Changing Linens in an Occupied Bed


After a bath, clean linens are placed on the bed to promote comfort. If the client is able to get out of the bed, assist the client to a chair and proceed to make the bed. If the client is unable to get out of bed, the linens must be changed around the client. Assistance will be needed if the client is in traction or cannot be turned. Care must be taken to avoid disturbing the traction weights. If the client cannot be turned, change the linens from head to toe. Place a waterproof draw sheet on the beds of clients who are incontinent or have profuse drainage. The type and amount of linens placed on the bed will vary based on the type of bed the client is using. Air beds and Clinitron beds for example, use only minimal linens under the client.


Equipment Needed:

Linen hamper

Top sheet, draw sheet, bottom sheet



Bath blanket


Top and bottom sheets, draw sheet, and pillowcase are used to make the occupied bed. Gloves reduce the transmission of microorganisms.



1.     Explain

2.     Bring equipment to the bedside procedure to client.

3.     Remove top sheet and blanket. Loosen bottom sheet at foot and sides of bed. Lower side rail nearest the nurse, if necessary for access. Client may be covered with a bath blanket

4.     Position client on side, facing away from you. Reposition pillow under head.

5.     Fan-fold or roll bottom linens close to client toward the center of the bed.

6.     Smooth wrinkles out of mattress. Place clean bottom linens with the center fold nearest the client. Fan-fold or roll clean bottom linens nearest client and tuck under soiled linen.Maintain an adequate amount of sheet at head and foot of bed for tucking.

7.     Miter bottom sheet at head of bed, then at foot of bed.To miter, lift the mattress and tuck the sheet over the edge of the mattress, lift edge of sheet that is hanging to form a triangle, and lay upper part of sheet back onto bed; tuck the lower hanging section under the mattress. Repeat for each corner.Tuck the sides of the sheet under the mattress.

8.     Fold the draw sheet in half. Identify the center of the draw sheet and place it close to the client. Fan-fold or roll draw sheet closest to client and tuck under soiled linen. Smooth linen. Add protective padding if needed.Tuck draw sheet under mattress,working from the center to the edges (see Figure 4-2-6). Draw sheet should be positioned under the lower back and buttocks.

9.     Log roll client over onto side facing you. Raise side rail.

10.                       Move to other side of bed. Remove soiled linens by rolling into a bundle and place in linen hamper without touching uniform.

11.                       Unfold/unroll bottom sheet; then draw sheet. Look for objects left in the bed. Grasp each sheet with knuckles up and over the sheet and pull tightly while leaning back with your body weight. Client may be positioned supine.

12.                       Place top sheet over client with center of sheet in middle of bed. Unfold top of sheet over client. Remove bath blankets left on client to prevent exposure during bed making. Place top blanket over client, same as the top sheet

13.                       Raise foot of mattress and tuck the corner of the top sheet and blanket under.Miter the corner. Repeat with other side of mattress

14.                       Grasp top sheet and blanket over clients toes and pull upward, then make a small fan-fold in the sheet.

15.                       Remove soiled pillowcase.Grasp center of clean pillowcase and invert pillowcase over hand/ arm.Maintain grasp of pillowcase while grasping center of pillow.Use other hand to pull pillowcase down over pillow. Place pillow under clients head.While changing pillowcase, client can be instructed to rest head on bed, or place a blanket under clients head

  1. Document procedure used to change linens and clients condition during the procedure.
  2. Wash hands.