Bed making

Patients, clients and service users use beds in the care setting for a variety of purposes and for widely differing amounts of time. This includes people who may use a bed for a short while, e.g. in the clinic setting, assessment unit or day care setting through to individuals who may be bed bound in long-term care settings which might include hospitals or care homes. Some beds used are specialised in their purposes and may require different forms of bed linen, while for the majority of cases, a standard hospital style bed is used and will form the basis of this procedure.

The purpose of bed making in the care setting is to ensure the comfort and safety of the current, or future occupant, it requires understanding of the procedure and practical skills (Pellat, 2007).

While also being a housekeeping activity, undertaking bed making correctly is potentially an important part of the daily activity of the nurse because it requires:

• Consideration of infection control:
  • In disposing of used, potentially soiled, bed linen
  • Preventing the creation of airborne pathogens (Hansen et al., 2010)
  • Cleaning the bed and mattress
  • Patient hygiene
  • Staff hand hygiene

Bed making needs to be done  properly to avoid unnecessary complications:

• Pressure ulcers relating to creased linen
• Patient discomfort

Undertaken bed making correctly, be the bed empty or occupied, should be relatively simple to do and should expend minimal nursing effort. 

The equipment needed to undertake bed making will depend on the type of bed, whether the bed is occupied, whether the person in the bed requires personal care and the mobility of the patient and might include:

• Linen skip for used linen
• Water soluble laundry bag (for soiled linen)
• Fresh linen
  • Bed sheet(s)
  • Pillowcase(s)
  • Blanket(s) / duvet
• Personal protective equipment (PPE)
  • Apron
  • Gloves
• Another person to assist

The procedure will vary according to whether the bed is occupied or not. If the occupant of the bed can get out of bed, they should be encouraged and/or assisted to do so (Argenio-Haines et al, 2021). 

1. The nurse should gather the equipment they need to make the bed and ensure it is in easy reach, e.g. on a chair or the linen tray on the bed (if fitted)
2. The nurse should wash their hands as described by Public Health England (PHE, 2020a) or sanitise if their hands are already clean (PHE, 2020b)
3. The nurse should don PPE as required (PHE, 2020c)
4. Ensure that there is good working space around the bed
5. Remove any equipment not necessary for the bed making process
6. Prepare any items which need to be accounted for during the bed making process, e.g. IV fluids, catheter bags
7. Adjust the height of the bed so that it

Failing to keep bed linen clean and fresh may mean patients are at risk from infection, pressure sore development and being uncomfortable. Poor hygiene practices also place other patients at risk.

Nurses involved in making beds or overseeing the making of beds should ensure they are up to date with the processes and the local policies which guide them.

References

Argenio-Haines S, Aparecida de Rezende H, Llewelyn R.  Patient comfort and supporting personal hygiene in Lister S, Hofland J, Grafton H and Wilson C (eds.). The Royal Marsden Manual of Clinical Nursing Procedures (10th edn). Chichester: Wiley Blackwell; 2021 pp.403-453.

Hansen D, Krude J, Blahout B, et al. Bed-making in the hospital setting – Does it pose infectious risks? Healthcare Infection. 2010;15(3):85-87. https://doi.org/10.1071/HI10012.

Lawton S, Shepherd E. The underlying principles and procedure for bed bathing patients. Nursing Times [online]. 2019;115(5):45-47. https://www.nursingtimes.net/roles/hospital-nurses/the-underlying-principles-and-procedure-for-bed-bathing-patients-25-04-2019/ (Accessed 03 February 2022)

National Institute for Health and Care Excellence. Healthcare-associated infections: Scenario: Prevention and control of healthcare associated infections. 2019. https://cks.nice.org.uk/topics/healthcare-associated-infections/management/management/#hand-hygiene (Accessed 03 February 2022)

Pellatt GC. Clinical skills: bed making and patient positioning. Br J Nurs. 2007;16(5):302-5. https://doi.org/10.12968/bjon.2007.16.5.23010 

Public Health England. Best Practice: How to hand wash step by step images. 2020a. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886217/Best_practice_hand_wash.pdf (Accessed 03 February 2022)

Public Health England. Best Practice: How to handrub step by step images. 2020b.