurse may decide to use one. In some institutions, the protective pad doubles as a drawsheet.
11. Pull the bottom sheet over the corners at the head and foot of the mattress. (See the Skill Variation in your skills book for using a flat bottom sheet instead of a fitted sheet.) Tuck the drawsheet securely under the mattress.
12. Move to the other side of the bed to secure bottom linens. Pull the bottom sheet tightly and secure over the corners at the head and foot of the mattress. Pull the drawsheet tightly and tuck it securely under the mattress.
13. Place the top sheet on the bed with its center fold in the center of the bed and with the hem even with the head of the mattress. Unfold the top sheet. Follow same procedure with top blanket or spread, placing the upper edge about 6 inches below the top of the sheet.
14. Tuck the top sheet and blanket under the foot of the bed on the near side. Miter the corners.
15. Fold the upper 6 inches of the top sheet down over the spread and make a cuff.
16. Move to the other side of the bed and follow the same procedure for securing top sheets under the foot of the bed and making a cuff.
17. Place the pillows on the bed. Open each pillowcase in the same manner as you opened other linens. Gather the pillowcase over one hand toward the closed end. Grasp the pillow with the hand inside the pillowcase. Keep a firm hold on the top of the pillow and pull the cover onto the pillow. Place the pillow at the head of the bed.
18. Fan-fold or pie-fold the top linens.
19. Secure the signal device on the bed, according to agency policy.
20. Raise side rail and lower bed.
21. Dispose of soiled linen according to agency policy.
22. Remove any other PPE, if used. Perform hand hygiene.
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